Copyright © 1995, 1988 by Richard A. Warshak, Ph.D. All Rights Reserved.
No part of this publication may be reproduced or distributed in any form or by any means without the prior written permission of the author. Available from Clinical Psychology Associates, 16970 Dallas Parkway, Suite 202, Dallas, Texas 75248-1928, (972) 248-7700.
The Warshak Parent Questionnaire, Second Edition (WPQ-2; formerly the WICAA-2) was developed to assist clinicians in evaluating the emotional, behavioral, and learning disorders of children and adolescents. It consists of questions, checklists, and rating scales that yield a wealth of demographic, historical, and descriptive information. The WPQ-2 is useful in determining the type, severity, and etiology of disorders, in making differential diagnoses, and in assessing ego strengths.
The WPQ-2 elicits:
This information would take several hours to obtain through interviews, yet it takes only a few minutes of professional time to read and digest the completed Parent Response Booklet.
The WPQ-2 was created to serve three major purposes.
1. The WPQ-2 provides an organized and structured format for obtaining parents' perceptions of their child's problem behaviors.
For many of the most prevalent childhood disorders (e.g., Oppositional Defiant, Attention-deficit Hyperactivity, Separation Anxiety) the diagnostically significant behaviors occur primarily in natural settings such as home or school. Such behaviors are not always visible in the office or clinic, particularly during initial contacts. And children are often unable or unwilling to report these behaviors accurately. For these reasons, parents' and teachers' observations of children's behavior are usually essential for the detection and diagnosis of childhood disorders.
The WPQ-2 represents one means of fulfilling this need. Compared to clinical interviews, the WPQ-2 is more thorough and certainly more economical in terms of professional time. A valued feature of the WPQ-2 is the correspondence between inventory items and the DSM-IV diagnostic criteria for the most prevalent childhood disorders. For each such item, the appropriate DSM-IV diagnosis is coded in the left margin.
2. The WPQ-2 provides ratings of the frequency and severity of the child's problem behavior compared with peers.
This is important because many childhood disorders are characterized by attributes and behaviors that occur, to a lesser extent, in most children. For example, most children argue with adults: In considering the diagnosis of Oppositional Defiant Disorder, one needs to know if the child argues more frequently than most children of the same mental age.
3. The WPQ-2 provides information useful in determining the etiology of the child's problems.
Because the identical symptom in two children may signal two very different disorders, one needs a tentative formulation of the origin and evolution of the problems. Treatment recommendations rely heavily on this formulation. For example, depending on other factors and the examiner's theoretical orientations, a child's negative mood can be viewed as a stable temperamental trait, an acute reaction to situational stress, a sequela of learning disabilities, or a symptom of depression. Each explanation of the child's negative mood will suggest different treatment approaches.
By providing information that bears on the full range of possibilities,
the WPQ-2 helps to pinpoint areas of greatest concern that require
in-depth investigation. The WPQ-2 thus serves as a natural springboard
for diagnostic interviews. Also, it contributes to decisions regarding the
need for psychological and neuropsychological testing and consultation by
allied health professionals such as educational consultants.
The WPQ-2 has several benefits in addition to the three purposes discussed above.
1.The WPQ-2 facilitates report writing by providing, in an organized format, demographic data, presenting problems, history, and description of current functioning.
2.The WPQ-2 helps parents clarify and organize their perceptions of their child, thus better preparing them for the initial consultation. Many parents have remarked that the WPQ-2 helped them think in a different way about their child's behavior and reinforced their decision to pursue the consultation.
3. In responding to the questions concerning their child's earlier development, parents can consult written records (such as baby books) and relatives or other caregivers to aid recall of developmental facts. During an interview these sources typically are not available, thus often compromising the accuracy of the information obtained. Although parents' distortions of their child's development are clinically relevant, the clinician also requires accurate facts in order to identify developmental delays and detours.
4. The WPQ-2 helps create a positive first impression with parents, who are reassured that the clinician is concerned with obtaining a comprehensive view of their child's assets and liabilities.
5. The WPQ-2 is a permanent record that documents the thoroughness of an evaluation (e.g., for legal purposes or reviews by third party payers). This type of documentation has become increasingly necessary because of the proliferation of litigation.
