doi: psychologica

213Psychologica Belgica2011 51-34 213-235

Caroline Braet Department of Developmental Personality and Social Psychology JustineCallens and Mark Schittekatte Testpracticum Veerle Soyez Department of Special Edu-cation Celina Druart Department of Data Analysis Herbert Roeyers Department ofExperimental Clinical and Health Psychology All authors are affiliated with Ghent Univer-sityWe thank the Faculty of Psychology and Educational Sciences of Ghent University for theirfinancial supportCorrespondence concerning this article should be addressed to Caroline Braet Departmentof Developmental Personality and Social Psychology H Dunantlaan 2 B-9000 Gent E-mail CarolineBraetUGentbe

ASSESSING EMOTIONAL AND BEHAVIOURAL PROBLEMS WITH THE CHILD BEHAVIOUR CHECKLIST

EXPLORING THE RELEVANCE OF ADJUSTING THE NORMS FOR THE FLEMISH COMMUNITY

Caroline BRAET Justine CALLENS Mark SCHITTEKATTE Veerle SOYEZ Celina DRUART amp Herbert ROEYERS

Ghent University

The Child Behaviour Checklist (CBCL) is one of the most frequently useddimensional instruments for screening behavioural and emotional problems inchildren In this study the psychometric properties of the CBCL 2001-versionand the usefulness of existing US norms within a Flemish community samplewere explored Mothers of young children (N = 170) and school-aged childrenand adolescents (N = 718) completed the CBCL and the Strengths and Diffi-culties Questionnaire (SDQ) Reliability of both the CBCL1frac12-5 and CBCL6-18 was excellent There were substantial correlations between the SDQ andCBCL scales indicating a good concurrent validity Significant differenceswere found when comparing the mean CBCL raw scores of the different sub-samples (for different ages and gender groups) with the US norms Generallyspoken the mean CBCL raw scores as well as the clinical and borderline clin-ical cutpoints for Flemish children were mostly lower specifically for the TotalProblems score and the Externalising scales

Introduction

It is generally accepted that assessment of psychological problems in childrenand adolescents should not be delayed until these problems reach more seri-ous levels and more intensive and expensive interventions are required (Braetamp van Aken 2006 Costello amp Angold 2000 Culbertson 1993 Tick van derEnde amp Verhulst 2007) Additionally the high prevalence rates of psycho-pathology among children as demonstrated by research in random samplescompared to the relatively low number of referrals to specialised care illus-trate that it is crucial to screen children in community samples (BurnsPhilips Wagner Barth Kolko Campbell et al 2004) To identify at-risk

psychobelg2011_3-4book Page 213 Tuesday November 8 2011 1041 AM

Guest
Typewritten Text
DOI httpdxdoiorg105334pb-51-3-4-213

214 ASSESSING EMOTIONAL AND BEHAVIOURAL PROBLEMS

children mental health professionals need reliable and valid screening meth-ods for behavioural and emotional problems in children However screeningthrough observation or interview is a great burden and these methods are gen-erally neither very reliable nor cost-effective (Jensen amp Weisz 2002) There-fore rating scales with clear cutpoints are seen as lsquogolden standardsrsquo for mon-itoring youth with mental problems and to select potential cases for furtherassessment However the appropriateness of these instruments is still understudy

Determining cutpoints for screening instruments implies they have beentested on their sensitivity and specificity to identify cases whereby thenumber of false positives and false negatives is kept as low as possible More-over the norm group upon which they rely must meet the highest criteriaregarding representativeness according to the community they refer toAlthough for the Flemish community (Dutch speaking part of Belgium) normgroups are already available for some small-band problems like disruptivebehaviour disorders (Oosterlaan Baeyens Scheres Antrop Roeyers amp Ser-geant 2008) or depression (Timbremont Braet amp Roelofs 2008) hardly anynorm groups are available for broad-band screening instruments in Dutchspeaking samples Up to now only one study (Van Leeuwen MeerschaertBosmans De Medts amp Braet 2006) discussed the use of a general screeninginstrument and provided norms for 4- to 7-year-old children In the meantime screening instruments developed in US are widely used in clinical prac-tice without investigating empirically whether the norms and cutpoints ofthese instruments are appropriate for the Flemish community Although someimpressive studies already tested the robustness of screening instrumentsacross diverse cultures (Achenbach Becker Doumlpfner Heiervang RoessnerSteinhausen et al 2008 Crijnen Achenbach amp Verhulst 1997 IvanovaAchenbach Dumenci Almqvist Weintraub Bilenberg et al 2007 Res-corla Achenbach Ivanova Dumenci Almqvist Bilenberg et al 2007) sev-eral authors are convinced that as long as norm groups for specific popula-tions with specific instruments are lacking the assumption cannot beaccepted that norms are omnicultural (Petot Petot amp Achenbach 2008) Thisis specifically relevant in the 21st century characterised by new economicproblems new family structures millions of immigrants and blending of dif-ferent subcultures within and between communities (Achenbach et al 2008)

