Poster #60 - Measuring Attachment disorders in school-aged children: Validation of the ETRAD-Q (Early TRAuma-related Disorders Questionnaire)

• In Event: 3-003 - Poster Session 09
  In Poster Session: PS 09 Section - Developmental Psychopathology

Integrative Statement

Introduction: Attachment Disorders (AD), namely Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED), are psychiatric disorders that children may develop as a result of severe early adversity (e.g., maltreatment, institutionalization, repeated change of caregivers). Although measures of AD are currently available, they present several weaknesses: most focus only on DSED, none has been through a complete validation process and none are based on the new diagnostic criteria of DSM-5 (APA, 2013). Consequently, we developed the ETRAD-Q (Early TRAuma-related Disorders Questionnaire; Monette, 2016), a new questionnaire measuring both RAD and DSED symptoms and based on the updated DSM-5 criteria. The objective of this study is to present the ETRAD-Q and data supporting its reliability and validity.

Method. The sample consists of 834 school-aged children (6-12 years old), which was divided in four groups: 1. Children from the general population enrolled in regular schools (n = 597); 2. Adopted children (n=101), 3. Children in foster care (n=80), and Children in residential treatment care (RTC, n=56).

Measures. Primary caregivers completed the following questionnaires: 1. Sociodemographic questionnaire; 2. ETRAD-Q (42 items); and 3. RPQ (Relationship problem questionnaire, Minnis et al., 2002), a screening questionnaire to assess RAD (6 items) and DSED (4 items), based on DSM-IV and ICD-10 criteria. Primary caregivers were also questioned using the RADA interview (Minnis, 2017), a recently updated semi-structured interview assessing RAD (11 items) and DSED (9 items) based on the DSM-5 criteria.

Results and conclusion: Confirmatory factor analysis (see Figure 1 and Table 1) on items of the ETRAD-Q indicates that the best fitting model includes two second-order factors: 1) a RAD scale (with 3 subscales: Low selective attachment, Low social and emotional responsiveness, Emotional unpredictability) and a DSED scale (with 2 subscales: Interaction with unfamiliar adults, Social disinhibition). Fit indices indicate an acceptable fit of the model (X2 = 2674.62, df = 765, CMIN/df = 3.49, RMR = .04, RMSEA = .054, CFI = .913). The RAD and DSED scales are moderately correlated (r = .58). Because the item measuring DSED criterion A3 saturated the RAD factor, instead of the DSED factor, it was removed. Other researchers have obtained similar results (Dobrova-Krol et al., 2010, Pears et al., 2010), which calls into question the relevance of the DSED criterion A3.
The ETRAD-Q RAD scale (sum of 25 items) correlates in the expected direction with the RPQ RAD scale (r = 0.82) and the RADA interview RAD scale (r = 0.72). The ETRAD-Q DSED scale (sum of 16 items) correlates in the expected direction with the RPQ DSED scale (r = 0.89) and the RADA interview DSED scale (r = 0.76). Internal consistency of both RAD and DSED ETRAD-Q scales are very high (Cronbach alpha: 0.94 et 0.95, respectively). Test-retest correlations are also very high (r = .91) for both scales. Finally, at-risk groups (adopted, foster care, RTC children) all showed higher scores on ETRAD-Q scales, compared to children from the general population. These results indicate that the ETRAD-Q has excellent psychometric properties.

Authors

• Sebastien Monette, UQAM
  Presenting Author

• Chantal Cyr, University of Quebec at Montreal
  Non-Presenting Author

• Maude Archambault, Université du Québec à Montréal
  Non-Presenting Author

• Miguel T. Terradas, Université de Sherbrooke
  Non-Presenting Author

• Sophie Couture, Université de Montréal
  Non-Presenting Author