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Withdrawn behavior is present in many psychological problems and it is often used interchangeably with other psychological constructs, making accurate classification difficult. In an effort to better understand the classification and developmental course of withdrawn behavior in youth, the current study used parent-report to assess 649 Dutch youth at three time points across eight years, using the Withdrawn/Depressed (W/D) scale of the Child Behavior Checklist (CBCL). Mean age of participants at each time point are 7.52 (Wave 1), 11.77 (Wave 2), and 15.53 (Wave 3) years. Latent class analysis and latent transition analysis was employed to empirically derive distinct subclasses of withdrawn youth and to examine how these youth transition between classes over time. Most youth fell within a low symptom class (Time 1 = 79.4%, Time 2 = 79.2%, Time 3 = 68.5%). A shy/secretive class also emerged (Time 1 = 20.6%, Time 2 = 20.8%, Time 3 = 31.5%). For girls, the interpretation of the shy/secretive class changed at Time 3 (e.g., ages 14–17 years), such that the majority of girls in this class also exhibited depressed mood. The majority of youth remained in the same class over time. This study used a model-based person-centered approach to derive classes of withdrawn behavior over time. The W/D subscale could be used as a brief screening tool for early detection of the shy/secretive behavioral phenotype, which may be a risk factor for later psychopathology. It is recommended that future studies identify predictors of class transition and investigate whether withdrawn classes predict diagnostic outcome. Highlights: This study was the first latent class and transition analysis of the CBCL W/D scale. A low symptom withdrawn class and shy/secretive withdrawn class emerged. For adolescent girls, the shy/secretive class included elevated depressed mood. Most youth remained in the same withdrawn class over time. This study used a model-based person-centered approach to study youth withdrawn behavior. [ABSTRACT FROM AUTHOR]

This study examined the stability of internalizing and externalizing problems from age 1.5 to 6 years, while taking into account developmental changes in the presentation of problems. The study comprised a population-based cohort of 7,206 children (50.4 % boys). At ages 1.5, 3, and 6 years, mothers reported on problem behavior using the Child Behavior Checklist/1.5-5 (CBCL/1.5-5). At each age we performed latent profile analysis on the CBCL/1.5-5 scales. Latent transition analysis (LTA) was applied to study the stability of problem behavior. Profiles of problem behavior varied across ages. At each age, 82-87 % of the children did not have problems whereas approximately 2 % showed a profile of co-occurring internalizing and externalizing problems. This profile was more severe (with higher scores) at 6 years than at earlier ages. A predominantly internalizing profile only emerged at 6 years, while a profile with externalizing problems and emotional reactivity was present at each age. LTA showed that, based on profiles at 1.5 and 3 years, it was difficult to predict the type of profile at 6 years. Children with a profile of co-occurring internalizing and externalizing problems early in life were most likely to show problem behavior at 6 years. This study shows that the presentation of problem behavior changes across the preschool period and that heterotypic continuity of problems is very common among preschoolers. Children with co-occurring internalizing and externalizing problems were most likely to show persisting problems. The use of evidence-based treatment for these young children may prevent psychiatric problems across the life course. [ABSTRACT FROM AUTHOR]

Children meeting the Child Behavior Checklist Dysregulation Profile (CBCL-DP) suffer from high levels of co-occurring internalizing and externalizing problems. Little is known about the cognitive abilities of these children with CBCL-DP. We examined the relationship between CBCL-DP and nonverbal intelligence. Parents of 6,131 children from a population-based birth cohort, aged 5 through 7 years, reported problem behavior on the CBCL/1.5-5. The CBCL-DP was derived using latent profile analysis on the CBCL/1.5-5 syndrome scales. Nonverbal intelligence was assessed using the Snijders Oomen Nonverbal Intelligence Test 2.5-7-Revised. We examined the relationship between CBCL-DP and nonverbal intelligence using linear regression. Analyses were adjusted for parental intelligence, parental psychiatric symptoms, socio-economic status, and perinatal factors. In a subsample with diagnostic interview data, we tested if the results were independent of the presence of attention deficit hyperactivity disorder (ADHD) or autism spectrum disorders (ASD). The results showed that children meeting the CBCL-DP ( n = 110, 1.8 %) had a 11.0 point lower nonverbal intelligence level than children without problems and 7.2-7.3 points lower nonverbal intelligence level than children meeting other profiles of problem behavior (all p values <0.001). After adjustment for covariates, children with CBCL-DP scored 8.3 points lower than children without problems ( p < 0.001). The presence of ADHD or ASD did not account for the lower nonverbal intelligence in children with CBCL-DP. In conclusion, we found that children with CBCL-DP have a considerable lower nonverbal intelligence score. The CBCL-DP and nonverbal intelligence may share a common neurodevelopmental etiology. [ABSTRACT FROM AUTHOR]

