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PubMed1994

Israeli norms for the Achenbach Child Behavior Checklist: comparison of clinically-referred and non-referred children.

This paper presents the Israeli norms for the Achenbach Child Behavior Checklist. Questionnaire data were collected on a clinically-referred sample (N = 2227) and a non-referred sample (N = 1275) of children between the ages of 4-16. Basic descriptive data for total behavior scores and scores for broad-band and narrow-band syndromes by sex, age group, and clinical status are presented. The mean total behavior score in the non-referred sample is similar to that reported for American and Dutch samples. For the Israeli referred sample, the mean total behavior score was considerably lower than that reported for the American and Dutch samples. Issues involved in selecting an optimal cutoff point to discriminate between clinically-referred and non-referred populations are discussed.

Adolescent↗

PubMed2005

Reliability and validity of the Child Behavior Checklist Obsessive-Compulsive Scale.

This study examined the psychometric properties of the Obsessive-Compulsive Scale (OCS) of the Child Behavior Checklist (CBCL). Participants included 48 youth with obsessive-compulsive disorder (OCD), 41 with a non-OCD internalizing disorder, and 101 with an externalizing disorder. Confirmatory factor analysis of the 8-item OCS did not result in an adequate fit. Exploratory factor analysis identified a 1-factor model consisting of 6 items. Adequate internal consistency for the revised OCS (OCS-R) was obtained, and convergent validity was supported by moderate relationships with other OCD indices. The OCS-R had stronger associations with measures of OCD symptoms than with measures of depression and externalizing behaviors. Youth with OCD had significantly higher OCS-R scores than those with internalizing and externalizing disorders. Suggestions for cutoff scores are provided using results from ROC analyses. Overall, these findings suggest that the OCS-R is a reliable and valid instrument for the assessment of pediatric OCD.

Adolescent↗

PubMed2001

Long-term stability of the Child Behavior Checklist in a clinical sample of youth with attention deficit hyperactivity disorder.

Evaluated the long-term stability of the Child Behavior Checklist (CBCL) in a longitudinal clinical sample of youth with attention deficit hyperactivity disorder (ADHD), testing the hypothesis that the CBCL scales will show stability over time. Participants were 105 Caucasian, non-Hispanic boys with ADHD between the ages of 6 and 17 assessed at baseline and at a 4-year follow-up. Stability of CBCL scales were computed for dimensional (intraclass correlation coefficients [ICCs], Pearson correlations) and dichotomized scale scores (kappa coefficients and odds ratios [ORs]). Evidence was found for stability of the categorical and dimensional types of scores, as demonstrated by statistically significant stability of the Pearson correlation coefficients, kappas, and ORs. The robust findings obtained from ICCs and kappa coefficients document substantial stability for CBCL scales over time within individuals with ADHD. These results support the informativeness of the CBCL as a useful measure of longitudinal course in clinical samples of youth with ADHD.

Adolescent↗

PubMed2001

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.

Adolescent↗

PubMed2000

Child Behavior Checklist item scores in Norwegian children.

In an epidemiological study of children aged four to 16, 1170 parents responded to the Child Behavior Checklist (CBCL). Similar effects of age and socio-economic status (SES) on item scores as those reported in several international studies with the CBCL were found in the total sample. Contrary to the results of other studies, differences related to gender were found for only a few items. A subgroup of 41 children and 36 adolescents and their parents were interviewed with psychiatric interviews. Several CBCL problem items were good predictors of psychiatric disorder in the interviewed children and adolescents. High positive and negative predictive values were found for the items clumsy and the item unhappy, sad or depressed in this sample.

Adolescent↗

PubMed1999

Syndrome dimensions of the child behavior checklist and the teacher report form: a critical empirical evaluation.

The construct representation of the cross-informant model of the Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF) was evaluated using confirmatory factor analysis. Samples were collected in seven different countries. The results are based on 13,226 parent ratings and 8893 teacher ratings. The adequacy of fit for the cross-informant model was established on the basis of three approaches: conventional rules of fit, simulation, and comparison with other models. The results indicated that the cross-informant model fits these data poorly. These results were consistent across countries, informants, and both clinical and population samples. Since inadequate empirical support for the cross-informant syndromes and their differentiation was found, the construct validity of these syndrome dimensions is questioned.

Child↗

PubMed1997

Acceptability of the Conners Parent Rating Scale and Child Behavior Checklist to Dakotan/Lakotan parents.

