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.

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.     

Dimensionality and psychometric invariance of the Youth Self-Report Form of the Child Behavior Checklist in cross-national settings

The Youth Self-Report Form's (YSR's) factor model was derived from traditional exploratory factor analytical procedures. Assuming appropriate model specification, psychometrically invariant items, and that its items provide useful psychometric information across nations omitted from its normative samples, the YSR is widely used in cross-national studies of nonreferred children. Item response theory analytical procedures reveal (a) 2 dimensions partly overlapping with the YSR's Internalizing and Externalizing second-order factors; (b) variance (i.e., differential item functioning) in how well a few items discriminate for nonreferred children across two nations; and (c) variance in estimating severity levels in children with identical psychopathological severity cross-nationally. Addressing psychometric variance, limiting redundancy, and matching children's psychopathological severity levels with items measuring this severity might promote more accurate and economical assessment.     

Assessing ADHD and comorbid disorders in children: the Child Behavior Checklist and the Devereux Scales of Mental Disorders

Evaluated discriminant validity and clinical utility of selected subscales of the Devereux Scales of Mental Disorders (DSMD; Naglieri, LeBuffe, & Pfeiffer, 1994) and the Child Behavior Checklist (CBCL; Achenbach, 1991a) in 228 children referred to a clinic for the evaluation and treatment of attention deficit hyperactivity disorder (ADHD). The DSMD is a multiaxial behavior rating scale that measures symptomatology for a broad range of child psychopathology as described in the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-R-III] and 4th ed. [DSM-IV]; American Psychiatric Association, 1987, 1994). Discriminant function analyses as well as sensitivity, specificity, and predictive power analyses were computed to evaluate the discriminant validity and clinical utility of selected DSMD and CBCL subscales for assessing ADHD, oppositional defiant disorder (ODD), and anxiety disorders. Results indicated that the DSMD compared very favorably with the CBCL in the ability to discriminate between children with ADHD and those without ADHD and between children with comorbid ODD and anxiety disorders and children who did not meet criteria for these disorders. The DSMD Attention subscale may be somewhat better at ruling in ADHD combined subtype (ADHD-C) and ADHD inattentive subtype (ADHD-I) than the CBCL Attention Problems subscale, but the CBCL Attention Problems subscale may have slightly better utility than the DSMD Attention subscale in ruling out these subtypes. Both the CBCL and DSMD were more useful for ruling out than for ruling in ODD and anxiety disorders.     

The internal consistency and concurrent validity of a Spanish translation of the Child Behavior Checklist

The Child Behavior Checklist's applicability to a Hispanic sample was assessed by an examination of the instrument's internal consistency and concurrent validity. The CBCL and TRF were administered to a community sample representative of children of Puerto Rico aged 4 to 16. Cronbach's alpha was used to assess the internal consistency of empirically derived scales. The relation of CBCL and TRF scores to clinical diagnosis, adaptive functioning, and need for services served as indicators of the concurrent validity of the instrument's Spanish version. The results indicate that the total behavior problem scores on the instruments are good continuous measures of maladjustment for children in Puerto Rico. A child with high values on the scales has a high probability of being classified as a case by a psychiatrist. High levels of internal consistency were found in most subscales. Only scales comprising low prevalence problems showed poor internal consistency.     

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.     

Assessing differences in chemically dependent adolescent males using the Child Behavior Checklist

A study was conducted with 59 chemically dependent (CD) male adolescents (ages 13 to 16) using the Child Behavior Checklist (CBC). The CD sample was compared to a normative group on four adaptive behavior scales and twelve behavior problem scales, and was found to be significantly different on all measures. The CD sample was also compared to a general clinical group on nine behavior problem scales, and was found to score significantly higher on scales measuring delinquent and uncommunicative behaviors, and significantly lower on scales measuring immature and hostile-withdrawn behaviors. Summary profile types were compared with the clinical population and a separate assaultive/aggressive population. More of the CD population fit an uncommunicative/delinquent profile type and relatively fewer fit schizoid and immature/aggressive profile types as compared to the two other groups. The CBC differentiated subgroups in the CD sample with respect to completion of treatment and type of drug used, but not motivation for treatment at admission.     

The Ohio Scales Youth Form: Expansion and Validation of a Self-Report Outcome Measure for Young Children

We examined the validity and reliability of a self-report outcome measure for children between the ages of 8 and 11. The Ohio Scales Problem Severity scale is a brief, practical outcome measure available in three parallel forms: Parent, Youth, and Agency Worker. The Youth Self-Report form is currently validated for children ages 12 and older. The Ohio Scales Problem Severity scale was administered to a clinical and comparison sample of children, ages 8–11, then readministered 1 week later to a subsample of children in order to examine test-retest reliability. The Ohio Scales demonstrated acceptable internal consistency and reliability. The Ohio Scales was significantly correlated with the Behavior Assessment System for Children (BASC) across both samples, providing evidence for concurrent validity. Children of the clinical sample reporting higher scores (i.e., more symptomatic) than the children of the comparison sample on the Ohio Scales, thereby demonstrating construct validity.     

