Revised Behavior Problem Checklist Research Articles

Selecting Assessment Instruments for Problem Behavior Outcome Research With Youth

ABSTRACTUsing effect sizes from Erford, Paul, Oncken, Kress, & Erford (2014) meta-analysis for treatments of oppositional defiant disorder and Erford, Bardhoshi, Ross, Gunther, & Duncan (2017) meta-analysis of conduct problems in school-aged youth, the 6 most commonly used disruptive behavior instruments were analyzed for practical and technical strengths and weaknesses, and best use recommendations for screening and counseling outcome research were provided. The instruments included the Achenbach System of Empirically-Based Assessment (ASEBA), Revised Behavior Problem Checklist, Self-Report Delinquency Checklist, Eyberg Child Behavior Inventory/Sutter-Eyberg School Behavior Inventory, Conners–3 Rating Scale, and Parent Daily Report.

Psychometric Properties of the Vanderbilt ADHD Diagnostic Rating Scale Completed by Juvenile Corrections Staff

Objective: This research tests the psychometric performance of the Vanderbilt ADHD Diagnostic Teacher Rating Scale (VADTRS) completed by juvenile corrections (JC) staff. Method: With institutional review board (IRB) approval and appropriate consents/assents, data were collected from case managers (n = 18), teachers (n = 9), youth (n = 261), and an administrative database. Separate psychometric analyses were conducted for case managers and teachers. Results: For both respondent groups, 2-week retest reliability and internal consistency were high for all four VADTRS subscales, and confirmatory factor analysis suggested fit with previously reported VADTRS subscale structure. Significant correlations of VADTRS with respective Revised Behavior Problem Checklist subscale scores indicated good concurrent validity. Discriminative validity was strong for ADHD, but not for conduct subscales. Interrater agreement was poor, similar as reported in other settings. Conclusion: Acceptable VADTRS psychometric performance among two JC staff groups supports guideline-consistent practice of obtaining standardized rating scale information from JC staff to enhance the quality of ADHD treatment.

A study of child physical abuse

Background Child abuse − a form of family violence − is one of the major public health issues with far-reaching effects and costs and have many implications on health policy and prevention strategies. Objective The aim of the study was to assess risk factors of child physical abuse among school-aged children in the child’s background and family characteristics and to estimate its psychiatric sequelae. Patients and methods The study was conducted in Maternity and Children Hospital, Al Medina (Al Monawara), Kingdom of Saudi Arabia, on school-aged children referred from the committee protection program from September 2012 to April 2015 using such some psychometric tests as the Child Maltreatment Questionnaire, the Mini International Neuropsychiatric Interview for children and adolescents (for major depressive episodes), Revised Behavior Problem Checklist, and Copper Smith Self-Esteem Inventory. Results Out of 186 students (age range between 12 and 16 years) 49.4% were the youngest children, mainly boys (58%), 94% had good health, 70% were from large-sized families, and 51% of whose mothers and 54% of fathers were illiterate, and all these variables showed a significant difference in both mild/moderate and severe child abuse. There were significant associations between physical abuse and low self-esteem, major depressive episode, conduct disorder, anxiety withdrawal, attention deficit hyperactivity disorder, and socialized aggression, mainly with severe physical abuse. Conclusion Physical abuse is found in a significant proportion of children, mostly living in large-sized families, of illiterate unemployed parents. Furthermore, physical abuse is commonly associated with low self-esteem, major depression episodes, conduct disorder, attention deficit hyperactivity disorder, and socialized aggression.

Clarification in the nosology of conduct disorder.

