Clinical Utility of the CBCL Dysregulation Profile in Children with Disruptive Behavior

Background: Children who are severely dysregulated experience a range of concurrent and long-term impairments and psychopathology and are particularly at-risk for mood and anxiety disorders. The Child Behavior Checklist Dysregulation Profile (CBCL-DP) may be useful in identifying children who are highly dysregulated, which could facilitate early intervention.

Methods: We examined the prevalence, gender differences, parent-teacher agreement, and concurrent validity of two categorical definitions of the CBCL-DP in 348 children ages 6-12 who were clinic-referred for assessment and treatment because of disruptive behavior.

Results: Rates of the CBCL-DP were 3 times higher when a less stringent versus a more stringent definition of the CBCL-DP was used (46.8% vs. 15.2%). Girls were more likely than boys to meet criteria for the CBCL-DP when the more stringent definition was used. Parent-teacher agreement was low, particularly when the more stringent definition of the CBCL-DP was used. Children with the CBCL-DP were rated by their parents, but not their teachers, as more impaired than other children, regardless of the definition of the CBCL-DP used, and even when compared to children with clinically elevated scores on other CBCL subscales.

Limitations: Our cross-sectional data did not allow us to examine the predictive validity of the CBCL-DP, informant effects may have inflated associations between CBCL-DP and parent-rated impairment, and teacher ratings were missing for many children.

Conclusions: Our findings support other reports that provide evidence that the CBCL-DP may identify a particularly symptomatic and impaired group of children with disruptive behavior, as rated by their parents.