Child Behavior Checklist/4-18 Achenbach, T. M.

1991 Description of Measure Purpose To obtain caregiver report of children's competencies and behavior problems in a standardized format. Conceptual Organization The Child Behavior Checklist/4-16 (CBCL/4-16) was the first of what has become a multi-axial empirically based set of measures for assessing children from parent, teacher, and self-reports. In 1991, The CBCL/4-16 was re-normed to include children up to 18 years of age (becoming CBCL/4-18), and eight cross-informant constructs were identified to facilitate direct comparison between problem behavior scores on the CBCL, the Teacher Report Form (TRF), and the Youth Self-Report Form (YSR) (Achenbach, 1991). All three instruments include measurement of the following eight constructs or syndromes: Social Withdrawal, Somatic Complaints, Anxiety/Depression, Social Problems, Thought Problems, Attention Problems, Delinquent Behavior, and Aggressive Behavior. The CBCL is the only measure among the three instruments that contains the Sex Problems scale (Achenbach, 1991). In addition to focusing on a childs behavior as defined by one of the eight syndrome scales, the CBCL, TRF, and YSR also allow the examination of two broad groupings of syndromes: Internalizing Problems and Externalizing Problems. Internalizing Problems combines the Social Withdrawal, Somatic Complaints, and Anxiety/Depression scales, while Externalizing problems combines the Delinquent Behavior and Aggressive Behavior scales (Achenbach, 1991). The three corollary instruments also contain items that assess social competence. The CBCL/4-18 contains 20 competence items grouped into 3 scales (Activities, Social, and School) (Achenbach, 1991). Item Origin/Selection Process Items were derived from research and consultation with professionals and parents, and revisions were based on the findings of numerous pilot studies. For a complete description of item derivation for the CBCL, see the Manual for the Child Behavior Checklist/4-18 and 1991 Profile (hereafter referred to as the Manual) (Achenbach, 1991). Materials Manual, forms, and computerized scoring programs, available from the publisher. Time Required Twenty-five to thirty minutes. Administration Method The CBCL is designed to be completed independently by the caregiver. It requires fifth grade reading ability. The form can also be administered orally by an interviewer who records the caregivers answers. There are several items for which the respondent is asked to elaborate about an endorsed behavior in order to avoid improper scoring.

Training Requires thorough familiarity with the Manual, especially with the cautions related to commonly misinterpreted items (Manual, p. 13, pp. 249-250). Please see the Manual for additional information on training and educational requirements. Scoring Score Types Items are coded from 0 to 2. Instructions for hand scoring the instrument are provided in Appendix A of the Manual. Total scores may be computed for Social Competence, Behavior Problems, Internalizing Problems, Externalizing Problems, and Sex Problems, plus scores for each of the 8 syndrome scales (Achenbach, 1991) Raw scores can be converted to age-standardized scores (T scores having a mean = 50 and SD = 10) that can be compared with scores obtained from normative samples of children within the same broad age range. Please see the Manual for more information on CBCL scores. Score Interpretation For the syndrome scales, T scores less than 67 are considered in the normal range, T scores ranging from 67-70 are considered to be borderline clinical, and T scores above 70 are in the clinical range (Achenbach, 1991) Please see the Manual for additional information on specific syndrome scales For Total Problems, Externalizing Problems, and Internalizing Problems, T scores less than 60 are considered in the normal range, 60-63 represent borderline scores, and scores greater than 63 are in the clinical range (Achenbach, 1991). Norms and/or Comparative Data The CBCL/4-18 was normed on a sample of 2,368 non-handicapped 4 to 18 year old children. See Manual for additional information on norms and comparative data. . Psychometric Support Reliability Information on test-retest reliability and Cronbachs alphas are available from the author (Achenbach, 1991). Validity Evidence for content, construct, and criterion-related validity is well documented. See Chapter 6 in Manual for additional details.