The most frequently used method in Flanders to screen for behaviouraland emotional problems is Achenbachrsquos Empirically Based Assessment sys-tem (ASEBA) (Schittekatte Bos Spruyt Germeijs amp Stinissen 2003) Thesystem which is based on observation of children in US epidemiologicalstudies (Achenbach amp Rescorla 2001) comprises different versions of childparent and teacher instruments according to the age of the child in order toallow for multi-informant assessment For children between 6 and 18 years


CAROLINE BRAET et al 215

the Child Behaviour Checklist (CBCL Achenbach amp Rescorla 2001) is oneof the most important instruments of ASEBA and translated versions wereadopted in more than 30 societies Using parent reports on the preceding sixmonths it assesses 118 different emotional or behaviour problems Items arescored on a three-point scale allowing the calculation of broader-band scalescores The scores are categorised in eight domain-specific syndrome scalesas well as in two broad-band scales Internalising and Externalising problemsThe checklist provides normalised T-scores with T-scores ge 64 defined ashigh (clinical cutpoint) for Internalising problems Externalising problemsand for the Total Problems score whereas for the eight domain-specificscales T-scores ge 70 are defined as high (clinical cutpoint)

The validity and reliability of the Child Behaviour Checklist (CBCLAchenbach 1991) has been demonstrated across different cultures includingthe Netherlands (De Groot Koot amp Verhulst 1994) and Belgium (Hell-inckx Grietens amp Verhulst 1994) Concurrent validity is often demon-strated via a comparison with The Strengths and Difficulties Questionnaire(SDQ Goodman 1997) This is a rather new and brief measure also aimingto screen for behavioural and emotional problems in children and adoles-cents In a Flemish sample of 4-8 year olds correlations between the SDQand the CBCL were quite high and varied between 61 and 74 (Van Leeuwenet al 2006) A more recent Flemish study (Janssens amp Deboutte 2009)comparing parent versions of both instruments in a clinical sample revealedcorrelations of 81 for the Total Problems score and the Externalising scaleand 70 for the Internalising scale demonstrating excellent validity for theCBCL While these concurrent validity findings are very promising it mustbe noted that both studies employed the CBCL-1991 version In the revisedversion of the CBCL (Achenbach amp Rescorla 2001) a (limited) number ofitems that were unscored or rare were replaced with items that sharpen theassessment of important syndromes Most countries recently switched overto the use of this (translated) CBCL-2001 version but the psychometricproperties of the Dutch CBCL-2001 version have never been studied in Flan-ders Therefore the first aim of the present study is to replicate previous pos-itive findings concerning the reliability and concurrent validity of the CBCL-2001 version

So far only one study explored the construct validity of the 8-syndromestructure of the CBCL-1991 version in 30 different societies including chil-dren from the Netherlands France Turkey South-Korea as well as Flemishchildren (Hellinckx et al 1994 Ivanova et al 2007) Fit indices stronglysupported the 8-syndrome structure in each of the 30 societies and providedfirst evidence that patterning of problem items assessed by the CBCL is sim-ilar in all societies tested The authors concluded that although the CBCL wasdeveloped in the US and may assess problems that are particularly relevant



for US children the data suggest a somewhat lsquouniversalrsquo syndrome structuretapping the diverse problems of all children Furthermore Rescorla et al(2007) demonstrated additional support for the cross-cultural robustness ofthe CBCL Based on the same dataset and comparing the means on all the dif-ferent items parents belonging to 31 different societies rated their children ina very similar way (with an overall lsquonormalrsquo mean raw score of 225 on theTotal Problems scale) with some societies score 1 SD higher or lower and 19societies including Belgium within 1 SD Although the robustness of thestructure of the CBCL is quite convincing and provides a common languagebetween cultures we were more concerned whether the cutpoints of theCBCL 2001-version are not affected by small cultural differences and timetrends Therefore the second aim of the present study was to explore the use-fulness of the existing US norms for both the broad-band scales as well as forthe different syndrome scales for a representative sample of children and ado-lescents from the Flemish community

To conclude the objectives of the study are to examine some psychomet-ric properties of the CBCL1frac12-5 and CBCL6-18 in a community sample ofFlemish children between 1frac12 and 18 years of age In addition means stand-ard deviations and cutpoints will be analysed for the different age groups andfor both sexes which allows comparisons with findings in the US

Method

Participants

A representative sample of Flemish children and their parents was invited toparticipate in this study (selection procedure see below) Parents of 888 chil-dren divided in 170 CBCL1frac12-5 cases (84 boys and 86 girls) and 718CBCL6-18 cases (314 boys 404 girls) participated As Table 1 indicatesalmost half of the total sample (4640) was between 6 and 11 years oldFamilies were excluded when the mother mastered only a foreign languagewhen the age of the child did not fall within the age range when the child wasdiagnosed with a clinical DSM-disorder (eg dyslexia ADHD hellip) or whenfamilies were in psychological treatment with their child