Background Oppositional defiant disorder ( ODD) has components of both irritability and defiance. It remains unclear whether children with variation in these domains have different adult outcomes. This study examined the concurrent and predictive validity of classes of oppositional defiant behavior. Methods Latent class analysis was performed on the oppositional defiant problems scale of the Child Behavior Checklist in two samples, one in the US (the Achenbach Normative Sample, N = 2029) and one in the Netherlands (the Zuid-Holland Study, N = 2076). A third sample of American children (The Vermont Family Study, N = 399) was examined to determine concurrent validity with DSM diagnoses. Predictive validity over 14 years was assessed using the Zuid-Holland Study. Results Four classes of oppositional defiant problems were consistent in the two latent class analyses: No Symptoms, All Symptoms, Irritable, and Defiant. Individuals in the No Symptoms Class were rarely diagnosed concurrently with ODD or any future disorder. Individuals in the All Symptoms Class had an increased frequency of concurrent childhood diagnosis of ODD and of violence in adulthood. Subjects in the Irritable Class had low concurrent diagnosis of ODD, but increased odds of adult mood disorders. Individuals in the Defiant Class had low concurrent diagnosis of ODD, but had increased odds of violence as adults. Conclusions Only children in the All Symptoms class were likely to have a concurrent diagnosis of ODD. Although not diagnosed with ODD, children in the Irritable Class were more likely to have adult mood disorders and children in the Defiant Class were more likely to engage in violent behavior. [ABSTRACT FROM AUTHOR]

This study examined hostility and harsh discipline of both mothers and fathers as potential mechanisms explaining the association between a maternal maltreatment history and her offspring's internalizing and externalizing problems. Prospective data from fetal life to age 6 were collected from a total of 4,438 families participating in the Generation R Study. Maternal maltreatment was assessed during pregnancy using a self-administered questionnaire. Mothers and fathers each reported on their psychological distress and harsh discipline when the child was 3 years. Children's internalizing and externalizing problems were assessed by parental reports and child interview at age 6. Findings from structural equation modeling showed that the association between a maternal maltreatment history and her offspring's externalizing problems was explained by maternal hostility and harsh discipline and, at least partially, also by paternal hostility and harsh discipline. Child interview data provided support for both these indirect paths, with associations largely similar to those observed for parent reports. [ABSTRACT FROM AUTHOR]

Background Social withdrawal is a core neuropsychiatric phenomenon in developmental psychopathology. Its presence predicts psychopathology across many domains, including depression, psychosis, autism, anxiety, and suicide. Withdrawn behavior is highly heritable, persistent, and characteristically worsens without intervention. To date, few studies have successfully identified genetic associations with withdrawn behavior, despite the abundance of evidence of its heritability. This may be due to reliance of categorical over dimensional measures of the behaviorally inhibited phenotype. The aim of this study is to identify associations between known psychiatric candidate genes and a dimensionally derived measure of withdrawn behavior. Methods Genetic information was collected on 20 single-nucleotide polymorphisms ( SNPs) from a custom-designed SNP chip and TAQMAN arrays of 4 variable number of tandem repeat ( VNTR) genes for 551 individuals from 187 families. Linear mixed modeling was employed to examine the relationship between genotypes of interest and Child Behavior Checklist ( CBCL) Withdrawn Behavior Subscale Score ( WBS) while controlling for gender and age through multiple linear regressions. Results Withdrawn behavior was highly associated with polymorphism of the serotonin receptor 2A ( HTR2A) [ p = .009, estimate = 0.310 (bootstrap 95% CI 0.155-0.448), bootstrap p = .001] and of the alpha 2-adrenergic ( ADRA2A) [ p = .001, estimate = −0.310 (bootstrap 95% CI −0.479 to −0.126), bootstrap p = .001] genes after correction for gender and age. The association between withdrawn behavior and ADRA2A was stronger for younger children. Conclusions HTR2A and ADRA2A genes are associated with withdrawn behavior. This reinforces the role of catecholaminergic genes in the heritability of withdrawn behavior. [ABSTRACT FROM AUTHOR]

