Child Behavior Checklist Scale Scores Research Articles

Analysis of salivary steroid hormones in boys with autism spectrum disorder

BackgroundAutism spectrum disorders (ASD) is a neurodevelopmental disorder with high incidence rate and difficult diagnosis. The purpose of this study was to explore whether salivary cortisol, dehydroepiandrosterone (DHEA) and pregnenolone can be used as biomarkers of ASD children.MethodsThe saliva samples of 55 boys with ASD were collected as the experimental group, and the saliva samples of 24 neurotypical boys were collected as the control group. The Child Behavior Checklist (CBCL), Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), Repetitive Behavior Scale (RBS) were used to assess the severity of symptoms in boys with ASD. Cortisol, DHEA and pregnenolone concentrations in saliva were measured using an ABSSCIEX QTRAP® 6500 + LC/MS/MS system. SPSS 23.0 was used for statistical analysis. Comparisons between the two groups which conform to normal distribution were performed by T-test, and those which don’t conform to normal distribution were performed by Mann–Whitney U test. Correlation analysis between two variables was performed using Spearman's correlation analysis. Receiver operating characteristic curve (ROC) analysis was performed to evaluate the discriminatory sensitivity of each hormone between ASD and normal control groups. Logistic regression models were used to analyze whether DHEA and salivary pregnenolone can be used as a biomarker of ASD.ResultsThere were no significant differences in age, and weight between the ASD group and the normal control group. The ABC, SRS, RBS and CBCL scale scores in the ASD group were significantly higher than those in the normal control group. The salivary DHEA and pregnenolone concentrations in the ASD group were significantly higher than those in the normal control group, but there was no significant difference in cortisol. Spearman's correlation analysis showed that only pregnenolone associated with ABC. Logistic regression model analysis suggested that pregnenolone in saliva was an independent predictor of ASD. ROC analysis found that pregnenolone had good discrimination sensitivity between ASD and normal controls.ConclusionGave salivary preoperative a space for utilization as biomarker as number of cases are limited to this high expectation.

Teacher reports of emotional and behavioral problems in Nepali schoolchildren: to what extent do they agree with parent reports?

BackgroundTeacher reports of child emotional and behavioral problems (EBPs) are sparse in many low- and middle-income countries, especially when compared to reports from parents. Cross-informant information is pivotal to clinicians when dealing with mentally ill children. In this study from Nepal, we examined teacher reports of child EBPs, the agreement between teacher and parent reports, and how this agreement varied by type of EBP and child gender.MethodsThis cross-sectional, observational study included 3808 schoolchildren aged 6–18 years from 16 districts of Nepal. Teacher and parent reports of EBPs were measured by the Nepali versions of the Teacher Report Form (TRF) and the Child Behavior Checklist (CBCL), respectively. Linear mixed model analysis was used for group comparisons and intraclass correlations. Agreement between TRF and CBCL scale scores were analyzed using Pearson’s correlation coefficient.ResultsThe prevalence of EBPs according to teacher reports was 15.4%, whereas the previous parent reported prevalence was 19.1%. Also, the mean TRF score was significantly lower than mean CBCL score for the 90 common items. Mean TRF scores for Total Problems, Externalizing Problems, and Internalizing Problems were 26.9 (standard deviation, SD 24.5), 6.1 (SD 7.2), and 7.9 (SD 7.3), respectively. Consistent with parent reports, mean TRF scores for Total Problems and Externalizing Problems were higher among boys than girls, whereas no significant gender differences were found for Internalizing Problems. Teacher-parent agreement was moderate (r = .38), and slightly higher for Externalizing Problems than for Internalizing Problems (r = .37 versus r = .34). Moderate to low correlations were found for all syndrome scales, with coefficients ranging from r = .26 (Social Problems) to r = .37 (Attention Problems). The effect of child gender on the teacher-parent agreement was significant for Internalizing Problems only, with a higher agreement for girls than for boys.ConclusionNepali teachers reported fewer child EBPs than parents. Teacher-parent agreement was moderate and varied by type of EBP and child gender. Our findings underscore the importance of obtaining information on child EBPs from both parents and teachers when evaluating and treating children in low- and middle-income countries like Nepal.

