Description

Method

Participants

This study will make use of existing data from the BePPS project (Burke et al., 2016). 431 health care professionals (90% women) originally participated in the BePPS project. Of the participants, 366 (85%) was Dutch-native. The age of the participants was between 18 and 60+ years. 50% of the participants were aged between 40 and 59 years. 125 of the participants (29%) were psychologists, 21%  (91) were pedagogues, 91 (21%) were pediatricians, 52 (12%) were social workers, 30 (7%) were school mentors, 17 (4%) were psychiatrists. The remaining 21(5%) were professionals who do not work in a health-care related setting, such as professors,and were therefore not included in the current study. The total number of participants in the current study is therefore 431, see Table 1 for a complete overview of participant characteristics.

Procedure

An advertisement was published in employee newsletters or on the work or society website of childhood and adolescent mental-health organisations, to request participants. The advertisement contained information about the aim of the study with a link to an online questionnaire. The aim of the study was clearly indicated as the role of mental-health professionals during the initial evaluation of children. The ethical committee of the Vrije Universiteit (VU) approved the study.  Before the start of the questionnaire, instructions were given and participants were informed that the vignettes may lack information to make a complete diagnosis, but that it is their first impression that was of interest in the study and the vignettes provide enough information to generate a first impression. The first questions of the questionnaire were about participants’ demographic background information and their type of job. In the pages that followed, ten vignettes were presented, two of each disorder, one vignette per page. With every vignette, an open question was given regarding recognition of the problem presented. Once the participant had answered the recognition question and proceeded to the next vignette, it was not possible to go back to change previous answers. At the end of the questionnaire, information about the experience of the mental-health professional was asked. The duration of the questionnaire was approximately thirty minutes. Participants were not rewarded for their participation.

Measures

Participants were asked to evaluate ten vignettes describing children with symptoms of the most common childhood mental-health problems. In each vignette the following variables were included and systematically manipulated:  Problem type (ADHD, ASD, GAD, CD and MDD), Number of symptoms (5 or 10), Ethnicity (Dutch, Moroccan, Turkish, UK and Indian), gender, age (child (3-11 years) and adolescent (12-17 years) and SES (low or high). Each of the ten vignettes were randomly presented within questionnaires and were counter-balanced across questionnaires. Finally, the questionnaires were randomly but equally distributed.

Mental-health problems. Each vignette contained a description of a child presenting mental-health symptoms of one of the five most common childhood mental disorders: ADHD, ASD, GAD, CD and MDD. To create the vignettes, relevant criteria were selected from the DSM-IV-TR (APA 2000).  Criteria for each of the mental-health problems were used to compose the vignettes with the appropriate symptoms. The DSM-IV was used to describe the symptoms of the five mental-health problems in the vignettes because that was in circulation at the time of the study.  Each problem described symptomology equally in order to provide an equal opportunity for the mental health professionals to recognise the mental-health problems. In each vignette demographic characteristics were manipulated (Age, ethnicity, socioeconomic status and gender of the child). Combination of the variables resulted in 400 vignettes; 10 vignettes were combined to create the survey. In this study only the variables ethnicity (Dutch, Moroccan and Turkish), type professional and recognition were used for analyses.