LONGSCAN Use Data Points Ages 4, 6, 8, 10, 12, 14, & 16 Respondent Primary maternal caregiver. Mnemonic and Version CBBA (age 4 and 6): Social Competence items not administered. CBB (age 8): Administration of Social Competence items was optional by site; see Administration and Scoring Notes below. CBC (age 10): Social Competence administered at all sites. CBBD (ages 12, 14 and 16) CBCS (includes all scored data) Rationale The CBCL is one of the most commonly used measures of child psychopathology. It also provides parallel versions for Teacher Report and Youth Self-Report, meeting the need for multiple informants. Furthermore, versions are available to assess our sample at every time point from age 2 to young adulthood. Finally, the CBCL has been normed on a national sample. Administration and Scoring Notes Scored variables at every age can be found in the CBCS dataset. At age 8, the Social Competence section was administered at the discretion of sites. The MW, NW and SW sites chose to collect the Social Competence data at Age 8, while the EA and SO sites did not. The authors computerized scoring program was used to generate T scores.

Results Descriptive Statistics For descriptive statistics of the age 4 -12 Child Behavior Checklist, please refer to the 1st, 2nd, and 3rd volumes of the measures manuals (Hunter et al., 2003; Knight et al. 2008). Table 1 displays the percentage of children scoring in the borderline/clinical range and mean scores for select CBCL scales from the Age 16 interview.
Table 1. Child Behavior Checklist T scores at the Age 16 Interview
N Overall Gender Male Female Study Site EA MW SO SW NW
801

Aggression % M (SD)
10.9 56.3 (8.7)

Attention Problems % M (SD)

Anxiety/ Depression % M (SD)

Delinquency % M (SD)
16.7 57.6 (9.1)

Social Problems % M (SD)

387 414

9.6 12.0

55.7 (8.4) 56.9 (9.0)

13.7 11.3

56.4 (9.0) 56.0 (8.0)

6.5 6.5

53.6 (6.3) 54.2 (6.9)

16.3 17.1

57.5 (8.7) 57.7 (9.5)

6.7 5.8

54.7 (7.2) 55.0 (7.0)

160 120 132 204 185

5.0 8.3 12.1 16.6 10.3

54.4 (7.4) 54.5 (6.7) 56.3 (9.2) 58.3 (10.4) 56.9 (8.0)

6.2 9.2 9.1 21.0 13.0

53.8 (7.5) 53.8 (7.3) 55.4 (8.5) 59.1 (8.9) 57.3 (8.3)

3.1 3.3 5.3 11.2 7.0

52.2 (5.2) 52.5 (5.2) 53.5 (6.1) 55.5 (8.0) 54.8 (6.8)

13.1 14.2 15.1 21.9 16.8

55.9 (8.0) 55.8 (8.5) 56.9 (9.0) 59.9 (10.4) 58.1 (8.5)

3.1 4.2 7.6 8.3 7.0

53.4 (5.5) 53.2 (5.9) 54.6 (7.9) 56.2 (7.6) 56.0 (7.3)

Source. Based on data received at the Coordinating Center through July 09. % represents youth who had a T score that is borderline/clinical (>= 67) at age 16. Table 2 displays

the percentage of children scoring in the borderline/clinical range and mean T scores for the Internalizing, Externalizing and Total Problem Scales. Overall, T scores are highest on the Externalizing Problems Scale, and the NW and SW sites had higher mean scores and higher percentages of children considered borderline/clinical than the other sites on this scale.
Table 2. Internalizing, Externalizing and Total Problem Scales at the Age 16 Interview
N Overall Gender Male Female Study Site EA MW SO SW NW
801

Internalizing Problems % M (SD) 19.8 49.2 (11.8)

Externalizing Problems % M (SD) 30.9 53.7 (12.0)

% 25.8

Total Problems M (SD) 51.3 (12.6)

387 414

20.7 19.0

48.7 (11.4) 48.7 (12.0)

27.9 33.7

52.9 (12.0) 54.4 (12.1)

25.6 26.0

51.0 (12.4) 51.7 (12.9)