Byline: Jayaprakash. Raghavan Sir, Thanks to the detailed and objective observations and critical comments about the study titled “Determinants of symptom profile and severity of conduct disorder (CD) in a tertiary level pediatric care set-A pilot study.” The majority of study population (55%) was relatively smaller children (6–11 years), since the study setting was behavioral pediatrics unit, which is an exclusive center for providing child and adolescent mental health service under Pediatric Department. Many smaller children with externalizing disorder were being referred to. Experiences showed that the attributed stigma attached to availing mental health service to children and adolescents were less in the pediatric background. Conduct disorder is the most common child psychiatric disorder.[sup][1] It is also one of the most difficult and intractable mental health problems in children and adolescents, and is characterized by marked chronic conflict with parents, teachers, and peers. In the International Classification of Disease-10 (ICD-10) (WHO, 1992),[sup][2] CDs are included in the section called disorders of childhood and adolescence (F90–98) and coded as F91. When CD presents with co morbid hyperkinetic disorder, they are coded as F90.1. Hyperkinetic CD. Comparative nosology shows that ICD-10 diagnostic guide lines for CD are descriptive, but Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition Text Revision (DSM-IV-TR)[sup][3] is categorical. Another difference is that, ICD-10 diagnoses only CD and subtype it as oppositional defiant disorder (ODD) only, if less severe symptoms were present. However, DSM-IV-TR treats each disorder separately, may either diagnose ODD or CD. DSM-IV-TR divides the CD into two groups namely childhood onset and adolescent onset based on the age of onset, before or after the age 10 years. The ICD-10, diagnostic criteria for research (ICD-10, DCR)[sup][4] provides a symptom list of 23 items for DCR on CD as given in DSM-IV TR. The symptom list is divided into 8 less severe items and 15 more severe items. However ICD-10, DCR also diagnose only CD and subtype it as ODD, if only less severe symptoms were present. ICD-10, DCR gives specification for childhood or adolescent onset based on the age of onset before or after the age of 10 years as in DSM-IV-TR. Specification for possible subdivisions is given, based on hyperactivity, emotional disturbances and severity of CD. The severity of CD is graded as mild, moderate and severe. In the present study, we used ICD-10, DCR for defining the study population. The main critical points or comments raised for clarifications were three namely: *Does the children with CD having comorbid hyperkinetic disorder fulfilled the criteria for hyperkinetic CD? validity of findings in the present scenario could have been increased using a standardized scale child behavior checklist (CBCL) *The inherent problem of misreading of symptoms of hyperkinetic disorder and CD. Regarding the first point, the 45% of the children with CD also had fulfilled the diagnostic criteria for comorbid hyperkinetic disorder in the present study. Hence, it could be coded as F90.1 Hyperkinetic CD as per ICD-10. That is, both conduct and hyperkinetic symptoms were adequately present which satisfied the diagnostic guideline for hyperkinetic CD. Regarding the second point, the scale we used in the study was revised behavior problem checklist (RBPC).[sup][5] RBPC is an 89 item scale with each item having weighted scoring as 0, 1 and 2. The RBPC is developed and standardized for use in screening and clinical assessment of school-age children in kindergarten through 12[sup]th grade. …

Some neuropsychiatric comorbidities of attention deficit hyperactivity disorder

Objectives The aim of the study was to find out the possible neurological and psychiatric comorbid disorders that might be associated with attention deficit hyperactivity disorder (ADHD) and to assess the intelligence quotient (IQ) in the diagnosed patients, and hence improve the accurate diagnosis of ADHD and its management. Patients and methods This study is a comparative cross-sectional study (the study group and the control group). Participants were recruited from the Neuropsychiatric and Pediatric Clinics in Benha University Hospital, in addition to some private clinics and centers. The sample size of this study was 74 (divided into two groups, the study and the control groups). Participants were chosen by nonrandom technique; all patients who fulfilled the inclusion criteria and accepted (their parents) to participate were included in the study. All case and control groups were subjected to a semistructured interview, complete neuropsychiatric clinical assessment, psychometric testing using Wechsler Intelligence Scale for Children, Conners Parent Rating Scale-revised, long version, and Revised Behavior Problem Checklist. Electroencephalography was performed for some cases and controls. Results The mean age of the ADHD children was 8.78 years old; it was more prevalent among boys. Perinatal problems were significantly prevailing among cases of ADHD. In all, 70.3% had ADHD combined type, 10.8% had ADHD predominantly hyperactive-impulsive, and 18.9% had ADHD predominantly inattentive type. The control group showed higher mean IQ of 105.4 ± 9.6 compared with the ADHD case group who showed mean IQ of 93.8 ± 10.7. There were several significant comorbidities such as delayed language development, delayed developmental milestones, oppositional defiant disorder, conduct disorder, depressive symptoms, sleep disturbance, nocturnal enuresis, and soft neurological signs. Conners scale showed that the ADHD children showed higher mean in all Conners test items than the control group. ADHD children had higher mean along all Revised Behavior Problem Checklist compared with the control group. With respect to correlations, the oppositional defiant disorder was significantly correlated to the combined type ADHD. There was statistical significant difference in the whole sample where children who did not have oppositional defiant disorder had higher IQ (101.5 ± 11.5) than those who did (95 ± 11.1). Conclusion ADHD is a disorder that carries several neuropsychiatric comorbidities. Assessment of children with ADHD should address these comorbidities, and management should focus on them to obtain best outcomes for the patients.