Computerized adaptive testing to screen children for emotional and behavioral problems by preventive child healthcare

BackgroundQuestionnaires to detect emotional and behavioral problems (EBP) in Preventive Child Healthcare (PCH) should be short which potentially affects validity and reliability. Simulation studies have shown that Computerized Adaptive Testing (CAT) could overcome these weaknesses. We studied the applicability (using the measures participation rate, satisfaction, and efficiency) and the validity of CAT in routine PCH practice.MethodsWe analyzed data on 461 children aged 10–11 years (response 41%), who were assessed during routine well-child examinations by PCH professionals. Before the visit, parents completed the CAT and the Child Behavior Checklist (CBCL). Satisfaction was measured by parent- and PCH professional-report. Efficiency of the CAT procedure was measured as number of items needed to assess whether a child has serious problems or not. Its validity was assessed using the CBCL as the criterion.ResultsParents and PCH professionals rated the CAT on average as good. The procedure required at average 16 items to assess whether a child has serious problems or not. Agreement of scores on the CAT scales with corresponding CBCL scales was high (range of Spearman correlations 0.59–0.72). Area Under Curves (AUC) were high (range: 0.95–0.97) for the Psycat total, externalizing, and hyperactivity scales using corresponding CBCL scale scores as criterion. For the Psycat internalizing scale the AUC was somewhat lower but still high (0.86).ConclusionsCAT is a valid procedure for the identification of emotional and behavioral problems in children aged 10–11 years. It may support the efficient and accurate identification of children with overall, and potentially also specific, emotional and behavioral problems in routine PCH.

Are assisted reproduction technologies associated with categorical or dimensional aspects of psychopathology in childhood, adolescence or early adulthood? Results from a Danish prospective nationwide cohort study

An increasing number of children are conceived using assisted reproduction technologies (ART), but little is known about the long-term risk in terms of mental health outcomes. All twin and singleton children conceived via ART and born in 1995 were sampled from the Danish in vitro fertilization registry and matched to four spontaneously conceived (SC) children. The children were followed-up at the age of 3, 7, 14 and 18years in the Danish Psychiatric Central Research Registry, to estimate the prevalence of all possible psychiatric diagnoses; dimensional aspects of psychopathology were assessed at the age of 14years, using the Child Behavior Checklist (CBCL). The study included 858 ART children and 3436 SC children. ART and SC children were not clinically distinguishable on either the categorical measures of psychopathology at the age of 3, 7, 14 and 18years, or on CBCL scale scores at the age of 14years. The findings remained nonsignificant after controlling for sample differences. This large, prospective, nationwide cohort study provides evidence to support that ART exposure does not increase the risk of adverse mental health outcomes considered as a whole, while power was limited to discard an effect of ART on specific mental health disorders.

Do parents favor their adoptive or biological children? Predictions from kin selection and compensatory models

