Concurrent Validity of the Child Behavior Checklist DSM-Oriented Scales: Correspondence with DSM Diagnoses and Comparison to Syndrome Scales

This study used receiver operating characteristic (ROC) methodology and discriminative analyses to examine the correspondence of the Child Behavior Checklist (CBCL) rationally-derived DSM-oriented scales and empirically-derived syndrome scales with clinical diagnoses in a clinic-referred sample of children and adolescents (N = 476). Although results demonstrated that the CBCL Anxiety, Affective, Attention Deficit/Hyperactivity, Oppositional and Conduct Problems DSM-oriented scales corresponded significantly with related clinical diagnoses derived from parent-based structured interviews, these DSM-oriented scales did not evidence significantly greater correspondence with clinical diagnoses than the syndrome scales in all cases but one. The DSM-oriented Anxiety Problems scale was the only scale that evidenced significantly greater correspondence with diagnoses above its syndrome scale counterpart —the Anxious/Depressed scale. The recently developed and rationally-derived DSM-oriented scales thus generally do not add incremental clinical utility above that already afforded by the syndrome scales with respect to corresponding with diagnoses. Implications of these findings are discussed.     

Inter-Parent Agreement on the Syndrome Scales of the Child Behavior Checklist (CBCL): Correspondence and Discrepancies

Using multiple informants from a clinical setting, potential associations between inter-parental agreement and age, gender, and child diagnosis were explored in the current study. Archival data from psychological evaluations conducted on 174 children ages 5–18 through a hospital-affiliated outpatient psychology clinic were analyzed, focusing on mothers’ and fathers’ scores on the syndrome and index scales of the Child Behavior Checklist (CBCL). Although inter-parent correspondence levels on each of the subscales were found to be moderately high (averaging r = .50), significant discrepancies between the severity levels of parent reports were found on nine of 11 subscales, with mothers’ ratings consistently being slightly higher. Data from this clinical sample suggest that although single-informant ratings of child behavior may be generally representative of reports from both parents on many of the CBCL narrow-band scales, age, gender, and child diagnosis were related to several patterns of agreement on specific syndrome scales. Therefore, it is important to include fathers, because they provide a unique perspective on social problems, delinquency, and attention problems, in particular. Both correspondence and discrepancies between parent reports of specific child problems can provide valuable clinical information that is useful for child assessment and treatment.     

Eyberg Child Behavior Inventory (ECBI): Normative data,psychometric properties,and associations with socioeconomic status in Finnish children

Assessment of behavioral disorders is one of the most commonly encountered tasks in child psychiatry. The Eyberg Child Behavior Inventory (ECBI) is a widespread measurement tool used for assessing conduct problems, though the psychometric properties of the tool have varied in different samples. In this study, the ECBI was evaluated in a Finnish population based sample of children aged 4 to 12 years (n = 1,715). Factor structure and internal consistency of the ECBI and associates of behavioral problems in Finnish children were evaluated. The results showed that a unidimensional one‐factor solution for the ECBI intensity scale was the best fit for the data. The ECBI mean scores were considerably higher in our sample compared to other Nordic countries. Boys scored higher than girls on both ECBI scales, and the mean scores decreased with child's age. Socioeconomic status (SES) was weakly connected to the ECBI scores. Our results highlight the need for country specific reference norms in order to improve the clinical utility of evidence‐based measures for assessing conduct problems.     

A Psychometric Analysis of the Child Behavior Checklist DSM-Oriented Scales

The Child Behavior Checklist for Ages 6–18 (CBCL/6-18) possesses newly developed DSM-Oriented Scales, constructed through expert clinical judgment to match selected categories for behavioral/emotional problems as described in the DSM-IV. The present investigation examined the basic psychometric properties for all six DSM-Oriented Scales (i.e., Affective, Anxiety, Somatic, Attention-Deficit/Hyperactivity, Oppositional, and Conduct Scales) in a large clinical sample of children and adolescents (N = 673). Findings from the present study provide strong evidence for the reliability, as well as convergent and discriminative validity, of these scales. It appears that the DSM-Oriented Scales may provide accurate supplementary information that may be considered when formulating clinical diagnoses.