Data collection took place via schools and day care centres between April2009 and February 2010 following a standardised procedure and with respectto stratification according to four inclusion criteria region educational sys-tem age and gender The selection of schools and day care centres was guidedby two important factors namely region (province and level of urbanisation)and educational system of the child About half of the schools agreed to par-ticipate in the study In each school there was a random selection of five chil-dren per grade with respect to a good distribution of different ages and



sexes[1] The community sample was considered to be representative for chil-dren between 1frac12 and 18 years old of the Dutch speaking part of Belgium (iethe Flemish community)

Instruments

Achenbach system of empirically based assessment (CBCLfrac12-5 and CBCL6-18) (Achenbach amp Rescorla 2001)

The Achenbach System of Empirically Based Assessment (ASEBA) isthe most frequently used set of dimensional instruments to assess child psy-chopathology In contrast to categorically based assessment this dimension-ally based assessment is characterised by a bottom-up approach by obtainingscores for specific descriptors of childrenrsquos functioning Initial items werebased on reviews of the clinical research literature and consultations with cli-nicians Additionally items were added or revised on the basis of findings inpsychiatric case records and feedback from different kinds of informants andresulted in the final versions (Achenbach et al 2008) Two forms were ofimportance here

Child Behaviour Checklist for 112 to 5 years CBCL112-5 TheCBCL112 -5 obtains information from parents or other guardians who knowthe child from a household context The questionnaire asks about child func-tioning by means of 100 items that are scored on a 3-point scale ranging from0 (not true) over 1 (somewhat or sometimes true) to 2 (very true or often true)The questionnaire was developed to assess the functioning of children duringthe last two months in a standardised format Current norms of theCBCL112-5 are based on a national US sample of parents of childrenbetween the age of 18 (1 year and 6 months) and 71 months old (5 years and11 months) without considerable physical or mental impairments and ofwhom the parentsguardians speak English Children who experienced astressful event or who were referred to mental health services or special edu-cation during the last 12 months were excluded from the group The scaleswere finally normed on a sample of 700 children (362 boys and 338 girls) Asgender and age differences were minimal in this age group only one normdata set was obtained After factor analysis on both norm groups sevendomain-specific syndrome scales were derived (Emotionally reactive Anx-iousDepressed Somatic complaints Withdrawn Sleep problems Attentionproblems Aggressive behaviour) as well as two broad-band factors (Inter-nalising problems and Externalising problems) Raw scores on the seven syn-

1 Comparison analyses cutpoints and T-scores are available upon request(see also httpwwwtestpracticumugentbe)



drome scales on both broad-band factors as well as a Total Problems scorecan be transformed into normalised T-scores Compared with the previousCBCL for this age group the age range 2-3 years was elaborated and spansnow ages 1frac12-5 years

Child Behaviour Checklist for 6 to 18 years CBCL6-18 The CBCL6-18obtains parentsrsquo reports of childrenrsquos behavioural and emotional problemsand competencies Problems are assessed by means of 118 items which arescored on a 3-point scale ranging from 0 (not true) over 1 (somewhat or some-times true) to 2 (very true or often true) and 3 open-ended items The currentnorms of the CBCL are based on a national US sample of 1753 children ofchildren between 6 and 18 years their parents and teachers Different normsare available for girls and for boys subdivided in two age groups (6-11 yearsand 12-18 years) Problem items are aggregated to provide scores on eightsyndrome scales (AnxiousDepressed WithdrawnDepressed Somatic com-plaints Social problems Thought problems Attention problems Rule-breaking behaviour Aggressive behaviour) that have been derived throughfactor analytic methods Additionally two intercorrelated broad-band factors(Internalising problems and Externalising problems) and a Total Problemsscore can be calculated As is the case for the CBCL112 -5 version scores onthe syndrome scales broad-band factors and Total Problems score can betransformed into normalised T-scores Finally the revised CBCL6-18 forschool-aged children also contains DSM-IV oriented scales(wwwasebaorg)

As Achenbach indicated in the 2001 Manual (Achenbach amp Rescorla2001) there are many ways to look at construct validity Regarding the inter-nal structure of the Dutch CBCL both confirmatory and exploratory factoranalyses were already conducted in the Netherlands (De Groot et al 1994De Groot Koot amp Verhulst 1996) They showed identical consistenciescompared with the exploratory and confirmatory factor analyses conductedon the original US version Further evidence is provided by Achenbach andRescorla (2007) with good fit indices for all 30 societies in the study exceptLebanon These findings already strongly supported the cross-cultural robust-ness of the CBCL-syndrome structure

The strengths and difficulties questionnaires (SDQ)