lthough relations of various parental psychological problems and family functioning with child development are well documented, it remains unclear whether specific prenatal or specific postnatal risk factors are independently associated with child emotional and behavioural problems, or whether observed associations can be explained by general parental psychopathology. Using a stepwise approach, we examined the effects of prenatal and postnatal parental depressive symptoms, prenatal and postnatal hostility of the parents, as well as prenatal family functioning on the risk of child emotional and behavioural problems. This study was embedded in Generation R: a population-based cohort from foetal life onwards. Mothers and fathers of 2,698 children provided information about depressive symptoms, symptoms of hostility and family functioning during pregnancy and 3 years after birth. Mother and father each reported on child behaviour when the child was 3 years old. Parental depressive symptoms increased the risk of child emotional and behavioural problems, but this increase was explained by postnatal parental hostile behaviour. Postnatal symptoms of hostility of mothers (OR = 1.34, p value <0.001) and postnatal symptoms of hostility of fathers (OR = 1.30, p value <0.001) each contributed independently to the risk of child emotional and behavioural problems. Postnatal parental hostility is associated with an increased risk of child emotional and behavioural problems, independent of parental depressive symptoms. These findings suggest that prevention and intervention strategies should focus on psychological symptoms of both mothers and fathers, in particular on hostile behaviour, in families with young children. [ABSTRACT FROM AUTHOR]

Background: The Child Behavior Checklist Juvenile Bipolar Disorder (CBCL-JBD) profile and Posttraumatic Stress Problems (CBCL-PTSP) scale have been used to assess juvenile bipolar disorder (JBD) and posttraumatic stress disorder (PTSD), respectively. However, their validity is questionable according to previous research. Both measures are associated with severe psychopathology often encompassing multiple DSM-IV diagnoses. Further, children who score highly on one of these scales often have elevated scores on the other, independent of PTSD or JBD diagnoses. We hypothesized that the two scales may be indicators of a single syndrome related to dysregulated mood, attention, and behavior. We aimed to describe and identify the overlap between the CBCL-JBD profile and CBCL-PTSP scales. Method: Two thousand and twenty-nine (2029) children from a nationally representative sample (1073 boys, 956 girls; mean age = 11.98; age range = 6–18) were rated on emotional and behavior problems by their parents using the CBCL. Comparative model testing via structural equation modeling was conducted to determine whether the CBCL-JBD profile and CBCL-PTSP scale are best described as measuring separate versus unitary constructs. Associations with suicidality and competency scores were also examined. Results: The CBCL-JBD and CBCL-PTSP demonstrated a high degree of overlap ( r = .89) at the latent variable level. The best fitting, most parsimonious model was one in which the CBCL-JBD and CBCL-PTSP items identified a single latent construct, which was associated with higher parental endorsement of child suicidal behavior, and lower functioning. Conclusions: The CBCL-JBD profile and CBCL-PTSP scale overlap to a remarkable degree, and may be best described as measures of a single syndrome. This syndrome appears to be related to severe psychopathology, but may not conform to traditional DSM-IV classification. These results contribute to the ongoing debate about the utility of the CBCL-JBD and CBCL-PTSP profiles, and offer promising methods of empirically based measurement of disordered self-regulation in youth. [ABSTRACT FROM AUTHOR]

The Thought-Problem scale (TP) of the CBCL assesses symptoms such as hallucinations and strange thoughts/behaviors and has been associated with other behavioral disorders. This study uses parental reports to examine the etiology of variation in TP, about which relatively little is known, in 7-year-old twins. Parental ratings on TP were collected in 8,962 7-year-old twin pairs. Because the distribution of TP scores was highly skewed scores were categorized into 3 classes. The data were analyzed under a threshold liability model with genetic structural equation modeling. Ratings from both parents were simultaneously analyzed to determine the rater agreement phenotype (or common phenotype [TPc]) and the rater specific phenotype [TPs] that represents rater disagreement caused by rater bias, measurement error and/or a unique view of the parents on the child's behavior. Scores on the TP-scale varied as a function of rater (fathers rated fewer problems), sex (boys scored higher) and zygosity (DZ twins scored higher). The TPc explained 67% of the total variance in the parental ratings. Variation in TPc was influenced mainly by the children's genotype (76%). Variance in TPs also showed a contribution of genetic factors (maternal reports: 61%, paternal reports: 65%), indicating that TPs does not only represent rater bias. Shared environmental influences were only found in the TPs. No sex differences in genetic architecture were observed. These results indicate an important contribution of genetic factors to thought problems in children as young as 7 years. [ABSTRACT FROM AUTHOR]

