Skip to main content
SpringerLink
Log in

High Correspondence Between Child Behavior Checklist Rule Breaking Behavior Scale with Conduct Disorder in Males and Females

  • Original Article
  • Published:
Child Psychiatry & Human Development Aims and scope Submit manuscript

Abstract

This study investigated the diagnostic utility of the Child Behavior Checklist (CBCL) Rule-Breaking Behavior scale to identify children of both sexes with conduct disorder (CD). Participants were derived from four independent datasets of children with and without attention deficit hyperactivity disorder and bipolar-I disorder of both sexes. Participants had structured diagnostic interviews with raters blinded to subject ascertainment status. Receiver operating characteristic (ROC) curves were used to examine the scale’s ability to identify children with and without CD. The sample consisted of 674 participants (mean age of 11.7 ± 3.3 years, 57% male, 94% Caucasian). The interaction to test if CBCL Rule-Breaking Behavior scores identified males and females with CD differently was not significant, thus we performed ROC analysis in the combined group. The ROC analysis of the scale yielded an area under the curve of 0.9. A score of ≥ 60 on the scale correctly classified 82% of participants with CD with 85% sensitivity, 81% specificity, 48% positive predictive value, 96% negative predictive value. The CBCL Rule-Breaking Behavior scale was an efficient tool to identify children with CD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Merikangas KR, He JP, Burstein M et al (2010) Lifetime prevalence of mental disorders in U.S. adolescents: results from the national comorbidity survey replication–adolescent supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 49(10):980–989

    Article  Google Scholar 

  2. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders: DSM-5, 5th edn. American Psychiatric Publishing, Arlington

    Book  Google Scholar 

  3. Border R, Corley RP, Brown SA et al (2018) Independent predictors of mortality in adolescents ascertained for conduct disorder and substance use problems, their siblings and community controls. Addiction 113:2107–2115

    Article  Google Scholar 

  4. American Psychiatric Association (2013) Daignositic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Arlingotn

    Book  Google Scholar 

  5. Nock MK, Kazdin AE, Hiripi E, Kessler RC (2006) Prevalence, subtypes, and correlates of DSM-IV conduct disorder in the national comorbidity survey replication. Psychol Med 36(5):699–710

    Article  Google Scholar 

  6. Turgay A (2005) Treatment of comorbidity in conduct disorder with attention-deficit hyperactivity disorder (ADHD). Essent Psychopharmacol 6(5):277–290

    PubMed  Google Scholar 

  7. Biederman J, Faraone SV, Chu MP, Wozniak J (1999) Further evidence of a bidirectional overlap between juvenile mania and conduct disorder in children. J Am Acad Child Adoles Psychiatry 38(4):468–476

    Article  Google Scholar 

  8. Whitmore E, Mikulich S, Thompson L, Riggs P, Aarons G, Crowley T (1997) Influences on adolescent substance dependence: conduct disorder, depression, attention deficit hyperactivity disorder, and gender. Drug Alcohol Depend 47:87–97

    Article  Google Scholar 

  9. Groenman AP, Janssen TWP, Oosterlaan J (2017) Childhood psychiatric disorders as risk factor for subsequent substance abuse: a meta-analysis. J Am Acad Child Adolesc Psychiatry 56(7):556–569

    Article  Google Scholar 

  10. Wilens TE, Gignac M, Swezey A, Monuteaux MC, Biederman J (2006) Characteristics of adolescents and young adults with ADHD who divert or misuse their prescribed medications. J Am Acad Child Adolesc Psychiatry 45(4):408–414

    Article  Google Scholar 

  11. Wilens TE, Biederman J, Kwon A et al (2004) Risk of substance use disorders in adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry 43(11):1380–1386

    Article  Google Scholar 

  12. Wilens T, Biederman J, Martelon M et al (2016) Further evidence for smoking and substance use disorders in youth with bipolar disorder and comorbid conduct disorder. J Clin Psychiatry 79:1420–1427

    Article  Google Scholar 

  13. Achenbach TM, Howell CT, Quay HC, Conners CK (1991) National survey of problems and competencies among four to sixteen-year-olds: parents' reports for normative and clinical samples. Monogr Soc Res Child Dev 56(3):1–131

    Article  Google Scholar 

  14. Biederman J, Faraone SV, Doyle A et al (1993) Convergence of the child behavior checklist with structured interview-based psychiatric diagnoses of ADHD children with and without comorbidity. J Child Psychol Psychiatry 34:1241–1251

    Article  Google Scholar 

  15. Biederman J, Monuteaux MC, Kendrick E, Klein KL, Faraone SV (2005) The CBCL as a screen for psychiatric comorbidity in paediatric patients with ADHD. Arch Dis Child 90(10):1010–1015