The reliability and validity of the Turkish version of the brief infant–toddler social emotional assessment (BITSEA)

In this study the reliability and validity of the Turkish version of the brief infant–toddler social emotional assessment (BITSEA) were investigated in a community sample. The sample consisted of 462 children (mean age: 24.60 ± 7.93 [12–42] months) who had applied to Turkish health centers for immunization. Both parents completed the BITSEA; mothers completed the child behavior checklist 2/3 (CBCL). Internal consistencies of the BITSEA–problem (P) and competence (C) scales were good to excellent (Cronbach's α = 0.82 and 0.72, respectively). Interrater reliability between parents and test–retest reliability were good. BITSEA/P scores were significantly correlated with CBCL internalizing, externalizing and total problem scores (p < 0.001). Maternal BITSEA/P cutpoint scores revealed that 30.6% of male toddlers and 28.6% of females were in the subclinical range and 13.1% of males and 17.6% of females were in clinical range. Results reveal that the Turkish version of BITSEA is a reliable, valid and simply applicable instrument for screening social, emotional and behavioral problems among toddlers. Clinical validation of the BITSEA/C and BITSEA/P is warranted.     

Narcissism, vanity, personality and mating effort

The current study examined the relationship between narcissism and vanity, and the degree these are predicted by the ‘Big Five’ personality traits and mating effort (ME) using a sample of 103 females recruited from a large beauty salon. Narcissism correlated with vanity at 0.72 (P < 0.001), and was associated positively with extraversion (E), ME and the subscales of vanity; narcissism was associated negatively with neuroticism (N) and agreeableness (A). Vanity correlated positively with E, conscientiousness, both subscales of narcissism, and ME, and negatively with N and A. A composite narcissism–vanity score was produced using principal components analysis, and used along with scores from the NEO-FFI-R to predict mating effort. The narcissism–vanity composite, low A and E significantly and independently predicted mating effort (adjusted R² = 0.28, F(9.96) = 7.74, P < 0.001). These results show that mating effort is additionally predicted by narcissism as well as self-reported personality.     

Factor structure and aetiological architecture of the BRIEF: A twin study

Executive function is a broad construct that encompasses various processes involved in goal‐directed behaviour in non‐routine situations (Banich, 2009). The present study uses a sample of 560 5‐ to 16‐year‐old twin pairs (M = 11.14, SD = 2.53): 219 monozygotic twin pairs (114 female; 105 male) and 341 dizygotic twin pairs (136 female, 107 male; 98 opposite sex) to extend prior literature by providing information about the factor structure and the genetic and environmental architecture of the Behavior Rating Inventory of Executive Function (BRIEF; Gioia et al., 2000, Child Neuropsychol., 6, 235; Gioia et al., 2000, Behavior rating inventory of executive function, Lutz, FL: Psychological Assessment Resources), a multifaceted rating scale of everyday executive functions. Phenotypic results revealed a 9‐scale, 3‐factor model best represents the BRIEF structure within the current sample. Results of the genetically sensitive analyses indicated the presence of rater bias/contrast effects for the Initiate, Working Memory, and Task‐Monitor scales. Additive genetic and non‐shared environmental influences were present for the Initiate, Plan/Organize, Organization of Materials, Shift, and Monitor and Self‐Monitor scales. Influences on Emotional Control were solely environmental. Interestingly, the aetiological architecture observed was similar to that of performance‐based measures of executive function. This observed similarity provided additional evidence for the usefulness of the BRIEF as a measure of ‘everyday’ executive function.     

The impact of conventional versus robust norming on cognitive characterization and clinical classification of MCI and dementia

We examined the impact of conventional versus robust normative approaches on cognitive characterization and clinical classification of MCI versus dementia. The sample included participants from the National Alzheimer's Coordinating Center Uniform Data Set. Separate demographically adjusted z-scores for cognitive tests were derived from conventional (n = 4273) and robust (n = 602) normative groups. To assess the impact of deriving scores from a conventional versus robust normative group on cognitive characterization, we examined likelihood of having a low score on each neuropsychological test. Next, we created receiver operating characteristic (ROC) curves for the ability of normed scores derived from each normative group to differentiate between MCI (n = 3570) and dementia (n = 1564). We examined the impact of choice of normative group on classification accuracy by comparing sensitivity and specificity values and areas under the curves (AUC). Compared with using a conventional normative group, using a robust normative group resulted in a higher likelihood of low cognitive scores for individuals classified with MCI and dementia. Comparison of the classification accuracy for distinguishing MCI from dementia did not suggest a statistically significant advantage for either normative approach (Z = −0.29, p = .77; AUC = 0.86 for conventional and AUC = 0.86 for robust). In summary, these results indicate that using a robust normative group increases the likelihood of characterizing cognitive performance as low. However, there is not a clear advantage of using a robust over a conventional normative group when differentiating between MCI and dementia.     

