The CBCL dysregulated profile: An indicator of pediatric bipolar disorder or of psychopathology severity?

Mbékou, Valentin; Gignac, Martin; MacNeil, Sasha; Mackay, Pamela; Renaud, Johanne

doi:10.1016/j.jad.2013.10.033

Cited by 29 publications

(22 citation statements)

References 16 publications

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“…Although our results demonstrating the very high efficiency of the CBCL-BP profile in identifying children with pediatric BP-I disorder are consistent with previous research in a sample of youth with and without ADHD and their siblings (10), in a sample of Brazilian children (12), and in a meta-analysis (13), data from two community samples of treatmentseeking youth did not find an association between the CBCL-BP profile with pediatric BP spectrum disorder (18,31). Although the reasons for these discrepancies are not entirely clear, several explanations are plausible.…”

Section: Discussionsupporting

confidence: 91%

“…Although the reasons for these discrepancies are not entirely clear, several explanations are plausible. Subjects in these community samples were assessed by community clinicians with varied clinical skills and diagnostic traditions without the benefit of a structured diagnostic interview (18,31) raising the possibility that differences in assessment methodology may have accounted for the negative findings. It is also possible that CBCL-BP profile may be less accurate in children with pediatric BP spectrum disorders relative to children with more narrowly defined BP-I disorder.…”

Section: Discussionmentioning

confidence: 99%

“…A body of research (9)(10)(11)(12) and a meta-analysis (13) have shown very high correspondence between a unique profile of the CBCL consisting of elevations in the Attention, Anxiety/Depression and Aggression subscales greater than two standard deviations (SDs) above the norm (≥ 210 combined) with structured diagnostic interview derived clinical diagnosis of pediatric BP disorder (hence termed the CBCL-BP profile). However, because some studies failed to find an association between the CBCL-BP profile and a diagnosis of pediatric BP disorder, (14)(15)(16)(17)(18), there is a clear need for further evaluation of the utility of the CBCL to help identify children who may have BP disorder.…”

Section: Introductionmentioning

confidence: 99%

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3.11 Further Evidence of the Diagnostic Utility of the Child Behavior Checklist for Identifying Pediatric Bipolar I Disorder

Yule

Fitzgerald²,

Wilens³

et al. 2018

Journal of the American Academy of Child & Adolescent Psych

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Background: Pediatric bipolar (BP) disorder is a prevalent and highly morbid disorder. While structured diagnostic interviews have been developed to aid in the diagnosis of pediatric BP disorder, these tools are lengthy, costly and not widely available. One possible diagnostic aid is the Child Behavior Checklist (CBCL). Objective: To assess the diagnostic utility of the CBCL-BP profile to identify children with a diagnosis of BP-I disorder. Method: Subjects were derived from four independent data sets of children and adolescents with and without attention deficit hyperactivity disorder and BP-I. Subjects were recruited from pediatric and psychiatric clinics and the community. All subjects had structured clinical interviews with raters blinded to subject ascertainment status. We used an empirically derived profile from the CBCL consisting of an aggregate t-score from the Attention, Anxiety/Depression and Aggression subscales (CBCL-BP profile) to operationalize the presence or absence of BP symptoms. Receiver operating characteristic (ROC) curves were used to examine the ability of the CBCL-BP profile to identify children with and without a structured interview diagnosis of BP-I disorder. Results: The sample consisted of 661 subjects (mean age: 11.7 ± 3.3 years, 57% male and 94% Caucasian). In total, 20 percent of participants (n = 130) met structured interview criteria for a full diagnosis of BP-I disorder. The ROC analysis of the CBCL-BP profile yielded an area under the curve (AUC) of 0.91. A t-score of ≥ 195 on the CBCL-BP profile correctly classified 86% of subjects with BP-I disorder with 80% sensitivity, 87% specificity, 61% positive predictive value (PPV) and 95% negative predictive value (NPV). Conclusion: The CBCL-BP profile efficiently discriminated pediatric subjects with and without a structured interview diagnosis of BP-I disorder. Findings suggest that the CBCL-BP profile may be an efficient tool to help identify children who are very likely to suffer from BP-I disorder.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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3.11 Further Evidence of the Diagnostic Utility of the Child Behavior Checklist for Identifying Pediatric Bipolar I Disorder