OBJECTIVE: The objective of this pilot study was to determine how Dakotan/Lakotan parents view the Conners Parent Rating Scale (CPRS) and Child Behavior Checklist (CBCL). METHOD: Using a focus group methodology, four discussion groups were held in different sites across South Dakota where the CPRS and CBCL were in clinical use. RESULTS: Only two questions on each form were incomprehensible to these Dakotan/Lakotan parents. Other questions were hard to answer because certain questions contained implicit dominant cultural values that did not take into account Dakotan/Lakotan cultural values or traditions, or the questions were hard to answer because Dakotan/Lakotan believed their responses could or would be misunderstood by members of the dominant culture who did not understand Dakotan/Lakotan style or customs. CONCLUSIONS: The CPRS and CBCL were generally acceptable to Dakotan/Lakotan parents. Clinicians could make several statements to Native parents that would improve cultural acceptability.

Adult↗

PubMed2000

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.

Attention Deficit Disorder with Hyperactivity↗

PubMed2004

The utility of measures of child and adolescent anxiety: a meta-analytic review of the Revised Children's Manifest Anxiety Scale, the State-Trait Anxiety Inventory for Children, and the Child Behavior Checklist.

We evaluated the ability of the Revised Children's Manifest Anxiety Scale (RCMAS), the State-Trait Anxiety Inventory for Children (STAIC), and the Child Behavior Checklist (CBCL) to (a) discriminate between youth with an anxiety disorder and youth without a disorder, (b) discriminate between youth with an anxiety disorder and youth with either externalizing disorders or affective disorders, and (c) measure treatment change. In addition, variables, including age and sex, were explored as possible moderators of instrument utility. A meta-analysis of 43 articles was conducted. A large effect size was found when the instruments were used to compare youth with an anxiety disorder to youth without a disorder. When comparing anxious youth to psychiatric control groups, the picture was mixed; the instruments were found to be useful when discriminating between youth with an anxiety disorder and youth with an externalizing disorder, but not between youth with an anxiety disorder and children and adolescents with an affective disorder. The RCMAS, STAIC, and CBCL were found to be moderately sensitive to treatment gains.

Adolescent↗

PubMed1992

Cluster analysis of child behavior checklists of 6 to 11-year-old males with varying degrees of behavior disorders.

Achenbach Child Behavior Checklist ratings were collected on boys aged 6 to 11 years screened as not having significant behavior problems, as clinic-referred boys, and as boys diagnosed as having Attention Deficit-Hyperactivity Disorder alone or together with Oppositional-Defiant Disorder or Conduct Disorder. Cluster analysis resulted in a classification system related to DSM-III-R classification of the boys and parent self-report of mildly antisocial acts. Clusters also enhanced the ability of the instrument to detect Attention Deficit Hyperactivity Disorder and disruptive behavior disorders.

Attention Deficit Disorder with Hyperactivity↗

PubMed2000

Secondary analysis from the Seychelles Child Development Study: the child behavior checklist.

Human exposure to methylmercury (MeHg), a known neurotoxin, is primarily from fish consumption. As part of a large study examining the association between MeHg exposure and child development in a population with high fish consumption we examined school-age behavior using the Achenbach Child Behavior Checklist (CBCL). The CBCL Total T score was a primary endpoint and was reported earlier to show no adverse association with prenatal or postnatal MeHg exposure. In this study we analyzed the T scores of the CBCL subscales to determine if more discrete aspects of measured behavior were associated with exposure. The Seychelles Child Development Study (SCDS) is a prospective, double blind, longitudinal evaluation of over 700 children. The index of prenatal exposure was maternal hair total mercury (T-Hg) in a segment growing during gestation. Postnatal exposure was T-Hg in the child's hair taken at 66 months of age. The child's primary caregiver completed the CBCL during the 66-month evaluation. No association between prenatal or postnatal MeHg exposure and the CBCL subscales was found. In Seychellois children exposed to MeHg from consumption of ocean fish we found no association between either prenatal or postnatal MeHg exposure and behavior as measured by the CBCL subscales.

Adult↗

PubMed2003

Agreement between parents and teachers on behavioral/emotional problems in Japanese school children using the child behavior checklist.