The Family Alliance Assessment Scales: Steps Toward Validity and Reliability of an Observational Assessment Tool for Early Family Interactions

We present the first steps in the validation of an observational tool for father-mother-infant interactions: the FAAS (Family Alliance Assessment Scales). Family-level variables are acknowledged as unique contributors to the understanding of the socio-affective development of the child, yet producing reliable assessments of family-level interactions poses a methodological challenge. There is, therefore, a clear need for a validated and clinically relevant tool. This validation study has been carried out on three samples: one non-referred sample, of families taking part in a study on the transition to parenthood (normative sample; n = 30), one referred for medically assisted procreation (infertility sample; n = 30) and one referred for a psychiatric condition in one parent (clinical sample; n = 15). Results show that the FAAS scales have (1) good inter-rater reliability and (2) good validity, as assessed through known-group validity by comparing the three samples and through concurrent validity by checking family interactions against parents’ self-reported marital satisfaction.     

Contributions of Observed Parent Socialization of Coping and Skin Conductance Level Reactivity to Childhood Adjustment

This research examined the longitudinal association between parent socialization of coping and child adjustment, as well as the moderating role of children's skin conductance level reactivity (SCLR). Participants were a community sample of children (n = 64, M age = 9.02, 54.5% females, 93.2% Caucasian) and their parent(s). Parent coping suggestions were observed while their child engaged in a stressful challenge task, during which the child's SCLR, a measure of children's physiological reactivity to stress, was also measured. Parent(s) completed the Child Behavior Checklist (Achenbach & Rescorla, 2001) at baseline and a 6‐month follow‐up to assess internalizing and externalizing problems. Results revealed that secondary control engagement suggestions predicted fewer internalizing problems over time. In addition, disengagement suggestions predicted fewer externalizing problems over time among children with high SCLR. This study provides evidence that parent coping suggestions serve as a resource that protects youth from developing adjustment problems.     

Clarifying the role of impulsivity in dietary restraint: A structural equation modeling approach

This study was designed to clarify the relationship between the four dimensions of impulsivity in Whiteside and Lynam’s (2001) model and the two aspects of dietary restraint (Concern for Dieting and Weight Fluctuation) in a non-clinical sample. Data were collected from a volunteer community sample (N = 216) of women who responded to two self-report instruments related to impulsivity (UPPS Impulsive Behavior Scale, Whiteside & Lynam, 2001) and dietary restraint (Restraint Scale, Polivy, Herman, & Warsh, 1978). A structural equation model was tested. The model provided a good fit to the data (χ²/df = 1.64, p < .0001, RMSEA = 0.054, 90% CI = 0.050–0.058, p-value for test of close fit (RMSEA > 0.05) = .035) and revealed that Concern for Dieting was positively related to Urgency (standardized β = 0.25, p < .01). Weight Fluctuation was related to lack of Perseverance (standardized β = 0.25, p < .01) and tended to relate to Sensation Seeking (standardized β = 0.17, p = .056). Urgency and lack of Perseverance were found to play a significant role in predicting Concern for Dieting and Weight Fluctuation.     

The equivalence of the Child Behavior Checklist/1 1/2-5 across parent race/ethnicity, income level, and language

This study examined the equivalence of the Child Behavior Checklist/1 1/2-5 (CBCL/1 1/2-5) in 682 parents of 2- to 4-year-old children stratified by parent race/ethnicity (African American, Latino, and non-Latino White), family income (low vs. middle-upper), and language version (Spanish vs. English). Externalizing Scale means differed by income and child gender. Internalizing Scale means differed by income and parent race/ethnicity. Differential item analyses showed that few items functioned differently by racial/ethnic, language, and income group. A confirmatory factor analysis demonstrated that the Externalizing Scale provided a good fit with the data across racial/ethnic and income groups. However, model fit was improved for the Internalizing Scale when factor weights were allowed to vary. Findings support the equivalence of the CBCL/1 1/2-5 when used with parents of low-income preschool children from African American and Latino backgrounds, although further study of the factor structure for the Internalizing Scale is recommended.     

The Dimensional Nature of Externalizing Behaviors in Adolescence: Evidence from a Direct Comparison of Categorical,Dimensional, and Hybrid Models

Researchers have recognized the importance of developing an accurate classification system for externalizing disorders, though much of this work has been framed by a priori preferences for categorical vs. dimensional constructs. Newer statistical technologies now allow categorical and dimensional models of psychopathology to be compared empirically. In this study, we directly compared the fit of categorical and dimensional models of externalizing behaviors in a large and representative community sample of adolescents at two time points separated by nearly 2.5 years (N = 2027; mean age at Time 1 = 11.09 years; 50.8% female). Delinquent and aggressive behaviors were assessed with child and parent Child Behavior Checklist reports. Latent trait, latent class, and factor mixture models were fit to the data, and at both time points, the latent trait model provided the best fit to the data. The item parameters were inspected and interpreted, and it was determined that the items were differentially sensitive across all regions of the dimension. We conclude that classification models can be based on empirical evidence rather than a priori preferences, and while current classification systems conceptualize externalizing problems in terms of discrete groups, they can be better conceptualized as dimensions.     