Our objective was to examine the overlap between autistic traits and other behavioral problems in a general population sample, and explore the extent to which this overlap is due to genetic or environmental factors. Youth Self Report (YSR) data were collected in a general population sample of 424 twin pairs at 18 years of age, and their nontwin siblings. In 197 of these twin families, self-report ratings on the Autism-spectrum Quotient (AQ) were collected. Stepwise backward regression analyses revealed that of all 8 YSR syndrome scales, the Withdrawn Behavior (WB) and Social Problems (SOC) scale were the most important predictors of AQ scores, and together with sex, explained 23% of the variance in AQ scores. Genetic structural equation modeling showed that the overlap between AQ and WB and SOC was mainly due to genetic effects. About half of the genetic variance in AQ scores was specific to the AQ, with the remaining half shared with genetic variance in WB and SOC. Endorsement of autistic traits in a general population sample is associated with social and withdrawn behavioral problems and these problems partly share a common genetic etiology with autistic traits. However, most of the variance in AQ scores remains unexplained by YSR scores, and half of the genetic variance in AQ is unshared with WB and SOC. These results indicate that autistic traits have specific characteristics that are substantially genetically independent from other common but related behavioral domains such as social problems and withdrawn behavior. [ABSTRACT FROM AUTHOR]

More boys than girls with attention deficit hyperactivity disorder (ADHD) receive treatment. One explanation for this bias may be that boys score higher on disruptive behavior scales than girls. Although this was supported by findings in clinical samples, recent studies in nonreferred samples showed that boys and girls with ADHD are similar with respect to their levels of disruptive behavior as reported by their mother. In this report, we investigate whether the difference in treatment rate is associated with higher teacher problem scores in boys with ADHD than in girls with ADHD. Data were obtained from mothers and teachers in a nonreferred sample of 283 boys and 291 girls with and without ADHD. Children were selected when they scored either low (controls) or high (probands) on attention problems. Mothers completed DSM-IV interviews, Child Behavior Checklists (CBCL) and the Conners Rating Scale (CRS). Teachers filled in the Teacher Report Form (TRF), and the CRS. Boys and girls with ADHD had similar levels of psychiatric illness and school impairment (such as being held back, special class placement and learning problems) by mother report. Mothers reported similar levels of aggression and attention problems in boys and girls with ADHD. In contrast, teachers consistently rated boys with ADHD as having higher scores on reports of attention problems and aggression than girls with ADHD. Gender differences vary across settings: boys and girls with ADHD are rated as behaving differently at school, but not at home. The higher level of teacher reported problem behavior at school may explain the high male-female ratio for ADHD in clinical settings. These findings have implications for the results of genetic studies that rely on referred samples, as these studies may give a distorted view of sex differences in the population. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to determine a score on the Obsessive Compulsive Scale (OCS) from the Child Behavior Checklist (CBCL) to screen for obsessive compulsive disorder (OCD) in children and to rigorously test the specificity and sensitivity of a single cutpoint. Methods: A receiver operating characteristic (ROC) curve analysis was applied to data from 61 patients with clinically determined OCD, 64 clinical controls and 73 general population controls to determine the best sum score on the CBCL-OCS to predict confirmed OCD in children. Using the ROC-determined cutoff, this score was applied to a national sample of CBCL data from 2460 singleton children ages 4–18 and to 20,016 children ages 7–18 from three large general population twin samples to determine the estimated prevalence in the general population. Results: Using a CBCL-OCS score of 5 demonstrated an area under the curve (AUC) of .88 with high sensitivity (92%) and moderate specificity (67%) compared to clinical controls. Compared to the general population controls, the AUC was .96 with high sensitivity (92%) and specificity (89%). In the twin samples, the number of participants with CBCL-OCS scores above this cutpoint was 2.3–7.1%. Conclusions: These findings suggest that the OCS of the CBCL may provide a highly effective way to screen for childhood OCD, and that the prevalence of childhood OCD may have been underestimated, thus prompting the need for further research into screening children for this condition. [ABSTRACT FROM AUTHOR]

