Screening for DSM-IV externalizing disorders with the Child Behavior Checklist: A receiver-operating characteristic analysis

University of Vermont, Given Building, Room B229, Burlington, VT 05405, USA.
Journal of Child Psychology and Psychiatry (Impact Factor: 6.46). 11/2004; 45(7):1299-307. DOI: 10.1111/j.1469-7610.2004.00314.x
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ABSTRACT This study examines the diagnostic accuracy of the CBCL syndrome AS scales for predicting DSM-IV Attention Deficit-Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder with or without Conduct Disorder (ODD/CD).
The sample included 370 children (187 probands and 183 siblings) participating in a family genetic study of attention and aggressive behavior problems. Univariate and stepwise logistic regression analyses were used to derive models for predicting two diagnostic conditions: ADHD and ODD/CD.
The Attention Problems syndrome significantly predicted ADHD, and ODD/CD was significantly predicted by the Aggressive Behavior syndrome. Both scales demonstrated good diagnostic accuracy, as assessed through receiver operating characteristics analyses. Cut-point analyses confirmed the utility of low T-scores, 55 on the respective syndromes, for efficiently discriminating cases from noncases.
CBCL syndromes display good diagnostic efficiency for assessing common externalizing disorders in children.

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Available from: Martha Wadsworth, Sep 29, 2015
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    • "Although discrepant with findings of impaired selective attention among children with FASD (Connor et al., 1999; Streissguth et al., 1999; Burden et al., 2005; Mattson et al., 2006), the findings of average or better levels of performance reported here are consistent with evidence that children with ADHD also perform within the average range on the visual selective attention subtests of the TEA-Ch (Heaton et al., 2001; Manly et al., 2001). As the behavior of both children with ADHD and those with FASD is characterized as distractible and inattentive (American Psychiatric Association, 1994; Hudziak et al., 2004), the commensurate findings from the two groups suggest that the subtests of the TEA-Ch may be measures of selective attention that are not confounded with other aspects of attention, such as vigilance or control, that have been cited as the source of the attentional problems at least among children with ADHD (Manly et al., 2001). Conversely, the TEA-Ch subtests may not be sufficiently sensitive to detect nuanced real-world attentional problems. "
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    ABSTRACT: Parental reports of attention problems and clinical symptomatology of ADHD among children with fetal alcohol syndrome disorder (FASD) were assessed in relation to performance on standardized subtests of attentional control/shifting and selective attention from the Test of Everyday Attention for Children (TEA-Ch; Manly etal., 1998). The participants included 14 children with FASD with a mean chronological age (CA) of 11.7 years and a mean mental age (MA) of 9.7 years, and 14 typically developing (TD) children with no reported history of prenatal exposure to alcohol or attention problems with a mean CA of 8.4 years and a mean MA of 9.6 years. The children with FASD were rated by their caregivers as having clinically significant attention difficulties for their developmental age. The reported symptomatology for the majority of the children with FASD were consistent with a diagnosis of ADHD, combined type, and only one child had a score within the average range. These reports are consistent with the finding that the children with FASD demonstrated difficulties with attentional control/shifting, but inconsistent with the finding that they outperformed the TD children on a test assessing selective attention. These findings are considered within the context of the complexity in understanding attentional functioning among children with FASD and discrepancies across sources of information and components of attention.
    Frontiers in Human Neuroscience 03/2014; 8:119. DOI:10.3389/fnhum.2014.00119 · 2.99 Impact Factor
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    • "Clustering of subjects in terms of subtypes, as DISC does, neglects variation in severity as children with moderately elevated symptom scores on several subtypes won't meet DSM-IV criteria for ADHD while children with elevated symptom scores on one subtype will (Hudziak et al., 2004 Oct). As ADHD is known to have high psychiatric comorbidity, alterations in DNA methylation might be the result of other disorders . "
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    ABSTRACT: Attention deficit/hyperactivity disorder (ADHD) is a common and highly heritable psychiatric disorder. In addition, early life environmental factors contribute to the occurrence of ADHD. Recently, DNA methylation has emerged as a mechanism potentially mediating genetic and environmental effects. Here, we investigated whether newborn DNA methylation patterns of selected candidate genes involved in psychiatric disorders or fetal growth are associated with ADHD symptoms in childhood. Participants were 426 children from a large population based cohort of Dutch national origin. Behavioral data were obtained at age 6 years with the Child Behavior Checklist. For the current study, 11 regions at 7 different genes were selected. DNA methylation levels of cord blood DNA were measured for the 11 regions combined and for each region separately. We examined the association between DNA methylation levels at different regions and ADHD symptoms with linear mixed models. DNA methylation levels were negatively associated with ADHD symptom score in the overall analysis of all 11 regions. This association was largely explained by associations of DRD4 and 5-HTT regions. Other candidate genes showed no association between DNA methylation levels and ADHD symptom score. Associations between DNA methylation levels and ADHD symptom score were attenuated by co-occurring Oppositional defiant disorder and total symptoms. Lower DNA methylation levels of the 7 genes assessed at birth, were associated with more ADHD symptoms of the child at 6 years of age. Further studies are needed to confirm our results and to investigate the possible underlying mechanism.
    Journal of Psychiatric Research 11/2013; 49(1). DOI:10.1016/j.jpsychires.2013.10.017 · 3.96 Impact Factor
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    • "The CBCL assessment system includes forms for two age groups: youth aged 1.5 to 5 years old and youth aged 6 to 18 years old (Achenbach & Rescorla, 2001). The CBCL forms are widely used in research and practice applications and have demonstrated excellent score reliability and validity in numerous large and diverse samples of youth (Aschenbrand, Angelosante, & Kendall, 2005; Hudziak, Copeland, Stanger, & Wadsworth, 2004; Nakamura, Ebesutani, Bernstein, & Chorpita, 2009). "
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    ABSTRACT: High caseworker turnover has been identified as a factor in the poor outcomes of child welfare services. However, almost no empirical research has examined the relationship between caseworker turnover and youth outcomes in child welfare systems and there is an important knowledge gap regarding whether, and how, caseworker turnover relates to outcomes for youth. We hypothesized that the effects of caseworker turnover are moderated by organizational culture such that reduced caseworker turnover is only associated with improved youth outcomes in organizations with proficient cultures. The study applied hierarchical linear models (HLM) analysis to the second National Survey of Child and Adolescent Well-being (NSCAW II) with a U.S. nationwide sample of 2,346 youth aged 1.5- to 18-years-old and 1,544 caseworkers in 73 child welfare agencies. Proficient organizational culture was measured by caseworkers' responses to the Organizational Social Context (OSC) measure; staff turnover was reported by the agencies' directors; and youth outcomes were measured as total problems in psychosocial functioning with the Child Behavior Checklist (CBCL) completed by the youths' caregivers at intake and at 18 month follow-up. The association between caseworker turnover and youth outcomes was moderated by organizational culture. Youth outcomes were improved with lower staff turnover in proficient organizational cultures and the best outcomes occurred in organizations with low turnover and high proficiency. To be successful, efforts to improve child welfare services by lowering staff turnover must also create proficient cultures that expect caseworkers to be competent and responsive to the needs of the youth and families they serve.
    Children and Youth Services Review 11/2013; 35(11). DOI:10.1016/j.childyouth.2013.09.002 · 1.27 Impact Factor
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