Risk factors and the Child Behavior Checklist in a child mental health center setting

The relationship between risk factors and the severity and type of childhood disorder, as measured by parent-completed Child Behavior Checklists, was examined for 768 children, ages 4–16, seen at a child mental health center. Regression analyses revealed no significant relationships between any combination of risk factors and the total number of behavior problems, internalizing, or externalizing scores for the entire group, males and females separately, or for the age and sex groupings of 6- to 11- and 12-to 16-yearolds. Chi-square tests revealed no relationship of profile type with any risk factor or with total number of risk factors. Implications for broad-based child assessment and risk factor research within a clinical population are discussed.We wish to thank Orin Bolstad, Linda Magnuson, and Julian Taplin for their assistance in this project.     

Using Multiple Informants to Assess Child Maltreatment: Concordance between Case File and Youth Self-Report

To understand the psychosocial implications of child maltreatment, methods used to document prevalence must be clear. Yet, rates of maltreatment found in child self-report are generally inconsistent with data found in case files from state social service agencies. Although it is known that self-reports and case file reports of abuse disagree on occurrence of specific events, it is unclear if reporters agree when overall categories of abuse are considered. This study investigated differences between case file and youth report of abuse by examining four types of abuse—physical, sexual, neglect, and psychological—in a within-subjects design using a sample of 97 youth in foster care aged 8 to 22. Case files were coded for the presence of any indication of each type of abuse. Self-report of abuse was also assessed for any indication of each type of abuse. Results indicated that, overall, youth reported more physical and psychological abuse, and younger youth reported more sexual abuse than documented in their file. Implications for research and service provision for maltreated youth are discussed.     

Measurement Equivalence of the Child Behavior Checklist among Parents of African American Adolescents

The Child Behavior Checklist (CBCL/6-18) is a widely used parent-report measure of youth internalizing and externalizing problems. Accumulating evidence, however, suggests that the CBCL may not adequately assess clinical problems in diverse populations. We investigated the measurement equivalence (ME) of the CBCL in an African American adolescent sample (N = 145). Confirmatory factor analysis indicated poor factor model fit; however, modification indices and an alternative two-factor model produced improved fit statistics. Internal consistency coefficients of CBCL scales ranged from α = .65 to .88 and were generally lower than those reported for the normative sample. The CBCL exhibited convergent validity with conceptually similar scales on the Parent Report Scale of the Behavior Assessment System for Children; however, the correlations were weaker than those reported for the normative sample. The CBCL Internalizing composite failed to predict clinician-rated Emotional problems, however, the Externalizing composite predicted clinician-rated behavior problems. In summary, the CBCL did not exhibit unequivocal evidence of ME, as it both possesses and lacks a number of statistical attributes that would demonstrate its equivalence with African Americans. Future empirical and theoretical work is discussed.     

Testing Multicultural Robustness of the Child Behavior Checklist in a National Epidemiological Sample in Uruguay

Comparisons of Child Behavior Checklist (CBCL) scores from 31 societies (Rescorla et al. Journal of Emotional and Behavioral Disorders 15:13–142 2007) supported the instrument’s multicultural robustness, but none of these societies was in South America. The present study tested the multicultural robustness of the 2001 CBCL using data from a national epidemiological survey in Uruguay. Participants were 1,374 6- to 11-year-olds recruited through 65 schools nationwide; 1,098 (80%) had received no mental health or special education services in the past year (non-referred group), whereas 276 (referred group) had been referred for mental health services, had repeated ≥2 grades, or had significant developmental disabilities. Mean item ratings, factor structure, and scale internal consistencies were very similar to findings reported by Rescorla et al. (Journal of Emotional and Behavioral Disorders 15:13–142 2007) and Ivanova et al. (Journal of Clinical Child and Adoloescent Psychology 36: 405–417 2007). Children from low SES school environments obtained higher problem scores, especially in the referred group. Gender, age, and referral status effects paralleled those in the U.S. Non-referred children obtained somewhat higher mean problem scores in Uruguay than in the U.S., but mean score differences between non-referred and referred children were smaller in Uruguay than the U.S. Findings supporting the CBCL’s multicultural robustness in a South American country extend the generalizability of findings reported by Rescorla et al. (Journal of Emotional and Behavioral Disorders 15:13–142 2007) for 31 societies.     

