High Correspondence Between Child Behavior Checklist Rule Breaking Behavior Scale with Conduct Disorder in Males and Fem
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ORIGINAL ARTICLE
High Correspondence Between Child Behavior Checklist Rule Breaking Behavior Scale with Conduct Disorder in Males and Females Amy M. Yule1,2,3,5 · Maura DiSalvo1 · Timothy E. Wilens1,2 · Janet Wozniak1,2 · Stephen V. Faraone4 · Rachael M. Lyons1 · K. Yvonne Woodworth1 · Joseph Biederman1,2
© Springer Science+Business Media, LLC, part of Springer Nature 2020
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. Keywords Child behavior checklist (CBCL) · Rule breaking behavior · Conduct disorder · Children
Introduction Conduct disorder (CD) is a childhood onset, prevalent, and morbid psychiatric disorder estimated to affect up to 7% of youth in the United States [1–3]. CD is characterized by “a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated,” as defined in the Diagnostic and * Amy M. Yule [email protected] 1
Pediatric Psychopharmacology Program, Division of Child Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA
2
Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA
3
Department of Psychiatry, Boston Medical Center, 720 Harrison Ave., Boston, MA 02118, USA
4
Department of Psychiatry, SUNY Upstate Medical University, 750 East Adams St., Syracuse, NY 13210, USA
5
Boston Medical Center, 720 Harrison Ave., Suite 915, Boston, MA 02118, USA
Statistical Manual of Mental Disorders, fifth edition (DSM 5) [4]. CD is more prevalent in males than in females [1, 5], and frequently co-occurs with other psychiatric disorders [6–8]. When CD co-occurs with other psychiatric disorders in the clinical setting the diagnosis of CD may not always be considered due to the higher acuity and therapeutic opportunities for the co-occurring disorders. Yet, CD is associated with se
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