Performance of the parent emotional functioning (PREMO) screener in parents of children undergoing hematopoietic stem cell transplantation

Parents of children undergoing hematopoietic stem cell transplantation (HSCT) may face emotional distress while managing intense
treatments with uncertain outcomes. We evaluated a brief parental emotional functioning (PREMO) screener from a health-related
quality of life instrument to identify parental emotional distress, as measured by the Structured Clinical Interview for DSM-IV
Axis I Disorders (SCID).

As part of a longitudinal pediatric HSCT study, parents (N = 165) completed the Child Health Ratings Inventories, which contain the 7-item PREMO screener. Some parents (n = 117) also completed SCID modules for Anxiety, Mood, and Adjustment disorders at baseline and/or 12 months. A composite
outcome was created for threshold or subthreshold levels of any of these disorders. Receiver operating characteristic (ROC)
analysis assessed how the PREMO screener predicted emotional distress as measured by the SCID. A prediction model was then
built.

Fifty-two percent of parents completing the SCID had an Axis I disorder at baseline, while 41 % had an Axis I disorder at
12 months. The area under the ROC curve was 0.75 for the PREMO screener and 0.81 for the prediction model.

The PREMO screener may identify parents with, or at risk for, emotional distress and facilitate further evaluation and intervention.