Evolutionary reasoning (Kin Selection Theory) predicts less favorable behaviors directed by parents toward their unrelated children, relative to their biologically related children. By extension, it may be argued that parents should also have less favorable perceptions of the intellectual, personality and other behavioral traits of unrelated children, compared with biologically related children. However, recent work has modified this expectation, given the distinction between unrelated adopted children (who are acquired intentionally) and unrelated stepchildren (who are acquired via mating effort). The compensatory model takes into account evolved desires for parenting and the evolutionarily novel availability of unrelated children. It predicts that adopted children may be viewed as favorably, or even more favorably, than biological children due to parents' compensation for the perceived challenges and stigma linked to their exceptional family structure. In the present study, IQ, Adjective Checklist and Child Behavior Checklist scale scores were available for 135 virtual twin pairs (same-age unrelated siblings raised together). Virtual twins included 41 adopted–biological pairs and 94 adopted–adopted pairs, with a mean age of 6.14years (SD=3.51). These unique data allowed tests of hypotheses and predictions concerning parenting perceptions, given the matched age and placement of the biological and adoptive siblings. Consistent with prior research, the IQ scores of the biological children exceeded those of the adopted children, both between and within pairs. A between-pair analysis revealed no difference between biological children and members of adopted–adopted pairs in ratings of favorable or unfavorable traits. However, more telling within-family comparisons of adopted–biological pairs revealed higher scores for adoptees on unfavorable traits, consistent with Kin Selection Theory, but no differences between adoptive and biological children on favorable traits, consistent with the compensatory model. These findings refine our understanding of parenting genetically related and unrelated offspring.

Assessing Adolescent Personality Disorders With the Shedler-Westen Assessment Procedure for Adolescents

This two-part study describes the development and validation of a method for quantifying adolescent personality pathology using the latest edition of the Shedler–Westen Assessment Procedure for Adolescents (SWAP-II-A), an instrument designed to be used by clinically experienced observers. In Study 1, experienced psychologists and psychiatrists described a normative clinical sample of 950 North American patients. Study 2 applied the SWAP-II-A in a day treatment setting. Results indicated that SWAP-II-A personality disorder (PD) scales evidenced high internal consistency, construct validity with Diagnostic and Statistical Manual of Mental Disorders (5th ed.) symptoms and diagnoses, and concurrent validity with Child Behavior Checklist (CBCL) ratings. Independent observers saw patients similarly, and PD assessments were significantly associated with CBCL scale scores and ward behavior.

Nighttime fears of preschool children: A potential disposition marker for anxiety?

ObjectiveTo examine if children who suffer from significant Nighttime Fears (NF) experience higher degree of general fears and behavioral problems and to explore whether effortful control mediates NF association with internalizing problems. MethodsOne-hundred and nine preschool children (64 boys) between the ages 4 and 6years suffering from significant NF and 30 healthy children (16 boys) were evaluated using parental reports of behavioral problems [Child Behavior Checklist (CBCL)], parental and child report of fears [Fear Survey Revised for Parents (FSS-PC), Koala Fear Questionnaire (KFQ)], and a measure of effortful control derived from the Child Behavior Questionnaire (CBQ). ResultsChildren with severe NF also suffer from an increased level of a wide variety of fears other than NF, and exhibit more behavioral problems than controls both on parental and children’s measures of general fears, and main CBCL scale scores (Internalizing, Externalizing, Total score). Additionally, children with NF had lower abilities of effortful control (as manifested in CBQ attention and inhibitory control scales). Attention control mediated NF association to internalizing problems scale. ConclusionsNF may serve as a marker for anxiety vulnerability, and this vulnerability might be mediated by abnormal attentional control. Our finding also highlights the need for a more comprehensive assessment of behavioral problems, fears and anxiety phenomena among children referred with NF.

Time Trends in Psychopathology

Time-trend studies are required to learn about children's mental health status in changing societies. Some international studies have already analyzed secular trends over periods of 10 to 25 years, but the results are inconsistent. Our study aims to detect German time trends of psychopathology in children aged 8-11, from the first large Child Behavior Checklist (CBCL)-based study in Marburg/Germany 1987 until the present day (2008). Parents filled in the CBCL to report psychopathological symptoms in their children. The school-based samples from the years 1987 and 2008 were matched for sex, age, and socioeconomic status. The matched samples each consists of 212 girls and boys (girls: 50.5 %, boys: 49.5 %). MANCOVAs and ANCOVAs were used to test differences in mean CBCL scale scores. Somatic symptoms showed a significant increase from 1987 to 2008. Similar trends were found for other internalizing symptoms, but did not reach significance. Externalizing symptoms showed no significant increase. Boys showed more aggressive or delinquent behavior and attention problems than girls. The children with the lowest socioeconomic status showed the highest symptom levels in both assessment years. The increase in somatic problems might be an effect of changes in expected school performance and economic aspects. The overall high rate of psychopathology in children highlights the necessity of effective prevention and intervention programs, particularly regarding families with lower socioeconomic status.