We investigated the agreement between Japanese parents' and teachers' ratings concerning their children's behavioral/emotional problems. Mothers (n = 276) and teachers (n = 19) assessed each child (n = 316; 6 to 12 years old ) using Japanese parent and teacher version of the Child Behavior Checklist. Parent-teacher agreement were examined through three indices; mean scores, correlations and D scores (generalized distance between item profile). Mean scores rated by parents were significantly higher than those by teachers. The differences of parents' ratings according to sex of the child or parents' occupational level, and those of teachers' ratings according to sex of the child were consistent with previous Western studies. Parent-teacher correlations were in the low to middle range (0.16-0.36). We obtained significant sets of independent variables accounting for the variance of D scores, but the effect size of these variables was small. These results indicated that, as seen in Western studies, Japanese parents and teachers would also assess their child's problems differently and the child's demographics affect their evaluation. For further research, parent and teacher characteristics which may influence on their perspective of the child's problems could be examined.

Child↗

PubMed1994

[Reliability and factorial validity of the Child Behavior Checklist--an analysis of a clinical and field sample].

The purpose of this study was to assess the reliability (internal consistency), the correlations of the scale scores and the factorial validity of the German version of the Child Behavior Checklist (CBCL). The analyses were performed in a sample of patients at two child and adolescent psychiatric facilities (N = 1653) and in a community sample (N = 1622). The analyses were based on the 1991 American version of the CBCL. The internal consistency of most of the scales was good to excellent (rtt > .80). The reliability of the scales "Withdrawn", "Somatic complaints" and "Social Problems" was not completely satisfactory (rtt > .70). The reliability of the syndrome scales "Thought Problems" and "Sex Problems" and the Competence Scales was unsatisfactory (rtt < .70). The internal consistency of the syndrome scales in the German and American samples was very similar. The correlations between the scales were predominantly in the lower range, with some in a medium range (rtt > .50). Factor analyses in the clinical sample confirmed that the syndrome scales had been well-designed. With the exception of the scales "Social Problems" and "Withdrawn", where the items have loadings on a common factor, the scales proved to be factorially valid.

Adolescent↗

PubMed2004

Genetic and environmental contributions to the Child Behavior Checklist Obsessive-Compulsive Scale: a cross-cultural twin study.

CONTEXT: We have reported elsewhere on the development of an 8-item Obsessive-Compulsive Scale (OCS) contained in the Child Behavior Checklist (CBCL) to identify children who meet criteria for DSM-IV obsessive-compulsive disorder. Twin studies of obsessive-compulsive disorder have indicated a significant genetic component to its expression. OBJECTIVE: To determine the relative contributions of genetic and environmental influences on childhood obsessive-compulsive behavior using the CBCL OCS in twin samples. DESIGN: The CBCL data were received by survey of twins in the Netherlands Twin Registry (NTR) and the Missouri Twin Study (USA/MOTWIN). SETTING: General community twin samples. PARTICIPANTS: Participants were 4246 twin pairs aged 7 years, 2841 aged 10 years, and 1562 aged 12 years (who also participated in the study at 7 and 10 years of age) from the NTR and 1461 mixed-age twin pairs (average age, approximately 9 years) from the USA/MOTWIN. MAIN OUTCOME MEASURES: Model fitting to test for genetic and environmental influences, sex differences, and sibling interaction/rater contrast effects on the CBCL OCS. RESULTS: In each case, the best-fitting model was one that indicated significant additive genetic influences (range, 45%-58%; 95% confidence interval [CI], 45%-61%), and unique environmental influences (range, 42%-55%; 95% CI, 39%-55%), with shared environmental influences in the NTR sample aged 12 years (16%). Sex differences were seen in the mixed-age USA/MOTWIN model, but not in the NTR samples. No evidence of dominance, sibling interaction, or rater-contrast effects was seen. These data were relatively consistent across age and cultures. CONCLUSIONS: The CBCL OCS is influenced by genetic factors (approximately 55%) and unique environmental factors (approximately 45%) in the younger sample, with common environmental influences only at 12 years of age. These effects do not vary with differences in sex or sibling interaction/rater contrast effects. Our data reveal higher genetic influences for obsessive-compulsive behavior and do not demonstrate genetic differences across sex.

Age Factors↗

PubMed2005

The Child Behavior Checklist, Teacher Report Form and Youth Self Report problem scales in a normative sample of Croatian children and adolescents aged 7-18.