Background: No clear consensus has been reached yet on how best to characterize children who suffer from pediatric bipolar disorder (PBD). The CBCL-PBD profile on the Child Behavior Checklist (CBCL) has been consistently reported showing deviant findings on the Attention Problems, Aggressive Behavior, and Anxious-Depressed subscales. Aim: To examine the sensitivity and specificity of the proposed CBCL-PBD profile for determining DSM diagnosis of PBD. Methods: We applied receiver operating characteristic (ROC) curve analysis to data from 471 probands from two family studies of attention-deficit hyperactivity disorder and their 410 siblings. Results: The CBCL-PBD score demonstrated an area under the curve (AUC) of 0.97 for probands and 0.82 for siblings for current diagnosis of PBD, suggesting that the CBCL-PBD provided a highly efficient way of identifying subjects with a current diagnosis of PBD in this sample. Conclusions: These findings suggest that the CBCL-PBD may provide a highly efficient way of screening for childhood bipolar disorder. [ABSTRACT FROM AUTHOR]

Background: No consensus has been reached yet on how best to characterize children with juvenile bipolar disorder (JBD). Several groups have shown that children on the attention problems (AP), aggressive behavior (AGG), and anxious-depressed (AD) syndromes of the Child Behavior Checklist (CBCL) are likely to meet criteria for DSM-JBD. We aimed to use a large population-based twin sample to evaluate the prevalence and genetic architecture of the CBCL-JBD (deviant on AP, AGG, and AD) phenotype and compare these data to children who are deviant on just the CBCL-AP syndrome. Methods: Structural equation modeling (SEM) was applied to CBCL data from 5418, 3562, and 1971 Dutch twin pairs at ages 7, 10, and 12 years. Results: The CBCL-JBD phenotype occurs in ∼1% of children at each age. Among the children who meet criteria for the CBCL-AP phenotype (∼ 5%), between 13 and 20% also meet criteria for CBCL-JBD. The best SEM for CBCL-JBD includes additive genetic, shared and unique environmental factors. The best SEM for CBCL-AP includes dominant and additive genetic and unique environmental factors. Conclusions: These data suggest that CBCL-JBD is common, and even more common among children who have severe attention problems. CBCL-JBD shows familial aggregation due to both genetic and shared environmental factors. [Copyright &y& Elsevier]

Objective: To estimate the genetic and environmental contributions to oppositional defiant behavior (ODB) from mother, father, and teacher report using the Conners Revised Short Forms in a large twin sample. Method: ODB data were collected from 1,595 mothers, 1,114 fathers, and 793 teachers of 7-year-old twin pairs from the Netherlands Twin Registry in the 1990-1992 cohort with an 80% response rate. Models were fit for each informant to determine the genetic, environmental, gender, and informant influences on ODB. Results: Genetic analyses of the ODB quantitative scale showed additive genetic (A) by mother (55%), by father (57%), and by teacher (21% girls, 38% boys) unique environmental (E) (mother, 22%; father, 29%; teacher, 48% girls, 39% boys) and shared environmental (C) (mother, 14%; father, 23%; teacher, 31 % girls, 23% boys) influences. Conclusions: Additive genetic and unique environmental factors account for the majority of the influences on ODB for boys and girls by all informants. [ABSTRACT FROM AUTHOR]

Objective: The majority of published reports on twin studies of attention deficit hyperactivity disorder (ADHD) have indicated robust additive genetic influences and unique environmental influences. These studies typically used DSM ADHD symptoms collected by telephone or interviews with mothers. The purpose of this study was to test the genetic architecture of ADHD by using the ADHD index from Conners' Rating Scales—Revised. Method: From the Conners' scale forms, data for the ADHD index were collected from the mothers of 1,5957-year-old twin pairs from the Netherlands Twin Registry. Rates of ADHD diagnoses were computed by using Conners' gender- and age-specific cutoff points. Contributions from additive, dominant, unique environmental, interaction, and gender effects were computed by using gender-genetic models. Results: The prevalence of ADHD across the sample of 7-year-old twin pairs was about 4% according to the mothers' reports, consistent with other reported rates of ADHD. However, using the gender norms provided with the ADHD index, the authors found slightly higher rates of ADHD in girls than previously reported. Genetic analyses yielded a model that includes genetic dominance (48%), additive genetic factors (30%), and unique environmental factors (22%). Conclusions: The ADHD index from Conners' Rating Scales—Revised identified an appropriate percentage of children across this epidemiologic twin sample as being at risk for ADHD. The results of the genetic analyses are consistent with prior reports that ADHD is predominantly influenced by genetic factors that are both dominant and additive. [ABSTRACT FROM AUTHOR]