    Article  Google Scholar 

  16. Gould MS, Bird H, Jaramillo BS (1993) Correspondence between statistically derived behavior problem syndromes and child psychiatric diagnoses in a community sample. J Abnorm Child Psychol 21(3):287–313

    Article  Google Scholar 

  17. Kasius MC, Ferdinand RF, van den Berg H, Verhulst FC (1997) Associations between different diagnostic approaches for child and adolescent psychopathology. J Child Psychol Psychiatry 38(6):625–632

    Article  Google Scholar 

  18. Edelbrock C, Costello AJ (1988) Convergence between statistically derived behavior problem syndromes and child psychiatric diagnoses. J Abnorm Child Psychol 16:219–231

    Article  Google Scholar 

  19. Kazdin AE, Heidish IE (1984) Convergence of clinically derived diagnoses and parent checklists among inpatient children. J Abnorm Child Psychol 12:421–436

    Article  Google Scholar 

  20. Freitag CM, Konrad K, Stadler C et al (2018) Conduct disorder in adolescent females: current state of research and study design of the FemNAT-CD consortium. Eur Child Adolesc Psychiatry 27(9):1077–1093

    Article  Google Scholar 

  21. Biederman J, Faraone S, Milberger S et al (1996) A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Arch General Psychiatry 53(5):437–446

    Article  Google Scholar 

  22. Biederman J, Monuteaux M, Mick E et al (2006) Psychopathology in females with attention-deficit/hyperactivity disorder: a controlled, five-year prospective study. Biol Psychiatry 60(10):1098–1105

    Article  Google Scholar 

  23. Wilens TE, Biederman J, Adamson JJ et al (2008) Further evidence of an association between adolescent bipolar disorder with smoking and substance use disorders: a controlled study. Drug Alcohol Depend 95(3):188–198

    Article  Google Scholar 

  24. Wozniak J, Petty CR, Schreck M, Moses A, Faraone SV, Biederman J (2011) High level of persistence of pediatric bipolar-I disorder from childhood onto adolescent years: a four year prospective longitudinal follow-up study. J Psychiatr Res 45(10):1273–1282

    Article  Google Scholar 

  25. Orvaschel H, Puig-Antich J (1987) Schedule for affective disorders and schizophrenia for school-age children: epidemiologic version. Nova University, Fort Lauderdale

    Google Scholar 

  26. Orvaschel H (1994) Schedule for affective disorder and schizophrenia for school-age children epidemiologic version. Nova Southeastern University, Center for Psychological Studies, Ft. Lauderdale

    Google Scholar 

  27. Hollingshead AB (1975) Four factor index of social status. Yale University Press, New Haven

    Google Scholar 

  28. Achenbach TM (1991) Manual for the child behavior checklist/ 4–18 and 1991 profile. University of Vermont, Burlington, VT

    Google Scholar 

  29. Hanley JA, McNeil BJ (1982) The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 143(1):29–36

    Article  Google Scholar 

  30. Kaminski JW, Claussen AH (2017) Evidence base update for psychosocial treatments for disruptive behaviors in children. J Clin Child Adolesc Psychol. 46(4):477–499

    Article  Google Scholar 

  31. Biederman J, Ball SW, Monuteaux MC, Kaiser R, Faraone SV (2008) CBCL clinical scales discriminate ADHD youth with structured-interview derived diagnosis of oppositional defiant disorder (ODD). J Atten Disord 12(1):76–82

    Article  Google Scholar 

  32. Hudziak JJ, Copeland W, Stanger C, Wadsworth M (2004) Screening for DSM-IV externalizing disorders with the child behavior checklist: a receiver-operating characteristic analysis. J Child Psychol Psychiatry 45(7):1299–1307

    Article  Google Scholar 

Download references

Funding

This work was supported by 5K12DA00357-17 to Dr. Yule and the MGH Pediatric Psychopharmacology Council. The data used in the current analysis was collected with support from the NIH grants R01HD036317 and R01MH050657 to Dr. Biederman, R01 DA012945 to Dr. Wilens, and 5 R01 MH066237-05 to Dr. Wozniak. The funding sources had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.

Author information

Authors and Affiliations

  1. Pediatric Psychopharmacology Program, Division of Child Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA

    Amy M. Yule, Maura DiSalvo, Timothy E. Wilens, Janet Wozniak, Rachael M. Lyons, K. Yvonne Woodworth & Joseph Biederman

  2. Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA

    Amy M. Yule, Timothy E. Wilens, Janet Wozniak & Joseph Biederman

  3. Department of Psychiatry, Boston Medical Center, 720 Harrison Ave., Boston, MA, 02118, USA

    Amy M. Yule

  4. Department of Psychiatry, SUNY Upstate Medical University, 750 East Adams St., Syracuse, NY, 13210, USA

    Stephen V. Faraone

  5. Boston Medical Center, 720 Harrison Ave., Suite 915, Boston, MA, 02118, USA

    Amy M. Yule

Authors
  1. Amy M. Yule
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maura DiSalvo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Timothy E. Wilens
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Janet Wozniak
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stephen V. Faraone
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rachael M. Lyons
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. K. Yvonne Woodworth
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Joseph Biederman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Amy M. Yule.