6. The WPQ-2 is a means of obtaining detailed information from parents in situations where one may want to limit direct contact. In evaluating suspicious or highly resistant adolescents, for example, too much contact with parents in the initial phases of the evaluation, can increase the adolescent's worry that the therapist is acting merely as an agent of the parents. This can interfere with the establishment of a good working alliance. Yet the clinician may require developmental data that are best supplied by parents, in order to determine the nature of the adolescent's problems and the appropriate approaches to treatment. The WPQ-2 alleviates this dilemma by providing an alternative avenue for parental input.
7. The statement of the main problems on the WPQ-2 face sheet spares the clinician the necessity of searching through notes from the initial interviews in order to review the chief concerns of the parents. This convenient reminder of the main problems is especially welcome during conferences with parents regarding evaluation results and treatment progress.
The WPQ-2 has several features, not found in other instruments, that increase its utility in clinical situations.
1. In designing the WPQ-2, items were selected that reflect DSM-IV criteria for prevalent child and adolescent diagnoses. These include, but are not limited to, Attention-deficit Hyperactivity Disorder, Conduct Disorder, Dysthymic Disorder, Generalized Anxiety Disorder, Oppositional Defiant Disorder, and Separation Anxiety Disorder. Diagnostic codes and the number of symptoms necessary to meet the criteria appear in the shaded column next to the corresponding WPQ-2 items. This facilitates the process of differential diagnosis.
2. The WPQ-2 is compatible with various theoretical conceptualizations of childhood disorders.
Developmental and psychoanalytic perspectives are represented through detailed inquiry regarding complications during pregnancy, delivery, and neonatal period, parental approaches to feeding and toilet training, transitional objects, ages when developmental milestones were reached, age of onset for each symptom of psychological disorder, history of stressful life events, and ego and superego development (pages 3-6, 8-9, and 11-16).
An information processing approach to understanding child development guided the development of the Skills and Abilities checklist (page 10) which contributes information bearing on the presence or absence of learning disabilities.
Perspectives on biochemical and genetic contributions to psychological problems as well as environmental influences on psychopathology are reflected in the detailed Family History (page 8).
Attributes of temperament, regarded by some as enduring features of personality structure, are assessed throughout the WPQ-2 (pages 4-6, 9, and 11-16).
3. The WPQ-2 avoids the limitations of existing questionnaires by combining the best features of each. Some questionnaires use only open-ended statements to elicit information. Examples of such statements are, "Describe your child's school adjustment. Describe any health problems your child has had. What was mother's physical condition during the pregnancy?" Other questionnaires list all relevant problems and instruct parents to check the items that apply to their child.
Each approach has advantages and disadvantages. The first approach provides valuable descriptive information, but may result in important areas not receiving adequate attention. Often, facts that are of great interest to the clinician are not spontaneously reported by parents. In some cases parents do not appreciate the value of their knowledge and thus neglect to mention important facts. In other cases they may not recall facts.
The second approach is less likely to be affected by memory lapses and defensive operations (often it is easier to neglect to mention a fact than to explicitly deny it). However, the checklist approach restricts parents to "yes" and "no" answers that provide no room for elaboration.
On the WPQ-2, parents are instructed to respond to checklists and rating scales, but they are also invited to provide pertinent explanatory information in the spaces provided. This strategy has proved to be much more useful to clinicians than the other approaches. Also, parents find it easier and more gratifying to complete. It places less of a burden on parents to formulate narrative answers to questions, yet it allows them an opportunity to amplify and clarify their responses. This helps avoid the frustration inherent in many questionnaires in which respondents feel forced to choose between a few alternatives, neither of which accurately captures their personal situation.
4. A significant limitation of existing questionnaires is that they are to be completed by one parent only. The WPQ-2 was designed to elicit and easily contrast the perceptions of mothers with the perceptions of fathers. This provides, in effect, a built-in test of rater reliability. Also, it alerts the clinician to discrepancies between the parents in how they view their child. These discrepancies often reflect family system variables (such as a weak parental coalition) that warrant further investigation.
5. The WPQ-2 includes a full-page rating scale of positive personality attributes. This provides a necessary balance to the usual focus on pathology, helps the clinician discover assets that may facilitate the treatment, and reassures parents that the clinician is interested in obtaining a complete picture of their child's psychological functioning.
6. In obtaining family demographic information and family history, the WPQ-2 provides a format that is well-suited to nontraditional family structures that are becoming more prevalent in our society, such as divorced and remarried families. In addition to providing necessary information in a convenient format, this feature has the fringe benefit of suggesting to parents that the clinician is prepared to deal with the complexities of their family.