Self-Reports on Mental Health Problems of Youth With Moderate to Borderline Intellectual Disabilities

To determine the extent to which the Youth Self-Report (YSR) can be used to assess emotional and behavioral problems in adolescents with intellectual disabilities (IDs). In 2003, 281 11- to 18-year-olds with IDs (IQ > or =48) completed the YSR in an interview, and in 1993, 1,047 non-ID adolescents completed the YSR themselves. Parents completed the Child Behavior Checklist (CBCL). The ID sample was split into lower (IQ 48-69) and higher (IQ > or =70) IQ groups. Cronbach's alpha values of the YSR scales and (intraclass) correlation coefficients between and within YSR and CBCL scale scores were calculated to determine parent-adolescent agreement and YSR construct validity, which were compared between samples. Mean YSR scale scores were compared between adolescents with ID with and without psychiatric symptoms. Cronbach's alpha, parent-adolescent agreement, and indications of construct validity were about similar in all samples, although discriminant validity was somewhat weaker in the lower IQ group. Mean scale scores were 1.5 to 2.0 times higher for ID adolescents with psychiatric symptoms. The YSR seems applicable in youth with an IQ > or =48. Further research is needed to refine and confirm these findings and the factor structure of the YSR in adolescents with ID and to differentiate between adolescents with moderate and mild IDs.

Behavioural problems and psychiatric symptoms in 5?13 year-old Swedish children?a comparison of parent ratings on the FTF (Five to Fifteen) with the ratings on CBCL (Child Behavior Checklist)

As part of the validation procedure of a new parent questionnaire ("Five to Fifteen" or the FTF) a random sample of 1500 children aged 5-13 years from the Swedish Population Register (SPAR) was approached. The FTF and the Child Behavior Checklist (CBCL) were sent to the parents of the children together with questions about background conditions. After two reminders the response rate was 55.6%. The final sample had a mean age of 9.12 years (SD=1.89) and a sex distribution with 55% boys and 45% girls. Analysis of attrition did not support overrepresentation of foreigners/immigrants in the attrition population. FTF like CBCL showed sensitivity to sociodemographic variables. On the FTF fewer problems were indicated for girls in all domain scales, whereas this was true for the summary scale Externalizing and Mixed problems of the CBCL. The effects of age and area of residence were slight, but parental education was negatively related to all domain scales of the FTF and to all the CBCL scales. The intercorrelations of the FTF and CBCL scales with common content showed substantial overlap supporting the validity of the FTF scales. The correlation between scales within the FTF however also indicates a substantial comorbidity. This is also supported by the substantial correlation between problem score of the FTF domains perception, language, motor skills and the CBCL scale scores Attention, Social problems as well as the summary scale Mixed problems. These findings indicate that problems with inattention and social relations are shared across the various problem domains. Factor analysis of the FTF subdomain scores resulted in two factors, one representing learning problems and the other behavioural/emotional problems. Despite the low response rate the representativity of the sample was supported by the fact that the total problem score of CBCL was very similar to that of another Swedish sample with a relatively high response rate. The finding of a frequency of AD/HD symptoms in the FTF rating corresponding to the figures of prevalence of AD/HD in several international epidemiological studies could also be seen as support for the relevance of the findings. Thus, the results give support to the usefulness of the FTF questionnaire as an instrument that can help in delineating specific problem areas within the field of child neuropsychiatry. Through the comparison with the CBCL the validity of the FTF for the parts that the two instruments share could be ascertained and the value of tapping a broader problem area could be elucidated.