Ethics declarations

Conflict of interest

Amy Yule received grant support from the Massachusetts General Hospital Louis V. Gerstner III Research Scholar Award from 2014 to 2016. Dr. Yule is currently receiving funding through the American Academy of Child and Adolescent Psychiatry Physician Scientist Program in Substance Abuse 5K12DA000357-17. She was a consultant to the Phoenix House from 2015 to 2017 and is currently a consultant to the Gavin House (clinical services). Timothy Wilens receives or has received grant support from the following sources: NIH(NIDA). Dr. Timothy Wilens is or has been a consultant for: Alcobra, Neurovance/Otsuka, and Ironshore. Dr. Timothy Wilens has a published book: Straight Talk About Psychiatric Medications for Kids (Guilford Press); and co/edited books ADHD in Adults and Children (Cambridge University Press), Massachusetts General Hospital Comprehensive Clinical Psychiatry (Elsevier) and Massachusetts General Hospital Psychopharmacology and Neurotherapeutics (Elsevier. Dr. Wilens is co/owner of a copyrighted diagnostic questionnaire (Before School Functioning Questionnaire). Dr. Wilens is Chief, Division of Child and Adolescent Psychiatry and (Co) Director of the Center for Addiction Medicine at Massachusetts General Hospital. He serves as a clinical consultant to the US National Football League (ERM Associates), U.S. Minor/Major League Baseball; Phoenix/Gavin House and Bay Cove Human Services. Janet Wozniak received research support from PCORI in 2017–2018. She is the author of the book, “Is Your Child Bipolar” published May 2008, Bantam Books. In 2015-2017, her spouse, Dr. John Winkelman, received an honorarium from Otsuka; royalties from Cambridge University Press and UptoDate; consultation fees from Advance Medical, FlexPharma and Merck; and research support from UCB Pharma, NeuroMetrix, and Luitpold. Faraone received income, potential income, travel expenses continuing education support and/or research support from Lundbeck, KenPharm, Rhodes, Arbor, Ironshore, Shire, Akili Interactive Labs, CogCubed, Alcobra, VAYA, Sunovion, Genomind and NeuroLifeSciences in the past year. With his institution, he has US patent US20130217707 A1 for the use of sodium-hydrogen exchange inhibitors in the treatment of ADHD. Joseph Biederman is currently receiving research support from the following sources: AACAP, Feinstein Institute for Medical Research, Food & Drug Administration, Genentech, Headspace Inc., Lundbeck AS, Neurocentria Inc., NIDA, Pfizer Pharmaceuticals, Roche TCRC Inc., Shire Pharmaceuticals Inc., Sunovion Pharmaceuticals Inc., and NIH. Dr. Biederman’s program has received departmental royalties from a copyrighted rating scale used for ADHD diagnoses, paid by Bracket Global, Ingenix, Prophase, Shire, Sunovion, and Theravance; these royalties were paid to the Department of Psychiatry at MGH. In 2019, Dr. Biederman is a consultant for Akili, Jazz Pharma, and Shire. Through MGH corporate licensing, he has a US Patent (#14/027,676) for a non-stimulant treatment for ADHD, a US Patent (#10245271) on a treatment of impaired cognitive flexibility, and a patent pending (#61/233,686) on a method to prevent stimulant abuse. He received honoraria from the MGH Psychiatry Academy for tuition-funded CME courses. In 2018, Dr. Biederman was a consultant for Akili and Shire; he received honoraria from the MGH Psychiatry Academy for tuition-funded CME courses. In 2017, Dr. Biederman received research support from the Department of Defense and PamLab. He was a consultant for Aevi Genomics, Akili, Guidepoint, Ironshore, Medgenics, and Piper Jaffray; he was on the scientific advisory board for Alcobra and Shire; he received honoraria from the MGH Psychiatry Academy for tuition-funded CME courses. Maura Disalvo, Rachael Lyons and K. Yvonne Woodworth declares that they have no conflicts of interest at this time.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Written informed consent was obtained from all individual participants’ parents in this study. Written assent was obtained from all children and adolescents included in this study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yule, A.M., DiSalvo, M., Wilens, T.E. et al. High Correspondence Between Child Behavior Checklist Rule Breaking Behavior Scale with Conduct Disorder in Males and Females. Child Psychiatry Hum Dev 51, 978–985 (2020). https://doi.org/10.1007/s10578-020-00978-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10578-020-00978-7

Keywords

Search

Navigation