Inconsistencies in psychosocial assessment of children after severe burns.

Health care providers usually except children with severe burns to have psychosocial problems due to the severity of the injuries and resulting deformities. To test the validity of that expectation, 72 children (43 boys, 29 girls) who had suffered severe burns were assessed at least 1 year after burn injury for behavior problems and competence, by use of the 1991 Achenbach questionnaires: Child Behavior Checklist (CBCL), Youth Self-Report, and Teacher Report Form. The scores on each questionnaire then were compared by use of paired t tests. Also, the scores of the patient population were compared with those of the nonreferred reference populations provided by Achenbach. Compared with the Teacher Report Form and Youth Self-Report, the CBCL revealed a statistically significant (p < 0.05) greater number of behavior problems and lower level of competence for all age groups and both sexes. Item analysis revealed in most instances excess endorsement of specific items on all scales for the patient population compared with their respective reference populations, but more items were endorsed on the CBCL. These results could be explained by increased parental sensitivity to problem behavior or decreased competence of their children after severe burns. Further studies are needed to understand the discrepancies between the CBCL and the other scales.