Evaluating Behavioral and Emotional Disorders with the CBCL, TRF, and YSR Cross-Informant Scales

The aim was to determine whether ratings of 2- and 3-year-olds could yield more differentiation among their behavioral/emotional problems than the internalizing-externalizing dichotomy found in previous studies. The 99-item Child Behavior Checklist for Ages 2-3 (CBCL/2-3) was designed to extend previously developed empirically based assessment procedures to 2-and 3-year-olds. Factor analyses of the CBCL/2-3 completed by parents of 398 2- and 3-year-olds yielded six syndromes having at least eight items loading greater than or equal to .30 and designated as Social Withdrawal, Depressed, Sleep Problems, Somatic Problems, Aggressive, and Destructive. Second-order analyses showed that the first two were related to a broad-band internalizing grouping, whereas the last two were related to a broad-band externalizing grouping. Scales for the six syndromes, two broad-band groupings, and total problem score were constructed from scores obtained by 273 children in a general population sample. Mean test-retest reliability r was .87, 1-year stability r was .69, 1-year predictive r with CBCL/4-16 scales at age 4 was .63, 2-year predictive r was .55, and 3-year predictive r was .49. Children referred for mental health services scored significantly higher than nonreferred children on all scales. A lack of significant r's with the Minnesota Child Development Inventory, Bayley, and McCarthy indicate that the CBCL/2-3 taps behavioral/emotional problems independently of the developmental variance tapped by these measures.

The relations between scores on statistically derived behavior problem syndromes and DSM-III diagnoses were examined for 270 clinically referred children aged 6 through 16. Each child's parent completed the Child Behavior Checklist (CBCL) and was administered the NIMH Diagnostic Interview Schedule for Children (DISC)--a structured interview covering DSM-III diagnostic criteria. Numerous behavior problems scales scored from the CBCL were significantly related to one or more diagnoses. The strongest relations were between scores on the Hyperactive, Delinquent, and Depressed scales and diagnoses of Attention Deficit Disorder, Conduct Disorder, and Depression/Dysthymia, respectively. This convergence supports the validity of some syndromal constructs common to both assessment paradigms.