Predicting Anxiety Diagnoses and Severity with the CBCL-A: Improvement Relative to Other CBCL Scales?
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The Child Behavior Checklist (CBCL) is a widely used parent-report of child and adolescent behavior. We examined the ability of the CBCL-A scale, a previously published subset of CBCL items, to predict the presence of generalized anxiety disorder (GAD), separation anxiety disorder (SAD), and social phobia (SoP), as well as anxiety severity, among 488 youth randomized in the Child Anxiety Multimodal Study (CAMS). We predicted that the CBCL-A’s unique inclusion of items related to somatic symptoms would better identify anxiety disorder and severity than other CBCL scales, given that somatic complaints are often key features of anxiety among youth. Results support the use of the anxiety-based CBCL subscales as first-line screeners for generally elevated symptoms of anxiety, rather than tools to identify specific anxiety disorders. Although somatic symptoms are often reported and included in diagnostic criteria for certain anxiety disorders (e.g., SAD, GAD), the unique combination of somatic and non-somatic symptoms for the CBCL-A subscale did not increase its ability to consistently predict the presence of specific anxiety disorders.
KeywordsChild anxiety Child behavior checklist Assessment Clinical utility
This research was supported by grants (U01 MH064089, to Dr. Walkup; U01 MH64092, to Dr. Albano; U01 MH64003, to Dr. Birmaher; U01 MH63747, to Dr. Kendall; U01 MH64107, to Dr. March; U01 MH64088, to Dr. Piacentini; and U01 MH064003, to Dr. Compton) from the National Institute of Mental Health.Views expressed within this article represent those of the authors and are not intended to represent the position of NIMH, NIH, or DHHS.
Conflict of Interest
Dr. Compton is currently receiving funding from NIH and has in the past receivedfunding from Shire and Tourette’s Syndrome Association. He is also an associate editorfor Journal of Consulting and Clinical Psychology, Journal of Child and AdolescentPsychopharmacology (JCAP), and BMC Psychiatry. Dr. Piacentini receives grant or research support from the National Institute of MentalHealth, the Tourette Syndrome Foundation, and Pfizer Pharmaceuticals through theDuke University Clinical Research Institute; consultant fees from the Coleman ResearchGroup; book royalties from Guilford Press and Oxford University Press; and speakinghonoraria/travel support from the International OCD Foundation and the TouretteSyndrome Association. He is a co-author of assessment tools, none of which arecommercially published and therefore no royalties are received. Dr. Walkup receives grant/research support from the Tourette Syndrome Association andthe Hartwell Foundation. He serves the speakers’ bureau of the Tourette SyndromeAssociation. He receives royalties from Guilford Press and Oxford University Press. Dr. Birmaher receives research support from NIMH. He has or will receive royaltiesfrom Random House, Inc., Lippincott Willaims & Wilkins, and UpToDate. Dr. Sakolsky receives research support from NIMH and the National Alliance forResearch on Schizophrenia and Depression (NARSAD). She received an honorariumfrom the American Academy of Child & Adolescent Psychiatry for participation at the37th Annual Review Coruse in Child and Adolescent Psychiatry in 2012. She serves asan editorial board member of Child & Adolescent Psychopharmacology News andspecialty consultant for the Prescriber’s Letter. Her husband is a computer programmerfor Thermo Fisher Scientific. Dr. Keeton receives research support from NIMH and the Institute of EducationSciences. Dr. Albano receives research support from NIMH. She receives honoraria from theAmerican Psychological Association. She receives royalties from Oxford UniversityPress and Lynn Sonberg Book Associates. Dr. Kendall receives research support from the National Institute of Mental Health(NIMH). He has received honoraria from professional societies for speaking atconventions. He receives royalties from Guildford Press, Ericsson, Workbook Publishing(his spouse’s employment), and Oxford University Press. Dr. Caporino, Dr. Sherrill, Dr. Ginsburg, Dr. Gosch, Ms. Read, Mr. Peterman, and Ms.Settipani report no biomedical financial interests or potential conflicts of interest.
All procedures were approved by the Institutional Review Board at each study site.
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