This study examines the diagnostic accuracy of the CBCL syndrome AS scales for predicting DSM-IV Attention Deficit-Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder with or without Conduct Disorder (ODD/CD). The sample included 370 children (187 probands and 183 siblings) participating in a family genetic study of attention and aggressive behavior problems. Univariate and stepwise logistic regression analyses were used to derive models for predicting two diagnostic conditions: ADHD and ODD/CD. The Attention Problems syndrome significantly predicted ADHD, and ODD/CD was significantly predicted by the Aggressive Behavior syndrome. Both scales demonstrated good diagnostic accuracy, as assessed through receiver operating characteristics analyses. Cut-point analyses confirmed the utility of low T-scores, 55 on the respective syndromes, for efficiently discriminating cases from noncases. CBCL syndromes display good diagnostic efficiency for assessing common externalizing disorders in children. [ABSTRACT FROM AUTHOR]

Context We have reported elsewhere on the development of an 8-item Obsessive-Compulsive Scale (OCS) contained in the Child Behavior Checklist (CBCL) to identify children who meet criteria for DSM-IV obsessive-compulsive disorder. Twin studies of obsessive-compulsive disorder have indicated a significant genetic component to its expression. Objective To determine the relative contributions of genetic and environmental influences on childhood obsessive-compulsive behavior using the CBCL OCS in twin samples. Design The CBCL data were received by survey of twins in the Netherlands Twin Registry (NTR) and the Missouri Twin Study (USA/MOTWIN). Setting General community twin samples. Participants Participants were 4246 twin pairs aged 7 years, 2841 aged 10 years, and 1562 aged 12 years (who also participated in the study at 7 and 10 years of age) from the NTR and 1461 mixed-age twin pairs (average age, approximately 9 years) from the USA/MOTWIN. Main Outcome Measures Model fitting to test for genetic and environmental influences, sex differences, and sibling interaction/rater contrast effects on the CBCL OCS. Results In each case, the best-fitting model was one that indicated significant additive genetic influences (range, 45%-58%; 95% confidence interval [CI], 45%-61%), and unique environmental influences (range, 42%-55%; 95% CI, 39%-55%), with shared environmental influences in the NTR sample aged 12 years (16%). Sex differences were seen in the mixed-age USA/MOTWIN model, but not in the NTR samples. No evidence of dominance, sibling interaction, or rater-contrast effects was seen. These data were relatively consistent across age and cultures. Conclusions The CBCL OCS is influenced by genetic factors (approximately 55%) and unique environmental factors (approximately 45%) in the younger sample, with common environmental influences only at 12 years of age. These effects do not vary with differences in sex or sibling interaction/rater contrast effects. Our data reveal higher genetic influences for obsessive-compulsive behavior and do not demonstrate genetic differences across sex. [ABSTRACT FROM AUTHOR]

Objective: Studies on 3-, 7-, and 10-year-old twins' internalizing and externalizing problems have emphasized the importance of understanding sources of agreement and disagreement between maternal and paternal ratings. A psychometric model that assumes that each parent assesses rater-specific aspects of the child's behavior provided the best explanation for parental disagreement. This study investigates two models that have been used to explain the agreement and disagreement between mothers and fathers in the ratings of their children. Method: Child Behavior Checklists filled in by mothers and fathers were collected for a sample of 1,481 twelve-year-old twin pairs. Genetic and environmental influences on Internalizing and externalizing problems were estimated using models that corrected for rater bias, rater-specific effects, and unreliability. Results: The psychometric model fitted the data significantly better than a rater bias model. Significant influences of genetic, shared, and nonshared environmental factors were found for internalizing and externalizing behavior. Parent-specific views, rater bias, and unreliability were significant. Conclusions: The best-fitting model implies that disagreement between parents is due to the fact that mothers and fathers provide information from their own perspective. This information should be seen as important and adding to the diagnostic formulation rather than as a point of disagreement. The finding that internalizing and externalizing problems are influenced by genetic and environmental factors fosters the understanding that it is the interaction of nature and nurture that puts children at risk for common behavioral disorders. Key Words: parental rating; rater bias; problem behavior; twins. [ABSTRACT FROM AUTHOR]