The main goal of this study was to standardize the Child Behavior Checklist (CBCL), Teacher Report Form (TRF) and Youth Self Report (YSR) questionnaire problem scales on a normative random sample of children and adolescents (N=3309) aged 7 to 18 throughout Croatia. The second goal was to compare boys-girls problem scales data and CBCL-TRF-YSR differences in our sample. The mean value of CBCL scores for the Total Problems scale for different groups (children/adolescents; boys/girls) ranged from 17.07 to 20.71. Overall instruments' internal consistency ranged from 0.83 to 0.86. In almost all the scales parents reported higher scores than teachers (p < 0.01). In all the scales adolescents reported significantly higher scores than their parents and teachers (p < 0.01). This study standardized the questionnaires for our specific socio-cultural circle, which satisfy complex psychopathology study criteria. Problem scales results in our sample suggest similarity to previous European researches.

Adolescent↗

PubMed2006

The Obsessive Compulsive Scale of the Child Behavior Checklist predicts obsessive-compulsive disorder: a receiver operating characteristic curve analysis.

BACKGROUND: The purpose of this study was to determine a score on the Obsessive Compulsive Scale (OCS) from the Child Behavior Checklist (CBCL) to screen for obsessive compulsive disorder (OCD) in children and to rigorously test the specificity and sensitivity of a single cutpoint. METHODS: A receiver operating characteristic (ROC) curve analysis was applied to data from 61 patients with clinically determined OCD, 64 clinical controls and 73 general population controls to determine the best sum score on the CBCL-OCS to predict confirmed OCD in children. Using the ROC-determined cutoff, this score was applied to a national sample of CBCL data from 2460 singleton children ages 4-18 and to 20,016 children ages 7-18 from three large general population twin samples to determine the estimated prevalence in the general population. RESULTS: Using a CBCL-OCS score of 5 demonstrated an area under the curve (AUC) of .88 with high sensitivity (92%) and moderate specificity (67%) compared to clinical controls. Compared to the general population controls, the AUC was .96 with high sensitivity (92%) and specificity (89%). In the twin samples, the number of participants with CBCL-OCS scores above this cutpoint was 2.3-7.1%. CONCLUSIONS: These findings suggest that the OCS of the CBCL may provide a highly effective way to screen for childhood OCD, and that the prevalence of childhood OCD may have been underestimated, thus prompting the need for further research into screening children for this condition.

Adolescent↗

PubMed2007

Present and previous psychopathology of juvenile onset migraine: a pilot investigation by Child Behavior Checklist.

The objective was to describe the premorbid state of migraine with juvenile onset. Thirty subjects with migraine and 30 healthy subjects were enrolled in a case-control study. A structured questionnaire (Child Behavior Checklist, CBCL) was administered to the mothers and ratings were obtained for the past two age periods (0-3 and 4-6 years) and for the present state. CBCL scores of the migraine group (MG) were compared to those of the control group (CG) during the three periods. A longitudinal study was performed to evaluate the evolution of psychopathology comparing CBCL scores of MG in the three age periods. During the premorbid period MG showed significantly higher mean scores on total, internalising, anxious-depressive scales. In the longitudinal perspective, internalising traits were present in the premorbid period in MG. Children later diagnosed as having migraine differ from CG in several scales during different age periods. Migraine could be considered as the expression of a previous vulnerability.

Adolescent↗

PubMed2005

The child behavior checklist together with the ADHD rating scale can diagnose ADHD in Korean community-based samples.

OBJECTIVE: The purpose of this study was to examine the clinical validities and efficiencies of the Child Behavior Checklist (CBCL) and the ADHD Rating Scale-IV (ARS) in identifying children with attention-deficit hyperactivity disorder (ADHD) in Korean community-based samples. METHOD: A large sample of elementary school students (n = 1668) participated in this study. We used the CBCL and the ARS as the screening instruments. Diagnoses were determined by clinical psychiatric interviews and confirmed by DSM-IV-based structured interviews. RESULTS: Of the 46 subjects who underwent clinical psychiatric interviews, 33 were diagnosed as having ADHD. A T score of 60 with regard to the Attention Problems profile of the CBCL resulted in a reasonable level of sensitivity or positive predictive value in the diagnosis of ADHD. In both the parent and teacher reports of the ARS, 90th percentile cut-off points resulted in a high level of predictive value. The highest levels of specificity and positive predictive value were obtained when we combined the CBCL (T > or = 60 in Attention Problems) and the ARS (parent-teacher total > or = 90th percentile) reports. CONCLUSIONS: These findings suggest that the combined use of the CBCL and the ARS could serve as a rapid and useful clinical method of predicting or even diagnosing children with ADHD in epidemiologic case definitions.

Attention Deficit Disorder with Hyperactivity↗