Parent–Child Relational Problem: Field Trial Results, Changes in DSM‐5, and Proposed Changes for ICD‐11

• Author: Diana Clarke,Anthony Cordaro,Marianne Wamboldt
• Date: 01 March 2015
• DOI: http://doi.org/10.1111/famp.12123
• Published date: 01 March 2015

Parent–Child Relational Problem: Field Trial Results,

Changes in DSM-5, and Proposed Changes for

ICD-11

MARIANNE WAMBOLDT*

ANTHONY CORDARO JR*

DIANA CLARKE*

Caregiving relationships are significant factors in the development, mediation, or

moderation of childhood mental health problems. However, epidemiological and clin ical

research has been limited by lack of reliable, succinct, and standardized methods of assess-

ing parent–child relationship constructs. The Relational Processes Workgroup (ad hoc to

the DSM-5 process) proposed more specific criteria to define a parent–child relational prob-

lem (PCRP). These criteria were field tested in one of the DSM-5 Field trial sites, utilizing

a similar research design as DSM-5. Participants included 133 symptomatic children

(5–17 years) in active treatment for a mental health problem and their primary caregiver

(86% mothers). Two separate clinicians, each blinded to the assessment of the other clini-

cian as well as the DSM-5 diagnoses, interviewed the dyads within a 2-week period, utiliz-

ing the proposed PCRP criteria. Prior to each interview, parents were asked to write about

their relationship with their child, and children (over the age of 10 years) filled out the

Parental Bonding Instrument, Brief Current, and the Perceived Criticism Measure. Clini-

cians were able to read the narratives and see results of the child report measures befor e

assessing the dyad. The weighted prevalence of a PCRP in this sample was 34%. The inter-

class kappa for overall agreement between clinicians was 0.58 (0.40, 0.72), which indicates

good interrater reliability. Further, clinicians found the PCRP diagnostic criteria clini-

cally useful and an improvement over the brief description of PCRP that was presented in

DSM-IV. Relationships between children and their primary caregiver can be assessed in a

reliable manner, based on clinical interview with the child–caregiver dyad and several

self-report measures.

Keywords: Parent–Child Relationship; Problem; Field Trial; DSM-5; ICD-11

Fam Proc 54:33–47, 2015

NEED FOR RELIABLE ASSESSMENT OF PARENT–CHILD RELATIONSHIPS

Caregiving relationships are a significant environmental factor in the development,

mediation, and/or moderation of children’s mental health problems (Beach, Wam-

boldt, Kaslow, Heyman, First, et al., 2006). With new technologies and methodologies to

assess and control for genetic effects, diverse fields of research have demonstrated how

the parent–child relationship is particularly salient. For example, Meaney and colleagues

*Psychiatry, Children’s Hospital Colorado, Aurora, CO.

Correspondence concerning this article should be addressed to Marianne Wamboldt, Psychiatry, Chil-

dren’s Hospital Colorado, 13123 East 16th Ave B130, Aurora, CO 80045. E-mail: marianne.wamboldt@

childrenscolorado.org.

33

Family Process, Vol. 54, No. 1, 2015 ©2015 Family Process Institute

doi: 10.1111/famp.12123