Objective: To study familial and nonfamilial environmental influences on attention problems and attention-deficit/hyperactivity disorder (ADHD) in monozygotic twins discordant and concordant-high and low for these traits.Method: Ninety-five twin pairs from The Netherlands Twin Register were selected. Longitudinal survey data were collected at 1, 2, 3, 5, 7, 10, and 12 years from parents, twins, and teachers. Mothers participated in a structured clinical interview when twins were between 10 and 17 years of age.Results: Affected twins from discordant pairs scored higher than unaffected cotwins on multiple measures of attention problems, ADHD, and other behavior problems according to mother, teacher, and self. Behavioral discordance was evident at age 2 and all subsequent measurements. Compared with unaffected cotwins, affected twins had lower birth weight and delayed physical growth and motor development. Differences between discordant and concordant groups were reported for maternal smoking, sleeping in different rooms, and living with only one parent.Conclusions: Significant markers of ADHD are found in infancy and include low birth weight and delayed motor development. As the knowledge of specific genetic and environmental influences on ADHD increases, future studies may focus on their complex interplay. [ABSTRACT FROM AUTHOR]

Abstract Background Studies of white matter connectivity in children with disruptive behavior have yielded inconsistent results, possibly owing to the trait's heterogeneity, which comprises diverse symptoms like physical aggression, irritability, and delinquency. This study examined associations of global and specific white matter connectivity with childhood disruptive behavior problems, while accounting for their complex multidimensionality. Methods In a large cross-sectional population-based study of 10-year-old preadolescents (n = 2567), we assessed four previously described empirically derived dimensions of disruptive behavior problems using the Child Behavior Checklist: physical aggression, irritability, disobedient behavior, and delinquent behavior. Global and specific white matter microstructure was assessed by diffusion tensor imaging. Results Global fractional anisotropy and mean diffusivity were not associated with broad measures of disruptive behavior, e.g., Child Behavior Checklist externalizing problems scale. Global fractional anisotropy was negatively associated with delinquent behavior (β = −.123, p false discovery rate adjusted =.028) and global mean diffusivity was positively associated with delinquent behavior (β =.205, p false discovery rate adjusted < 0.001), suggesting reduced white matter microstructure in preadolescents with higher levels of delinquent behavior. Lower white matter microstructure in the inferior longitudinal fasciculus, superior longitudinal fasciculus, cingulum, and uncinate underlie these associations. Global white matter microstructure was not associated with physical aggression, irritability, or disobedient behavior. Conclusions Delinquent behavior, a severe manifestation of childhood disruptive behavior, was associated with lower white matter microstructure in tracts connecting frontal and temporal lobes. These brain regions are involved in decision making, reward processing, and emotion regulation. This study demonstrated that incorporating the multidimensional nature of childhood disruptive behavior traits shows promise in advancing the search for elucidating neurobiological correlates of disruptive behavior. [ABSTRACT FROM AUTHOR]

Objective: Children with co-occurring internalizing and externalizing problems have higher levels of impairment and worse outcomes later in life, but it is unclear whether these children can be distinguished validly from children who have problems in a single domain. We used a person-centered statistical approach to examine whether a group of children with co-occurring internalizing and externalizing problems can be identified in a general-population sample of young children. Method: This study included a population-based sample of 6,131 children, aged 5 through 7 years. Mothers (92.6%) reported emotional and behavioral problems using the Child Behavior Checklist/1.5-5 (CBCL). A latent profile analysis was performed on the CBCL syndrome scales. Identified classes were compared on early socioeconomic and parental risk factors using multinomial logistic regression. Results: We identified 4 classes, as follows: a class scoring high on all internalizing and externalizing scales (1.8%); a class with internalizing problems (5.3%); a class with externalizing problems and emotional reactivity (7.3%); and a class without problems (85.6%). The first class, with co-occurring problems, was associated with higher levels of maternal and paternal affective symptoms and hostility than the other 3 classes. Conclusions: The class with co-occurring internalizing and externalizing problems appears to be highly similar to the CBCL Dysregulation Profile described in older children. This empirically based dysregulation profile offers a promise to the study of the development of poor self-regulation. [ABSTRACT FROM AUTHOR]

The article presents a 14-year follow up study which investigates the adult outcomes of children with severe self-regulation problems in Dutch population. The study conducted Child Behavior Checklist-Dysregulation Profile (CBCL-DP) among 2,076 from 13 birth cohorts 4 to 6 years of age. Results reveal the link between anxiety and disruptive behavior disorders with the CBCL-DP remains after controlling co-occurring disorders in adulthood.