To study the concurrent validity of the ASEBA-instruments Dutch versionsof the SDQ ndash Strengths and Difficulties Questionnaires (SDQ Goodman1997 Dutch translation Treffers amp van Widenfelt 2000) (see van Widen-feldt Goedhart Treffers amp Goodman 2003 for a description of the transla-tion process) were used Like the ASEBA the SDQ assesses behavioural andemotional problems in youth and is available in different versions according



to age range and informant type (parents teachers and youth) The SDQ que-ries 25 items divided into five scales (four negative scales and one positivescale Emotional symptoms Conduct problems HyperactivityInattentionPeer relationship problems Prosocial behaviour) Each item is scored usinga 3-point Likert-scale (0 = not true 1 = somewhat true and 2 = certainly true)The scores for these subscales are compiled by adding the scores for the fivecorresponding items (some positively phrased items need to be recoded) Thesum of the first four scales aggregates to provide a Total Problems score Theage range of the SDQ questionnaires is somewhat smaller (3-16 years) com-pared to the ASEBA questionnaires but the SDQ for children until 4 years dif-fers only for 4 items compared with the 4-16 years version of the SDQ Thismakes it easier to compare SDQrsquos between all age groups compared with theASEBA questionnaires CBCL112-5 and CBCL6-18 Also the SDQ isshorter than the CBCL and it includes items asking for positive qualities ofthe child The psychometric properties of the Dutch version of the SDQ havebeen described in a Dutch (van Widenfeldt et al 2003) and Flemish (VanLeeuwen et al 2006) sample

Questionnaire recording demographic information

A self-developed questionnaire recording demographic data of the child wasdistributed as well This questionnaire probes for the following variablesdegree of urbanisationregion family situation age of primary caregiver cur-rent level of education of the child mother tongue highest level of educationof the parents professional activities of the parents ethnicity of the parentsand some questions on possible contacts with treatment settings or mentalhealth service use

Procedure

The Ethical committee of Ghent University approved the protocol of thisstudy After giving consent to participate the parents of the selected childrenwere asked to complete the CBCL as well as the SDQ and a self-developedquestionnaire to record demographic information Data collection took placevia schools and day care centres between April 2009 and February 2010 fol-lowing a standardised procedure Most schools were visited by the projectcoordinator (Justine Callens) or by university students (both volunteering stu-dents or in exchange for course credits) The tests were administered as partof a larger project Although multi-informant information was collected in thepresent study only findings on the CBCL and the SDQ are reported Theresponse rate was 335 for the CBCL1frac12-5 and 671 for the CBCL6-18For 823 of the CBCL data an SDQ equivalent was available In 264 cases



(411) questionnaires of both parents were available In those cases thequestionnaire as completed by the mother was used in the analysis for thispaper to enhance homogeneity Consequently as in twenty-two cases (34)only the fathers participated we decided to exclude them here

Analyses

Data analysis was performed using SPSS 160 and R 2121 First to obtaininformation on the internal consistency of the subscales Cronbachrsquos alphavalues were calculated Second one-way ANOVArsquos were run to comparescale scores between boys and girls and between different ages Independentsamples t-tests were performed to assess the deviance between the Flemishsample and the American norms

It is generally acknowledged that raw scale scores can differ dependingon the version that is used (Achenbach amp Rescorla 2001 p 166) Thereforein clinical practice the use of T-scores is preferred when interpreting the dataallowing also comparisons between scales with a different number of itemsand a different score distribution For each age group (a) a clinical cutpointfor the domain specific syndrome scales is determined as the minimum rawscore corresponding with T-score ge70 or 98th percentile while for the broad-band scales Internalising Externalising and Total Problems score this clini-cal cutpoint is determined as the minimum raw score corresponding to a T-score ge 64 or 92nd percentile (b) the borderline clinical range (eg rangebetween clinical and subclinical cutpoint) is defined here as the raw scorescorresponding with a T-score between 65 and 69 (93rd to 97th percentiles) forthe domain specific syndrome scales and a T-score between 60 and 63 for thebroad-band scales Internalising Externalising and Total Problems score (84th

to 90th percentiles) (Achenbach amp Rescorla 2001 p 24-25)Finally the concurrent validity was evaluated by computing the Pearson

product-moment correlation between equivalent CBCL and SDQ scales

Table 1The study group of Flemish children Distribution of age and gender

Age GroupGender

TotalBoys Girls

1frac12 - 05 84 86 17006 - 11 183 229 41212 - 18 131 175 306

Total 398 490 888



Results

Scale reliability

The internal consistency between the 100 items of the CBCL1frac12-5 was esti-mated by calculating Cronbachrsquos α reliability coefficient The internal con-sistency was high with α = 94 The internal consistencies of the Internalisingand Externalising scales are α = 84 and α = 89 respectively Also for theCBCL6-18 the Cronbachrsquos α reliability coefficient was calculated Similarto the CBCL112-5 the internal consistency between the 118 items was highwith α = 94 The internal consistencies of the Internalising and Externalisingscales are both α = 88

Comparison of the Flemish data with US norms

Child behaviour checklist for 112 to 5 years CBCL112-5

Table 2 presents an overview of the raw mean scores and standard deviationsfor the different subscales of the CBCL112-5 in both the Flemish sample (N= 170) and the American sample (N = 700) (Achenbach amp Rescorla 2001)Parallel to the American study of Achenbach and Rescorla (2007) the samplewas not further divided in smaller subgroups based on gender and age cate-gory