Quantifying clinical judgment in the assessment of adolescent psychopathology: Reliability, validity, and factor structure of the Child Behavior Checklist for clinician report.

The aim of this study was to assess the reliability and validity of the Child Behavior Checklist (CBCL) as completed by doctoral-level clinicians in the treatment of adolescents. We asked 294 randomly selected, experienced psychiatrists and psychologists to describe a patient aged 14 to 18 in treatment for personality pathology. Clinicians completed the CBCL (parent-report version) and measures of adaptive functioning, personality pathology, and family and developmental history, which served as criterion variables to test the validity of the CBCL as completed by clinicians. Most CBCL scales demonstrated acceptable reliability. Validity estimates were impressive, and the data revealed clinically meaningful associations between specific CBCL scale scores and developmental and family history variables. Confirmatory factor analysis showed that the factorial structure of the clinician-report CBCL resembled that of the parent-report CBCL, with the exception of a substantially lower correlation between higher order internalizing and externalizing factors. The data suggest that clinical judgment can be both reliable and valid when quantified using psychometrically sound instruments.

The Concurrent Validity of the Devereux Scales of Mental Disorders

The present study was designed as an initial investigation of the concurrent validity of the Devereux Scales of Mental Disorders (DSMD; Naglieri, LeBuffe, & Pfeiffer, 1994) in relation to the Behavior Assessment System for Children (BASC) and the Child Behavior Checklist (CBCL) in two clinically referred samples of children and adolescents. The DSMD is a recently published multidimensional behavior rating scale comprised of empirically and conceptually derived scales designed to aid the diagnostic decision-making process for youth with severe psychiatric and educational classifications. To date, no published study has examined the concurrent validity of the DSMD. The first of the present studies compared the DSMD and BASC with 64 children and adolescents in an inpatient hospital setting; the second study compared the DSMD and CBCL with 74 children and adolescents classified as having serious emotional disturbance (SED) in residential care. Concurrent validity was assessed through correlations and squared semipartial correlation coefficients between the DSMD scale scores and the BASC and CBCL scale scores. Paired t tests (p < .001) were also computed across scales of similar constructs. In comparison to the BASC and CBCL, the DSMD demonstrated strong concurrent validity between conceptually similar scales, providing some evidence for the concurrent validity of the DSMD. Specifically, relative to the other measures, the DSMD appears to have some unique scales designed to detect more acute or serious pathology, whereas the BASC and CBCL may be better equipped to assess specific types of externalizing symptoms.

Associations between different diagnostic approaches for child and adolescent psychopathology.

To test the convergence between the empirical-quantitative approach of the Child Behavior Checklist (CBCL) and the clinical-diagnostic approach of the DSM. The parent version of the NIMH Diagnostic Interview Schedule for Children (DISC), version 2.3, was administered after completion of the CBCL for 231 children and adolescents consecutively referred to an outpatient mental health clinic. Of the subjects with a DSM-III-R diagnosis, 60% scored in the clinical range of the CBCL total problem score. The Withdrawn scale predicted affective and anxiety disorders. The Somatic Complaints scale predicted anxiety and mood disorders and Attention Deficit Hyperactivity Disorder. The Anxious/Depressed scale predicted anxiety and mood disorders and, to a lesser extent, disruptive behavior disorders. The Social Problems scale predicted Oppositional Defiant Disorder. The Attention Problems scale was the only significant predictor of "pure" Attention Deficit Hyperactivity Disorder (ADHD). The Aggressive Behavior scale predicted several disruptive behavior disorders, and Major Depression. The Delinquent Behavior scale was strongly associated with Conduct Disorder. Empirically based CBCL scale scores and DISC-P based DSM-III-R diagnoses converged. However, both approaches do not converge to a degree that one approach can replace the other. Instead, combining both approaches may be valuable by adding information from one approach that is not captured by the other.