Background: Little is known about the stability of obsessive-compulsive (OC) behavior during childhood. The objective of this study is to determine the developmental stability of pediatric OC behavior and the genetic and environmental influences on stability in a large population-based twin sample. Methods: Maternal and paternal ratings on the 8-item Obsessive Compulsive Scale of the Child Behavior Checklist (CBCL-OCS) on Dutch mono- and dizygotic twin pairs from 8083 families were collected at ages 7, 10, and 12 years. Using a longitudinal twin design, stability of OC behavior and genetic and environmental influences on stability were determined. Using cutoff criteria, persistent, resilient, and new onset cases were identified in this sample. Results: OC behavior assessed by the CBCL-OCS showed a moderate stability with phenotypic correlations of around .50 for boys and for girls. Stability of OC behavior was influenced by genetic factors, by environmental factors shared by children growing up in the same family, and by non-shared environmental factors. Stability for OCS was lower when categorical data were analyzed than when quantitative definitions were used. Conclusions: OC behavior is moderately stable in childhood. Stability of OC behavior is influenced by genetic, shared, and non-shared environmental factors. [Copyright &y& Elsevier]

Background: The Child Behavior Checklist–juvenile bipolar disorder phenotype (CBCL-JBD) is a quantitative phenotype that is based on parental ratings of the behavior of the child. The phenotype is predictive of DSM-IV characterizations of BD and has been shown to be sensitive and specific. Its genetic architecture differs from that for inattentive, aggressive, or anxious–depressed syndromes. The purpose of this study is to assess the developmental stability of the CBCL-JBD phenotype across ages 7, 10, and 12 years in a large population-based twin sample and to examine its genetic architecture. Methods: Longitudinal data on Dutch mono- and dizygotic twin pairs (N = 8013 pairs) are analyzed to decompose the stability of the CBCL-JBD phenotype into genetic and environmental contributions. Results: Heritability of the CBCL-JBD increases with age (from 63% to 75%), whereas the effects of shared environment decrease (from 20% to 8%). The stability of the CBCL-JBD phenotype is high, with correlations between .66 and .77 across ages 7, 10, and 12 years. Genetic factors account for the majority of the stability of this phenotype. There were no sex differences in genetic architecture. Conclusions: Roughly 80% of the stability in childhood CBCL-JBD is a result of additive genetic effects. [Copyright &y& Elsevier]

Background: The Child Behavior Checklist (CBCL) has been used to provide a quantitative description of childhood bipolar disorder (BPAD). Many have reported that children in the clinical range on the Attention Problems (AP), Aggressive Behavior (AGG), and Anxious-Depressed (A/D) syndromes simultaneously are more likely to meet the criteria for childhood BPAD. The purpose of this study was to determine if Latent Class Analysis (LCA) could identify heritable phenotypes representing the CBCL-Juvenile Bipolar (CBCL-JBD) profile and whether this phenotype demonstrates increased frequency of suicidal endorsement. Methods: The CBCL data were received by survey of mothers of twins in two large twin samples, the Netherlands Twin Registry. The setting for the study was the general community twin sample. Participants included 6246 10-year-old Dutch twins from the Netherlands Twin Registry. The main outcome measure consisted of the LCA on the items comprising the AP, AGG, and A/D subscales and means from the suicidal items #18 and #91 within classes. Results: A 7 class model fit best for girls and an 8 class fit best for boys. The most common class for boys or girls was one with no symptoms. The CBCL-JBD phenotype was the least common—about 4%–5% of the boys and girls. This class was the only one that had significant elevations on the suicidal items of the CBCL. Gender differences were present across latent classes with girls showing no aggression without the CBCL-JBD phenotype and rarely showing attention problems in isolation. Evidence of high heritability of these latent classes was found with odds ratios. Conclusions: In a general population sample, LCA identifies a CBCL-JBD phenotype latent class that is associated with high rates of suicidality, is highly heritable, and speaks to the comorbidity between attention problems, aggressive behavior, and anxious/depression in children. [Copyright &y& Elsevier]