Monotherapy versus Polytherapy in Epileptic Adolescents

Objective: Comparison between the effect of monotherapy and polytherapy on cognitive functions and growth measurements among epileptic adolescents. Methods: This study was carried on 57 adolescents from those with antiepileptics either monotherapy or polytherapy, in comparison with 20 controls. All were exposed to full neurological examination, Psychometric studies using Revised Behavior Problem Checklist “RBPC”, anthropometric measurements including height, weight, estimation of blood haemoglobin “Hb” , serum levels of copper and zinc. Results: We found that 29 cases were with monotherapy and 28 cases were with polytherapy. Scores of RBPC revealed that conduct disorders, socialized aggression and social anxiety withdrawn scales, showed significant increase in epileptic adolescents in comparison with controls which is more in cases with polytherapy, with higher frequency in distractability and restlessness in those with monotherapy. Those with polytherapy showed high frequency in depression and psychomotor retardation. Levels of heamoglobin, copper, and zinc was statistically decreased among epileptics, more with Polytherapy. There was increase in weight and BMI with monotherapy while there was decrease in weight and BMI with polytherpy as compared with controls. Conclusion: Epileptic patients with monotherapy scored better cognitive functions, than those with polytherapy. So we recommend monotherapy in treatment of epilepsy for better cognitive functions.

Profile of Behavior and IQ in Anemic Children.

Study the profile of behavior and intelligence of children with anemia and their possible association to the hematological parameters. Fifty-eight children (42 anemic; 16 controls), matched by age, sex, and culture with the patients, were subjected to both behavioral and IQ testing using Revised Behavior Problem Checklist (RBPCL) and Wechsler intelligence scale for children-revised and hematological laboratory evaluation After controlling for age, sex and culture, the mean IQ was lower in the iron deficiency group than both thalassemic and control groups (P<.000). The mean scores of conduct disorder, socialized aggression, and anxiety withdrawal of RBPCL were higher in thalassemic group while the mean scores of motor excess and attention problems score were higher in the iron deficiency group. Regression analysis showed that hemoglobin concentration in gram/dl was the predictor of IQ in both anemic group and for attention problems in iron deficiency group while the mean corpuscular volume was the predictor of motor excess score in iron deficiency group. Other associations were not statistically significant. Behavior problems and low intelligence were significantly high among anemic children. Their association with the hematological parameters varies according to the type of behavior and the type of anemia. These results cannot exclude the role of other factors in shaping the profile of behavior and IQ.

Delayed cognitive, behavioral, and radiological changes related to canial irradiation for pediatric brain tumors