For 8 of the 10 scales the raw mean scores of the Flemish sample differedsignificantly from those of American children As can be seen in Table 2Flemish children between one and a half and five years have significantlylower mean scores for all scales except the syndrome scales EmotionallyReactive and Somatic complaints for which no significant differences inmean scores were found

In a second step after calculating the percentiles the equivalent cutpointsof the Flemish sample were compared to those of American children andadded in Table 2 For 7 scales the clinical cutpoint was lower compared toAmerican peers Regarding the borderline clinical cutpoints also 7 cutpointswere found to be lower For example for the broad-band scales Internalisingand Externalising the cutpoints differed 2 to 4 points (lower for Flemish chil-dren) while the borderline and clinical cutpoints for the Total Problems scalewere even 12 and 13 points lower respectively Differences between cut-points of the seven syndrome scales were less than 2 points except forAggressive behaviour where there was a 3 point difference for the borderlinecutpoint



Table 2Mean and standard deviations for raw scores and T-scores of the norm group

CBCL112-5 years United States versus Flemish study Cutpoints for each scale t-tests for raw scores

ScalesUnited States

(N = 700)

Flemisha sample

(N = 170)

Comparison US and Flemish sample

t df SigEmotionally Reactive Raw score 24 (22) 24 (26) 0 23119 1

T-score 540 (57) 541 (62)Sub clinical score 6 7+

Clinical score 9 11+AnxiousDepressed Raw score 29 (23) 15 (17) 893 33657 lt001

T-score 542 (57) 539 (58)Sub clinical score 7 5-

Clinical score 9 7-Somatic Complaints Raw score 18 (19) 15 (17) 188 868 060

T-score 540 (58) 538 (58)Sub clinical score 5 5

clinical score 7 6-Withdrawn Raw score 15 (17) 08 (13) 590 32497 lt001


Clinical score 6 5-Sleep Problems Raw score 28 (24) 20 (23) 393 868 lt001


Clinical score 9 9Attention Problems Raw score 25 (19) 19 (19) 370 868 lt001


Clinical score 7 7Aggressive Behaviour Raw score 104 (64) 85 (59) 352 867 lt001


Clinical score 25 23-Internalising Raw score 86 (62) 63 (59) 438 868 lt001


Clinical score 18 14-Externalising Raw score 129 (77) 104 (71) 384 867 lt001


Clinical score 25 22-Total Problems Raw score 333 (187) 247 (173) 544 867 lt001


Clinical score 61 48-

a Note column 4 - and + refer to the difference between cut-offs (United States vs Flemish sample)



Gender and age differences for the CBCL112-5

Significant differences were found between boys and girls for four of theseven syndrome scales (Emotionally Reactive F(1 168) = 407 p = 045Withdrawn F(1 168) = 517 p = 024 Attention Problems F(1 168) =1147 p = 001 Aggressive Behaviour F(1 167) = 855 p = 004) and for thebroad-band scales (Externalising F(1 167) = 1124 p = 001 InternalisingF(1 168) = 415 p = 043) and Total Problems score F(1 167) = 635 p =013 In all cases the mean scores for boys were higher No significant age dif-ferences were found except for the subscale Attention Problems F(4 165) =301 p = 020 with the highest mean on this scale observed for the 1-year-olds


Tables 3 and 4 present an overview of the raw mean scores and standard devi-ations for the different subscales of the CBCL6-18 in both the Flemish sam-ple (N = 718) and the American sample (N = 1753) (Achenbach amp Rescorla2001) for boys and girls respectively Parallel to the American study ofAchenbach and Rescorla (2007) the sample was divided in four differentgroups based on gender and age category (6-11 and 12-18 years)

Comparing the raw mean scores of the Flemish and American boysbetween 6 and 11 years on the CBCL6-18 6 of the 11 scales were signifi-cantly different (Table 3) whereby for 3 scales Flemish boys scored higher(including the Internalising scale) and for 3 other scales their mean scoreswere lower (including the Externalising scale) In a second step after calcu-lating the percentiles the cutpoints were determined (11 clinical cutpointsand 11 borderline clinical cutpoints) of the Flemish sample and they werecompared to those of American children (not included in the table[2]) Visualinspection revealed no consistent pattern For example the cutpoints for theExternalising scale reveal that Flemish boys scored 2 points lower on both theborderline and clinical cutpoints while for the Internalising scale Flemishboys scored 3 (borderline clinical cutpoint) to 5 points (clinical cutpoint)higher

For boys between 12 and 18 years 3 of the 11 scale means were signifi-cantly different between Flemish boys and their American peers (see Table3) Mean scores were significantly lower for the Flemish sample on the sub-scales Rule-breaking Behaviour Aggressive Behaviour and Externalisingproblems After calculating the percentiles the cutpoints were determined

2 The cutpoints for the 6-18-year-olds based on our research can be consulted viahttpwwwtestpracticumugentbe



Tabl

e3

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

boys

t-te

sts f

or

raw

scor

es

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

esG

ende

rB

oys

Boy

sA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

387

N =

527

N =

183

N =

131

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

28

(27

)2

6 (2

7)