Concurrent Validation of the Treatment Outcome Package (TOP) for Children and Adolescents

The Treatment Outcome Package for children and adolescents (TOP) is a behavioral health and well-being assessment used widely in clinical and child welfare populations. The primary purpose of this study was to examine the concurrent validity of the Child and Adolescent versions of the TOP with the Child Behavior Checklist (CBCL) and the Strengths and Difficulties Questionnaire (SDQ) with a community sample. Children and adolescents (N = 203) 3–18 years of age from a community sample completed the CBCL, the SDQ, and the TOP. Significant correlations emerged between the TOP and theoretically similar scales on the SDQ and the CBCL. Analyses demonstrated that the TOP has excellent concurrent validity on most subscales with both the CBCL and the SDQ. These results provide additional evidence for the TOP’s utility and validity as a measure of psychological well-being and functioning.     

A meta-analytic approach to the association between inhibitory control and parent-reported behavioral adjustment in typically-developing children: Differentiating externalizing and internalizing behavior problems

Impairments in inhibitory control (IC) are traditionally seen as a vital aspect in the emergence and course of maladaptive behavior across early childhood. However, it is currently unclear whether this view applies to both the externalizing and internalizing domain of parent-reported behavioral adjustment. Furthermore, past (meta-analytic) developmental research and theory characterizing this association have largely neglected the vast heterogeneity of IC measures and conceptualizations. The present meta-analyses examined the association of IC with parent-reported externalizing (N = 3160, 21 studies) and internalizing (N = 1758, 12 studies) behavior problems, assessed with the Child Behavior Checklist (CBCL), in non-clinical populations of children aged 2–8 years. They further investigated the moderating effects of a priori IC categorization, according to a recently proposed two-factor model of IC (“Strength/Endurance” account, Simpson & Carroll, 2019). In line with previous research in the clinical domain, the current results corroborate the notion of a robust, but small association between IC and externalizing behavior problems (r = ?0.11) in early childhood. However, although frequently proposed in the literature, no significant linear association could be identified with internalizing behavior problems. Furthermore, in both meta-analyses, no significant moderating effects of IC categorization could be revealed. These findings enhance our knowledge about the cognitive underpinnings of early-emerging maladaptive behavior, indicating that different subtypes of IC are statistically related with externalizing, but not internalizing behavior problems. Overall, the small association of IC ability with behavior problems in non-clinical populations provokes broader questions about the role of IC in behavioral adjustment.     

International comparison of Cloninger’s temperament dimensions

Cloninger’s Tridimensional Personality Questionnaire (TPQ) and Temperament and Character Inventory (TCI) have been developed to measure the following temperament dimensions: novelty seeking (NS), harm avoidance (HA), reward dependence (RD) and persistence (P). We used our previous Finnish normative study of the TPQ and TCI (Miettunen et al., 2004) to estimate correction coefficients to convert TPQ scales to comparable TCI scales. Our aim was to compare these corrected temperament dimension scores across 20 countries adjusting for study sample differences in age and gender. In all, some variations were found in these temperament scores between countries. Differences were especially apparent between the Asian and the Western countries. By far the lowest mean score of the RD was in Japan (11.2 vs. 15.4 for other countries; effect size Cohen’s d = −5.74; z-test p < 0.001) and the highest mean score in P was in USA (5.5 vs. 4.4; d = 4.24, p = 0.001). Some of the findings could be explained by sample differences (e.g. age and education); while some may reflect real differences in the ways which personality is related to cultural factors, such as individualism/collectivism. These differences should be considered when interpreting studies with data on TPQ/TCI from different countries.     

The normative development of child and adolescent problem behavior

The aim of this study was to identify normative developmental trajectories of parent-reported problems assessed with the Child Behavior Checklist (CBCL; T. M. Achenbach, 1991) in a representative sample of 2,076 children aged 4 to 18 years from the general population. The trajectories were determined by multilevel growth curve analyses on the CBCL syndromes in a Longitudinal multiple birth-cohort sample that was assessed 5 times with 2-year intervals. Most syndromes showed a linear increase or decrease with age or a curvilinear trajectory, except for thought problems. Trajectories for most syndromes differed for boys versus girls, except those for withdrawn, social problems, and thought problems. These normative developmental trajectories provide information against which developmental deviance in childhood and adolescence can be detected.