20023 Purpose: To evaluate the delayed adverse changes in neuro-cognitive functions as well as white matter damage in radiated survivors of pediatric brain tumors. Methods: Forty two children (22 males) with primary brain tumors who were only treated with cranial radiation, were recruited. 28 patients were treated for low risk medulloblastoma, 10 patients for low grade astrocytoma, 3 patients for low grade ependymoma, and 1 patient for craniopharyngioma. Their ages ranged from 3 to 18 years (mean 10.3±3.98 years).They were subjected, initially just before radiotherapy and at follow-up 1–2 year after completion of cranial radiation, to serial clinical and neuropsychological assessments including Wechseler Intelligence Scale for Children, Vineland social maturity test, Benton Visual Memory Test, and Revised Behavior Problem Checklist. Magnetic resonance scans were also performed to detect the presence of white matter damage before radiotherapy and at follow up. Results: Initially, after surgery and before radiation, intelligence test scores were below normal scores for age and this was of high statistical significance (Total IQ: t= -3.02, P= 0.006). Visual memory test showed evidence of organicity in all cases. Social maturity showed a statistically significant decline as well (t= -2.11, P= 0.04). Follow-up after radiotherapy showed further decline with high statistical significance (Total IQ t= 3.228, P=0.003; visual memory t= 4.08, P= 0.001); An attentional problem has emerged (t= -6.12, P= 0.00). Both radiation dose and volume of radiation showed negative and statistically significant correlation with IQ. Age at diagnosis correlated positively and significantly with IQ ( r= 0.601, P=0.001). Multiple linear regression showed impaired neurocognitive function which was correlated with the degree of white matter damage. (standardized B= -0.577, P= 0.001) and young age at diagnosis (standardized B= -0.427, P= 0.014). Conclusions: Cranial radiation in pediatric brain tumors is associated with a decline in multiple neurocognitive functions including total IQ, visual memory, and attention; which are related to the toxic effect of cranial radiation on white matter of the brain especially in young age of childhood with high dose and whole cranial radiation. No significant financial relationships to disclose.

Psychometric Properties of the Pediatric Emotional Distress Scale in a Diverse Sample of Children Exposed to Interpersonal Violence

This study determined psychometric properties of the Pediatric Emotional Distress Scale (PEDS) with an ethnically diverse sample of 383 children 2 to 7 years of age exposed to interpersonal violence and participating in a community-based intervention. Means and alpha coefficients for the total scale and 3 subscales fell within previously reported parameters. Separate exploratory factor analysis and confirmatory factor analysis using structural equation modeling revealed that compared to the PEDS's 3-factor structure (Anxious/Withdrawn, Fearful, Act Out), a modified PEDS model with 2 latent factors (Act Out and Internalize) better fit the data and also held for both African American and White subsamples. Different correlations between the two factors and the Revised Behavior Problem Checklist further suggested that the factors represented unique latent constructs and gave evidence of construct validity. The modified PEDS could potentially be used for screening children exposed to violence.

Behavior Problems in Sexually Abused Children of Depressed Versus Nondepressed Mothers

Children's psychological adjustment following stressors, such as sexual abuse, is impacted by environmental variables. One such factor is parental support, which can be hampered when a caregiver suffers from psychopathology. The purpose of this study was to determine whether maternal depression would impact the children's adjustment to sexual abuse. It was hypothesized that depressed mothers would report more behavior difficulties for their sexually abused children than nondepressed mothers. Participants were 58 children (and their mothers) who were referred for trauma symptoms related to sexual abuse. Mothers completed the Beck Depression Inventory as a measure of their depression and rated their children's behaviors on the Revised Behavior Problem Checklist. The children completed the Children's Depression Inventory and the Revised Children's Manifest Anxiety Scale. Results revealed that depressed mothers reported more conduct problems, inattention/immaturity, and psychotic behavior than nondepressed mothers. Differences were not observed for mothers' report of depressive or anxious behaviors across groups. The children of depressed mothers reported increased levels of depression, but not anxiety, when compared to children of nondepressed mothers. Although both groups of mothers reported symptoms to be clinically significant, the children did not endorse their symptoms in clinically significant ranges.

The Scale for Assessing Emotional Disturbance: Concurrent Validity

The Scale for Assessing Emotional Disturbance (SAED) is a standardized, norm-referenced measure designed to operationalize the federal definition of Emotional Disturbance. It has demonstrated content validity and reliability. The two studies reported here address the SAED's concurrent validity. Samples in each study consisted of students identified with Emotional Disturbance. In both studies, special education teachers rated students on the SAED and a second measure of children's emotional and behavior problems. In the first study the SAED was compared to the Revised Behavior Problem Checklist. Correlations were generally moderate to high for similar subscales and low for dissimilar subscales. In the second study, the SAED was compared to the Teacher Report Form. Again, correlations generally were as expected and compatible with results of the first study. Results indicate that the SAED emotional and behavior problem subscales measure constructs akin to emotional and behavior problems measured by similar collections of item on the Revised Behavior Problem Checklist and Teacher Report Form. Implications of results and recommendations for use of the SAED are discussed.

Adapting the gang model: peer mentoring for violence prevention.