34

(39

)3

0 (3

6)

-18

726

547

062

-11

916

650

237

With

draw

nD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

11

(16

)1

9 (2

2)

14

(18

)1

5 (2

0)

-20

156

80

451

8965

50

59So

mat

ic C

ompl

aint

sM

ean

and

(SD

) raw

scor

e1

1 (1

7)

11

(18

)1

5 (2

0)

13

(19

)-2

33

305

910

21-1

12

653

265

Soci

al P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

24

(26

)1

8 (2

3)

20

(25

)1

7 (2

4)

174

568

083

044

656

659

Thou

ght P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

18

(20

)1

6 (1

9)

18

(21

)1

6 (1

9)

000

567

10

000

656

10

Atte

ntio

n Pr

oble

ms

Mea

n an

d (S

D) r

aw sc

ore

38

(34

)4

0 (3

7)

34

(33

)3

6 (3

4)

132

568

186

112

656

261

Rule

-Bre

akin

g Be

havi

our M

ean

and

(SD

) raw

scor

e1

9 (2

1)

28

(34

)1

2 (1

5)

18

(21

)4

5548

092

lt00

14

2432

093

lt00

1Ag

gres

sive

Beh

avio

urM

ean

and

(SD

) raw

scor

e4

7 (4

3)

47

(48

)3

9 (4

4)

35

(39

)2

0656

80

403

0023

799

003

Inte

rnal

isin

gM

ean

and

(SD

) raw

scor

e5

1 (4

8)

56

(53

)6

3 (6

5)

58

(62

)-2

23

279

210

27-0

34

178

287

35Ex

tern

alis

ing

Mea

n an

d (S

D) r

aw sc

ore

66

(60

)7

5 (7

5)

51

(55

)5

3 (5

6)

285

559

005

374

259

04lt

001

Tota

l Pro

blem

sM

ean

and

(SD

) raw

scor

e23

4 (1

69)

237

(19

0)21

3 (1

80)

204

(17

5)1

3656

81

76 1

81

656

071


225

Tabl

e4

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

girl

s t-

test

s for

ra

w sc

ores

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

eG

ende

rG

irls

Gir

lsA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

390

N =

449

N =

229

N =

175

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n en

(SD

) raw

scor

e3

2 (2

9)

32

(31

)3

0 (3

3)

30

(34

)0

7642

985

447

070

622

482

With

draw

nD

epre

ssed

Mea

n en

(SD

) raw

scor

e1

4 (1

7)

19

(21

)1

1 (1

8)

17

(21

)2

0761

70

391

0762

22

86So

mat

ic C

ompl

aint

sM

ean

en (S

D) r

aw sc

ore

13

(17

)1

4 (1

9)

13

(19

)1

5 (2

0)

000

616

10

-05

861

95

63So

cial

Pro

blem

sM

ean

en (S

D) r

aw sc

ore

26

(26

)1

8 (2

3)

21

(26

)1

5 (1

9)

231

61

70

211

6738

122

096

Thou

ght P

robl

ems

Mea

n en

(SD

) raw

scor

e1

7 (1

8)

14

(17

)1

6 (2

0)

17

(22

)0

6461

75

22-1

62

258

971

05At

tent

ion

Prob

lem

sM

ean

en (S

D) r

aw sc

ore

32

(31

)2

7 (3

1)

32

(31

)3

2 (3

2)

000

617

10

-17

962

20

73Ru

le-B

reak

ing

Beha

viou

rM

ean

en (S

D) r

aw sc

ore

16

(18

)2

2 (3

0)

13

(16

)1

7 (2

0)

215

523

380

322

4147

201

016

Aggr

essi

ve B

ehav

iour

Mea

n en

(SD

) raw

scor

e4

5 (4

3)

44

(47

)4

0 (4

6)

35

(38

)1

3661

71

742

4838

956

014

Inte

rnal

isin

gM

ean

en (S

D) r

aw sc

ore

60

(50

)6

5 (5

7)

54

(60

)6

1 (6

2)

128

411

732

030

7762

24

43Ex

tern

alis

ing

Mea

n en

(SD

) raw

scor

e6

1 (5

6)

66

(70

)5

3 (5

8)

51

(54

)1

6961

70

912

8640

850

005

Tota

l Pro

blem

sM

ean

en (S

D) r

aw sc

ore

229

(16

6)22

0 (1

82)

201

(18

0)20

1 (1

80)

196

617

050

118

622

240



Inspection of the cutpoints for all scales revealed no consistent pattern 5 cut-points were identical 6 were higher and 11 were lower for the Flemish boys(not included in the table) For example while the borderline and clinical cut-point scores for the scale Internalising problems were only one point higherfor the Flemish boys the Externalising problems and the Total Problemsscale revealed cutpoints which were substantially lower (for the borderlineclinical cutpoints the difference was 4 to 7 points and for the clinical cut-points the differences were 5 and 2 points respectively) compared to Amer-ican children