160 120 132 204 185

9.4 12.5 17.4 27.8 26.5

44.3 (10.8) 46.1 (11.0) 49.2 (11.1) 52.1 (12.0) 52.2 (11.3)

22.5 23.3 28.0 40.0 25.1

50.2 (11.9) 50.5 (11.7) 53.7 (11.8) 56.7 (12.5) 55.3 (10.8)

13.7 15.8 23.5 36.6 32.4

46.8 (11.8) 47.1 (12.7) 51.1 (12.0) 55.0 (12.8) 54.2 (11.5)

Source. Based on data received at the Coordinating Center through July 09. % represents youth who had a T score that is borderline/clinical (>= 67) at age 16.

Reliability As can be seen in Table 3, internal consistency for the Child Behavior Checklist scales using the LONGSCAN sample was good to excellent (ranging from .72 to .96).
Table 3. Cronbach Alphas for the Age 16 Child Behavior Checklist T scores
Aggression Age 16 .92 Attention Problems .85 Anxiety/ Depression .86 Delinquency .86 Social Problems .72 Internalizing Problems .90 Externalizing Problems .94 Total Problems .96

Source. Based on data received at the Coordinating Center through July 09.

Validity Table 4 illustrates the significant correlations (ranging from .20 to .33) between Child Behavior Checklist T Scores and Trauma Symptom Checklist T scores at the Age 16 Interview.
Table 4. Correlations between Age 16 Child Behavior Checklist T Scores Age 16 Trauma Symptom Checklist Outcomes
N Trauma Symptom Checklist Anger Anxiety Depression PTSD Dissociation 650 650 650 650 650 Internalizing Problems .27*** .25*** .30*** .23*** .25*** Externalizing Problems .33*** .22*** .26*** .23*** .20*** Total Problems .32*** .25*** .29*** .25*** .25***

Source. Based on data received at the Coordinating Center through July 09. *** <.001

Publisher Information University Associates in Psychiatry 1 South Prospect Street Burlington, VT 05401-3456 (802) 656-8313 References and Bibliography Achenbach, T. M. (1991). Manual for Child Behavior Checklist/ 4-18 and 1991 Profile. Burlington, VT: University of Vermont, Dept. of Psychiatry. Achenbach, T. M. (1992). Manual for Child Behavior Checklist/ 2-3 and 1992 Profile. Burlington, VT: University of Vermont, Dept. of Psychiatry. Achenbach, T. M., Edelbrock, C., & Howell, C. (1987). Empirically-based assessment of the behavioral/ emotional problems of 2-3 year old children. Journal of Abnormal Child Psychology, 15, 629-650. Achenbach. T. M., & Edelbrock, C. (1981). Behavioral problems and competencies reported by parents of normal and disturbed children aged 4- 16. Monographs of the Society for Research in Child Development, 46, 88.

Hunter, W. M., Cox, C. E., Teagle, S., Johnson, R. M., Mathew, R., Knight, E. D., & Leeb, R.T. (2003). Measures for Assessment of Functioning and Outcomes in Longitudinal Research on Child Abuse. Volume 1: Early Childhood. Accessible at the LONGSCAN web site (http://www.iprc.unc.edu/longscan/) Hunter, W.M., Cox, C.E., Teagle, S., Johnson, R.M., Mathew, R., Knight, E.D., Leeb, R.T., & Smith, J.B. (2003). Measures for Assessment of Functioning and Outcomes in Longitudinal Research on Child Abuse. Volume 2: Middle Childhood. Accessible at the LONGSCAN web site (http://www.iprc.unc.edu/longscan/) Knight, E. D., Smith, J. S., Martin, L. M., Lewis, T., & the LONGSCAN Investigators (2008). Measures for Assessment of Functioning and Outcomes in Longitudinal Research on Child Abuse Volume 3: Early Adolescence (Ages 12-14). Accessible at the LONGSCAN web site (http://www.iprc.unc.edu/longscan/).