This study assessed the effectiveness of an inner-city peer-mentoring program in modifying the attitudes and behaviors involving violence of preadolescent mentees. In a case-matched cohort study involving 7- to 13-year-old children, 50 children enrolled in peer mentoring (case subjects) were compared with 75 control subjects. Case subjects were involved before enrollment in the community program in which the intervention occurred; control subjects lived in the same housing project and were matched with case subjects on age, sex, and census tract. A total of 19 community adolescents mentored the case subjects by designing and presenting violence prevention lessons. Two reliable self-report scales, Determining our Viewpoints of Violent Events and Normative Beliefs About Aggression Scale, were used to measure attitudinal change. Teachers completed the Revised Behavior Problem Checklist to assess changes in behavior. At baseline, the survey scores of the case and control subjects were not different. After the intervention period, the case scores indicated less support for violence than the control scores. Case behavior scores did not change, but control behavior scores worsened. The data suggest that peer mentoring for younger children may be an important component of efforts to reduce youth violence. A larger multisite trial is warranted.

Comparing Activity Measurements and Ratings

The purpose of this article is to examine the relationship between rated and measured activity in children. Activity level is a theoretical component of temperament, and empirical studies of child behavior disorder consistently reveal hyperactivity as a behavior disorder. This article demonstrates that the Conners Teacher Rating Scale, Motor Excess subscale of the Revised Behavior Problem Checklist, and the Nervous-Overactive subscale of the Child Behavior Checklist-Teacher Rating Form are significantly and substantially intercorrelated, thereby supporting their construct validity. Additional large significant correlations between all three ratings and measured activity (steps per hour) further support the concurrent validity of activity ratings by teachers. However, important discrepancies exist between rated and measured activity for a substantial proportion of the boys. This finding strongly suggests that a second opinion be obtained through a 2-week behavioral sample using an activity measuring instrument, especially when concemn exists over excessive activity prior to reaching diagnostic and/or treatment conclusions.

Prevalence and predictors of substance use: a comparison between adolescents with and without learning disabilities.

A considerable body of literature has accumulated that examines patterns of substance use and abuse among adolescents attending general education classes. However, much less information exists on the prevalence and predictors of substance use among adolescents with learning disabilities. One purpose of this study was to determine the comparative prevalence of tobacco, alcohol, and marijuana use among a sample of 123 students with learning disabilities (91 male and 32 female, mean age = 14.37 years) and 138 nondisabled students (77 male and 61 female, mean age = 13.71 years). A second purpose was to determine whether two psychosocial variables (self-esteem and type of behavior problem) or severity of drinking problem best predicted use of tobacco and marijuana. Students were administered the Self-Esteem Inventory (SEI)-School form (Coopersmith, 1987) and the Adolescent Drinking Index (ADI) (Harrell & Wirtz, 1989); their teachers completed the Revised Behavior Problem Checklist (RBPC) (Quay & Peterson, 1987). Tobacco and marijuana use were proportionally higher for adolescents with learning disabilities; no differences emerged for alcohol use between groups. A discriminant function analysis revealed that scores on the SEI and subscale scores of the RBPC did not reliably predict tobacco or marijuana use for either group. ADI scores were reliable predictors of marijuana use for students with learning disabilities and tobacco use for both groups.

A Psychiatric Follow-Up Study of Adoptees

This is a five year follow-up study of adopted children and adolescents. Thirty-five adoptees and 23 control subjects were assessed. Five years earlier, the initial sample consisted of 57 pairs of adoptees and controls. The study showed that both adopted and control subjects were improved at the follow-up assessment and that there were no significant differences in clinical diagnoses and social adaptation between the groups. Compared with the controls, the adoptees were scored higher on a behaviour scale (Revised Behavior Problem Checklist) by parents. Adoption by the sixth month of age was associated with better overall psychosocial functioning. Significantly more adoptees were not living with their adoptive families. Factors associated with outcome are discussed.

Response perseveration, inhibitory control, and central dopaminergic activity in childhood behavior disorders.