Scale comparisons indicated further that also Flemish girls between 6 and11 years scored significantly lower than their American peers for 4 of the 11scales (see Table 4) the scales WithdrawnDepressed Social Problems Rule-breaking Behaviour and also the Total Problems scale After calculating thepercentiles the cutpoints were determined Visual inspection revealed that 10cutpoints for the different scales for Flemish girls between 6 and 11 yearswere lower (not included in the table) while only 4 were higher No differ-ences were found for the cutpoints on the Internalising scale while the cut-points for the Externalising scale were 2 points lower for the Flemish girlsDifferences in the cutpoints for the Total Problems scale were substantialwith Flemish girls having (both clinical and borderline) cutpoints that are 4points lower

Finally the means of the Flemish sub sample of girls between 12 and 18years differed on 3 of the 11 subscales from the American norm group (seeTable 4) For all three scales including the Externalising scale Flemish girlsscored significantly lower Further (not included in the table) after calculatingthe percentiles and cutpoints the cutpoints for 3 scales (AnxiousDepressedThought Problems and Attention Problems) were higher while for 4 scales(Social Problems Rule-breaking Behaviour Aggressive Behaviour andExternalising) the cutpoint scores were lower for Flemish girls (12-18 years)While there were no differences in cutpoint scores for the Internalising scaleand Total Problems scales the difference for the Externalising scale was 2points


No significant differences between boys and girls could be found in the meansubscale scores When comparing the subscale means between age catego-ries a significant difference could be found for 3 of the 11 subscales forSocial Problems children between 6 and 11 years score higher compared tothe group between 12 and 18 (F(1 716) = 642 p = 012) while for the sub-scales WithdrawnDepressed (F(1 716) = 770 p = 006) and Rule-breakingBehaviour (F(1 716) = 1266 p lt 001) the older age group showed signifi-cantly more problems



Concurrent validity comparison of the CBCL with the SDQ

The Pearson product-moment correlations between the equivalent scales ofthe CBCL and the SDQ were calculated (Total Problems InternalisingEmo-tional Symptoms ExternalisingConduct Problems Attention Prob-lemsHyperactivityInattention Social Problems (CBCL 6-18)Peer rela-tionship problems) (see Table 5) All correlations were significant at p lt 001level In general correlations with the SDQ seemed to be stronger for theCBCL1frac12-5 compared to the CBCL6-18 The correlations between 1frac12-5sample the CBCL6-18 sample and SDQ scales were substantial for all scalesexcept for Social ProblemsPeer relationship problems (r = 60)

Discussion

ASEBA is a widely used battery of instruments indicative for screening ofpsychopathology in children and adolescents Specifically the CBCL is oneof the most popular measures also in the Flemish community However thepsychometric properties of the CBCL were based on studies in US samplesand until now the scientific usefulness of the most recently translated versionwas never questioned In this study the reliability and concurrent validity ofthe Dutch CBCL-2001 as well as the usefulness of the US norms were eval-uated in two different community samples (1frac12-5 and 6-18 years) of childrenand adolescents

Table 5Correlations between equivalent CBCL and SDQ scales

Equivalent scales (CBCLSDQ)

Sample CBCL1frac12-5 respondent =mother

(N = 170)

Sample CBCL6-18 respondent = mother

(N =718)N r N r

Total Problems score Total SDQ 82 80 554 80Internalising Emotional Symptoms 82 75 554 75Externalising Conduct Problemsa

a Only the 5 year olds were considered because of a difference in version of the SDQ for the youngest andolder children

25 90 554 68Attention Problems HyperactivityInattention 82 77 554 74Social ProblemsPeer relationship problemsb

b Scale does not exist in the SDQ for the youngest age group

- - 554 60 p lt 001



A first criterion in evaluating the usefulness of a screening instrument is thequality of its internal consistency Results of the study provided strong supportfor the reliability of both Dutch versions of the CBCL The findings are com-parable with alpha coefficients found in international studies ranging between90 and 96 (Rescorla et al 2007) and with those in a Flemish study in a clin-ical sample with a previous CBCL version (Janssens amp Deboutte 2009)

Evidence was also found for the construct validity of the Dutch CBCLComparing the CBCL subscales with the conceptually related SDQ subscalesrevealed that all correlations were significant For the Total Problems score arobust correlation was found of 80 for both the sample 1frac12-5 years and thesample 6-18 years whereas for the Internalising and Externalising scale thecorrelations varied between 68 and 90 Correlations between the subscalesof the CBCL with the SDQ seem to be even stronger for the CBCL 1frac12-5 thanfor the CBCL6-18 Compared to another Flemish study in 4-7 years olds(Van Leeuwen et al 2006) the present study revealed even better SDQ-CBCL correlations for the youngest age group It was assumed that specifi-cally for older children parent reports can differ according to the specificitems that were questioned Also comparable to our study significant corre-lations between the (1991 version of the) CBCL and the SDQ were found ina Flemish study in a clinical sample with a broad age range (3-18 years) withcorrelations varying between 70 (Internalising scale) and 81 (Externalisingand Total scale) (Janssens amp Deboute 2009) Probably in clinical samplesheterogeneity can explain the somewhat lower correlations