Yule

Fitzgerald²,

Wilens³

et al. 2018

Journal of the American Academy of Child & Adolescent Psych

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“…The CBCL-Dysregulation Profile (CBCL-DP), characterized by simultaneous high values (above two Standard Deviations) in three syndrome scales (anxious/depressed, attention problems, and aggressive behavior), was firstly more closely related to the pediatric bipolar disorder, and named CBCL-Pediatric Bipolar Disorder profile (CBCL-PBD) . Further research has questioned this relationship (Youngstrom et al, 2005;Volk and Todd, 2007;Holtmann et al, 2011;Mbekou et al, 2014), while CBCL-DP it has been considered a reliable indicator of cooccurring Attention Deficit Hyperactive Disorder (ADHD), Contents lists available at ScienceDirect journal homepage: www.elsevier.com/locate/jad Oppositional Defiant Disorder (ODD) and Mood Disorder (MD) (Althoff, 2010).…”

Section: Introductionmentioning

confidence: 99%

Child behavior checklist dysregulation profile in children with disruptive behavior disorders: A longitudinal study

Masi

Pisano

Milone

et al. 2015

Journal of Affective Disorders

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“…Dysregulation has been found to be relatively stable over time, highly heritable (approximately 54%-68% additive genetic factors), and to have fairly substantial shared environmental factors (approximately 18%-30%; Althoff, Rettew, Faraone, Boomsma, & Hudziak, 2006;Boomsma et al, 2006;Hudziak, Althoff, Derks, Faraone, & Boomsma, 2005). Recent studies have also demonstrated positive associations between dysregulation and risk for suicidality (Althoff et al, 2006Ayer et al, 2009;Mbekou, Gignac, MacNeil, Mackay, & Renaud, 2014;Volk & Todd, 2007), bipolar disorder Biederman et al, 2009;Diler et al, 2009), aggression (Doerfler, Connor, & Toscano, 2010), oppositional defiant disorder, conduct disorder, attention deficit hyperactivity disorder (Volk & Todd, 2007), anxiety , and substance use disorders . Particular combinations of the widely used anxious/depressed, attention, and aggression subscales (AAA; Achenbach, 1991) are often used to index dysregulation because of the associations between elevation on these scales and psychiatric outcomes and impairment (Ayer et al, 2009).…”

mentioning

confidence: 99%

Dysregulation in children: Origins and implications from age 5 to age 28

et al. 2017

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Research shows that childhood dysregulation is associated with later psychiatric disorders. It does not yet resolve discrepancies in the operationalization of dysregulation. It is also far from settled on the origins and implications of individual differences in dysregulation. This study tested several operational definitions of dysregulation using Achenbach attention, anxious/depressed, and aggression subscales. Individual growth curves of dysregulation were computed, and predictors of growth differences were considered. The study also compared the predictive utility of the dysregulation indexes to standard externalizing and internalizing indexes. Dysregulation was indexed annually for 24 years in a community sample (n ¼ 585). Hierarchical linear models considered changes in dysregulation in relation to possible influences from parenting, family stress, child temperament, language, and peer relations. In a test of the meaning of dysregulation, it was related to functional and psychiatric outcomes in adulthood. Dysregulation predictions were further compared to those of the more standard internalizing and externalizing indexes. Growth curve analyses showed strong stability of dysregulation. Initial levels of dysregulation were predicted by temperamental resistance to control, and change in dysregulation was predicted by poor language ability and peer relations. Dysregulation and externalizing problems were associated with negative adult outcomes to a similar extent.

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The CBCL dysregulated profile: An indicator of pediatric bipolar disorder or of psychopathology severity?

Cited by 29 publications

References 16 publications

3.11 Further Evidence of the Diagnostic Utility of the Child Behavior Checklist for Identifying Pediatric Bipolar I Disorder

3.11 Further Evidence of the Diagnostic Utility of the Child Behavior Checklist for Identifying Pediatric Bipolar I Disorder

Child behavior checklist dysregulation profile in children with disruptive behavior disorders: A longitudinal study

Dysregulation in children: Origins and implications from age 5 to age 28

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