Diagnostic efficiency and validity of the DSM-oriented Child Behavior Checklist and Youth Self-Report scales in a clinical sample of Swedish youth
Open accessAbstract
The Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) are widely used measures of psychiatric symptoms and lately also adapted to the DSM. The incremental validity of adding the scales to each other has not been studied. We validated the DSM subscales for affective, anxiety, attention deficit/hyperactivity (ADHD), oppositional defiant (ODD), conduct problems (CD), and obsessive-compulsive disorder (OCD) in consecutively referred child and adolescent psychiatric outpatients (n = 267) against LEAD DSM-IV diagnoses based on the K-SADS-PL and subsequent clinical work-up. Receiver operating characteristic analyses showed that the diagnostic efficiency for most scales were moderate with an area under the curve (AUC) between 0.70 and 0.90 except for CBCL CD, which had high accuracy (AUC>0.90) in line with previous studies showing the acceptable utility of the CBCL DSM scales and the YSR affective, anxiety, and CD scales, while YSR ODD and OCD had low accuracy (AUC<0.70). The findings mostly reveal incremental validity (using logistic regression analyses) for adding the adolescent to the parent version (or vice versa). Youth and parent ratings contributed equally to predict depression and anxiety disorders, while parent ratings were a stronger predictor for ADHD. However, the youth ADHD rating also contributed. Adding young people as informants for ODD and OCD or adding the parent for CD did not improve accuracy. The findings for depression, anxiety disorders, and ADHD support using more than one informant when conducting screening in a clinical context.
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The CBCL's DSM-oriented scales for depression, anxiety disorders, ADHD, somatic symptoms, ODD, and conduct disorders can be used in clinical settings for screening for psychopathology based on the DSM classification system and enhancing diagnostic assessment.
“Although the scores in the clinical range for specific DSM-oriented scales of the CBCL are not directly equivalent to the corresponding specific diagnosis [41, 42], the CBCL’s DSM-oriented scales for depression, anxiety disorders, ADHD, somatic symptoms, ODD, and conduct disorders can be used in clinical settings for screening for psychopathology based on the DSM classification system and”
From Screen time and mental health: a prospective analysis of the Adolescent Brain Cognitive Development (ABCD) Study (2024) · cites this paper as [40]
Studies have demonstrated an acceptable correspondence between the CBCL DSM-oriented scales and DSM diagnoses.
“Studies have demonstrated an acceptable correspondence between the DSM-oriented scales and DSM diagnoses [33–40].”
From Screen time and mental health: a prospective analysis of the Adolescent Brain Cognitive Development (ABCD) Study (2024) · cites this paper as [40]
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- Authors
- Skarphedinsson, G., Jarbin, H., Andersson, M., & Ivarsson, T.
- Affiliations
- Lund University (SE)
- University of Gothenburg (SE)
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2021-07-22
- Volume
- 16
- Issue
- 7
- Pages
- e0254953
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC8297893
- OpenAlex
- W3185149730
- Cited by
- 29
- References
- 49
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 6 · 2023: 2 · 2022: 5 · 2021: 1
- FWCI
- 2.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Opin vísindi (Opin vísindi) (submittedVersion, cc-by-nc-sa)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Lund University Publications (Lund University) (submittedVersion)
- Opin vísindi (Opin vísindi) (submittedVersion, cc-by)
- Funders
- Stiftelsen Kronprinsessan Margaretas Arbetsnämnd för Synskadade (2008-22893)
- Development and Education (FoUU) within Region Halland, Sweden (MA, 110361)
- Development and Education (FoU) within Region Skåne, Sweden (133821)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- Child Behavior Checklist, Youth Self-Report, diagnostic validity, incremental validity, child and adolescent psychiatry, depression, anxiety disorders, attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, obsessive-compulsive disorder, screening, Swedish youth
- MeSH terms
- Adolescent, Adolescent Behavior, Anxiety, Attention Deficit Disorder with Hyperactivity, Child, Child Behavior, Female, Humans, Male, Sweden, Checklist, Self Report
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