We screened students (N = 710) in grades four through six at two public elementary schools for behavior problems, using the Revised Behavior Problem Checklist. Five groups of children were identified: conduct disorder (n = 8), attention deficit disorder (n = 9), conduct disorder plus attention deficit disorder with hyperactivity (n = 11), anxiety-withdrawal (n = 12), and normal control (n = 15). A response perseveration task, inhibitory control task, and a noninvasive measure of dopaminergic activity were administered to selected students, and group differences were predicted based on Quay's hypotheses as derived from Gray's theory of brain function. Hypothesized group differences were not found, although analyses revealed dimensional relationships that were consistent with the hypotheses. Results are discussed in terms of Quay's hypotheses and potential modifications to tasks for future research.

Interrater Reliability Among Teachers and Mental Health Professionals When Using the Revised Behavior Problem Checklist

The behavior of 181 adolescents diagnosed as conduct disordered was rated by three groups of raters on the Revised Behavior Problem Checklist. Raters included special education teachers, regular education teachers, and mental health professionals who had daily contact with adolescents in a state residential treatment facility. Subscale means and standard deviations were calculated for ratings by all three groups. Analysis of variance revealed statistically significant differences among mean ratings for the three groups. Post hoc procedures indicated statistically significant differences between ratings by special education teachers and regular education teachers across all six RBPC subscales. For the Conduct Disorder and Socialized Aggression subscales, special education teachers rated the students' behavior as more deviant than did the regular education teachers, while mental health professionals rated behavior as more deviant than did special education teachers. Pearson product-moment correlation cofficients revealed a low degree of agreement among all three group of raters. Implications are discussed.

Parent-adolescent congruence on decision-making and its relation to adolescent adjustment

Much attention has been paid to the nature of parent-adolescent relationships, with a frequent conclusion being that it is a time of marked disagreement between parents and their adolescents. However, other literature suggests that this time is not inherently conflictual. The purpose of this study was to examine agreement and disagreement between mothers, fathers, and adolescents on specific issues. Then, adolescent adjustment was assessed, and the degree to which it was a function of congruence with parents was examined. A modified version of the Issues Checklist was used to measure intrafamily agreement; the Revised Behavior Problem Checklist and the Harter Scale of Child's Actual Competence were completed by adolescents' social studies teachers to assess adolescent functioning. Relative to their parents, adolescents reported that they should make more decisions alone, while both mothers and fathers reported that decisions should be made jointly among all family members. Only father-adolescent congruence was found consistently to be related to adolescent functioning. Possible explanations for the present results and relevant issues pertaining to family agreement are discussed.

Subgroups of Rejected Boys: Aggressive Responses to Peer Conflict Situations

Evaluated strategies for resolving peer conflict among boys who varied with respect to peer status (rejected w nonrejected) and behavior (aggressive vs. nonaggressive). Using sociometric measures and the Revised Behavior Problem Checklist, 113 six year olds were screened to identify four subject groups: aggressive rejected, rejected nonaggressive, aggressive nonrejected, and controls who were neither rejected nor aggressive. Boys completed a task in which they reported solutions to hypothetical peer conflicts. In half of the situations intentionality was deliberate, and in half it was ambiguous. Responses were coded for physical aggression, indirect aggression, and assertiveness. Multivariate analyses indicated that aggressive-rejected boys used more indirect aggression, whereas aggressive-nonrejected boys used more assertiveness compared with other groups. Results suggest that the type of aggressive responding may be a better determinant of boys' social problems than the rate of aggression.

Distinguishing between conduct-problem and emotionally disturbed students in elementary school: a five-instrument discriminant analysis.

Five instruments, the Children's Manifest Anxiety Scale, Differential Test of Conduct and Emotional Problems, Personality Inventory for Children, Piers-Harris Children's Self-concept Scale, and Revised Behavior Problem Checklist, were employed to effect differentiations between 44 conduct-problem and 31 emotionally disturbed students placed in public elementary school classes for the severely emotionally handicapped. Discriminant analysis of each test's rate of classification germane to both a preassessment categorization as conduct-problem vs emotionally disturbed and a postassessment classification as no problem vs conduct-problem vs emotionally disturbed vs combined problem is presented. The analysis indicated that the Differential Test of Conduct and Emotional Problems, Personality Inventory for Children, and Revised Behavior Problem Checklist can, with variable effectiveness, significantly classify groups using such pre- and postassessment information.