Prediction of Cannabis Use Disorder Between Childhood and Young Adulthood Using the Child Behavior Checklist

A prospective investigation was conducted to evaluate the accuracy of internalizing and externalizing traits measured at ages 10–12 for predicting a DSM-IV diagnosis of cannabis use disorder manifest by age 22. The sample consisted of 189 boys rated on the Child Behavior Checklist (CBCL) by their biological mothers. The results indicated that externalizing but not internalizing disturbance was a significant predictor of cannabis use disorder. Moreover, a construct capturing their common variance did not predict cannabis use disorder better than externalizing behavior alone.     

Subfactors of DSM-IV Conduct Disorder: Evidence and Connections with Syndromes from the Child Behavior Checklist

Is conduct disorder (CD) as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) a unitary entity, or do variants of CD exist? We addressed this question, using data collected from the parents of 1,669 Australian boys, aged 6–17. Parents were interviewed to assess DSM-IV Conduct Disorder (DSM-IV CD) criteria. Results revealed 2 subfactors of DSM-IV CD symptoms, made up of overt behaviors (e.g., initiating physical fights) and covert behaviors (e.g., stealing without confrontation). Ordinary least squares regressions showed the 2 CD subfactors to be significantly and uniquely predicted by Child Behavior Checklist (CBCL; T. M. Achenbach, 1991a, 1991b) syndromes labeled Aggressive Behavior and Delinquent Behavior, respectively. The results are discussed in terms of the utility of differentiating these 2 variants of CD in future editions of the DSM.     

The Child Behavior Checklist for Group Care Workers: A Study Regarding the Factor Structure

In this study we examined the factor structure of the Child Behavior Checklist (CBCL) filled out by group care workers. Group care workers' judgements were collected on 846 children and adolescents treated in various residential settings in The Netherlands. Using confirmatory factor analysis, we were able to show that the original CBCL factor model based on parental judgments of child behavior also fits for the judgments of group care workers. This means that the well known 8 narrow-band syndromes (Withdrawn, Somatic Complaints, etc.) as well as the 2 broad-band syndromes (Internalizing and Externalizing) can be used to interpret the CBCL scores of group care workers. This confirmation of the CBCL factor structure is a first step to add a group care worker version to the CBCL family. However, as a second step, normative data need to be gathered to further enhance the use of the CBCL for group care workers.     

Identity formation in juvenile delinquents and clinically referred youth

IntroductionLittle is known about how juvenile delinquents and clinically referred youth handle the key developmental task of identity formation.ObjectiveThe aim of this study was to compare identity formation in juvenile delinquent and clinically referred boys to identity formation in boys drawn from the general population.MethodMean scores on identity dimensions and membership to identity statuses in ideological (i.e., education) and interpersonal (i.e., relationship with the best friend) domains were compared across groups of juvenile delinquent boys (n = 30), clinically referred boys (n = 21), and boys drawn from the general adolescent population (n = 30).ResultsJuvenile delinquents, but not clinically referred youth, displayed a weaker identity in both the ideological and interpersonal domain than adolescents from the general population.DiscussionIdentity formation among juvenile delinquents deserves more attention from both researchers and clinicians.     

A Short Form of the Portuguese Version of the Youth Self-Report

The youth self-report (YSR), which is theoretically based in the field of developmental psychopathology and follows a dimensional approach, is an important instrument to assess the behavioral and emotional problems and the psychosocial competencies of adolescents between the ages of 11 and 18 years in both clinical and research contexts. Our main aims were to propose a short form of the YSR, conduct a first validation study, and compare the short-form YSR with the full version of the Portuguese YSR. We conducted the first study (Study 1) in a sample of 1,266 Portuguese community adolescents between the ages of 11 and 21 years to analyze the factor structure of the YSR. We conducted the second study (Study 2) in a sample of 302 community adolescents between the ages of 11 and 21 years to validate the factor structure of the short form of the YSR, which consisted of 33 items that focused on the dimensions of internalization-depression, internalization-anxiety, externalization-destructiveness and externalization-exhibitionism. Our findings confirmed that the YSR-SF provides a good fit to the data, explains similarly the variance on several criteria compared with the longer version, and is sensitive to sex and age differences.     

Spanish validation of the Affective Neuroscience Personality Scales

The Affective Neuroscience Personality Scales have been designed to provide a personality assessment tool based on six distinct affective systems. The six neural systems involved were labeled PLAY, SEEK, CARE, FEAR, ANGER and SADNESS. Spirituality has been integrated into the questionnaire as a seventh dimension because, in opinion of Panksepp and his colleagues is one of the most interesting human emotion. The aim of the present paper was introduce the validation of the Spanish version of Affective Neuroscience Personality Scales and their first psychometric results in a sample of 411 college students. Participants completed the Spanish version of ANPS, just as a personality scale of five factors (NEO-FFI-R), and the Scales of Positive and Negative Affect (PANAS). The factor structure obtained and psychometric properties of the scales indicate that the Spanish version of the scales provides an effective tool to measure the seven dimensions of personality proposal in the original questionnaire.