When comparing the mean raw scores of the different subsamples withthe US norms some important differences emerged Generally spoken cut-points for the Total Problems scale and the Externalising scale and subscaleswere lower in the Flemish sample The majority of these differences weresupported by a significant difference in the mean scores between normgroups On the CBCL6-18 Flemish children in this study had a raw meanscore on the Total Problems scale of respectively 201 (girls 6-11 years) 201(girls 12-18 years) 213 (boys 6-11 years) and 204 (boys 12-18 years) whichdiffer 2-3 points with the US norms While Crijnen et al (1997) already indi-cated that Belgian children scored below the omnicultural mean of 224(CBCL-1991 version) Rescorla et al (2007) stated that such differenceshould not be seen as problematic as long as they are less than 1 SD How-ever visual inspection of the differences in cutpoints on the different scalesof both the CBCL6-18 version and the CBCL1frac12-5 version in the currentstudy revealed that according to US borderline clinical and clinical cutpointsa substantial part of the Flemish children will not be identified as lsquoat risk chil-drenrsquo suggesting an underestimation Consequently this can lead to morefalse negative cases compared with what is generally expected when usingthe CBCL



It must be acknowledged that for the different scales somewhat more dif-ferences with US norms were found for Flemish boys compared with Flemishgirls Interestingly here for the Internalising scale of the CBCL6-18 thenorm and cutpoints for boys 6 to11 years were not lower but substantiallyhigher So specifically for this subsample Flemish parents report signifi-cantly more internalising problems in their own children compared to Amer-ican parents

Some important age differences were noticed which justifies the sug-gested use of minimally 3 age norm groups (1frac12-5 years 6-11 years and 12-18 years) Although in this study for the CBCL6-18 years no significant dif-ferences could be found in the mean subscale scores for boys and girls thedifferent cutpoints in the subsamples plaid for the relevance of differentnorms for boys and girls Remarkably and in contrast with our findingsAchenbach and Rescorla (2001) did not find evidence for splitting the 1frac12-5years sample in gender-specific groups Until now only a few studiesexplored gender differences in the 1frac12-5 years sample and the findings seemrather inconsistent However a number of studies have shown higher rates ofexternalising problems in boys (eg Gross Fogg Young Ridge CowellRichardson et al 2006) The authors therefore strongly recommend furtherexploring the necessity of gender specific norms in all age groups in futureresearch

The present study has some important clinical implications In recentyears western countries have experienced several societal changes Researchfurther revealed that mental health problems in children slightly increasedover recent decades (Tick et al 2007) Therefore one must be aware thatidentifying a particular child as lsquoclinicalrsquo depends on the norm group it iscompared with Given the sparse number of studies that compared identicalassessments of population samples at different time points the study of Ticket al (2007) is unique because of an interesting comparison between CBCL-parent reports collected in 1983 and 20 years later In their conclusion theauthors reported that only small meaningful differences were found Changeswere strongest between 1993 and 2003 and mainly concerned internalisingproblems Although explaining time trends is difficult these results indicatethat using 1991 norms or 2001 norms will affect our clinical work

Besides the time factor also other factors may require the availability ofaccurate cultural specific norms While each individual parent holds differentthresholds and personal standards when rating problem behaviour (van derEnde 1999) a fairly consistent finding in literature is that parents of minoritygroups score higher than parents of white Caucasian children on parent-reported behaviour problem measures which raises questions about therobustness of an omnicultural norm group (Gross et al 2006) Although theabovementioned studies can be criticised for the fact that they confuse ethnic



background with income and socio-economic status the findings of the cur-rent study indicate that it is worthwhile to consider specific subcultures

Several explanations can be found for the differences found between cut-point scores in the Flemish sample compared to the US sample First withinthe Flemish community there is a high prevalence of middle and high-income groups (Reynders Nicaise amp Van Damme 2005) which mayaccount for a lower rate of child problems reported by parents compared tomore heterogeneous cultures like in the US Second several studies haveillustrated that different aspects of parenting (including beliefs goals valuesand behaviour style) are at least partly culturally constructed (Boushel 2000Rubin amp Chung 2006) This is especially relevant for small differencesamong societies within the same cultural area such as the Western worldWhile it is generally believed that there are no real cultural differences amongsocieties in Europe the US and other parts of the European Diaspora thefindings in the present study may refer to the fact that parents in different cul-tures think in a slightly different way about their children and consequentlyalso report differently about child problems Harkness and Super (2006)speak about lsquoparental ethnotheoriesrsquo in this context to explain the commonthemes as well as the variations they found in the discourses of native-bornmiddle-class parents from six different cultural samples in Western countries

Although the CBCL is a well-validated instrument for screening purposesone must be careful in adopting it The CBCL can by no means been used asa diagnostic tool (Warnick Weersing Scahill amp Woolston 2009) The extentto which the CBCL succeeds in an accurate identification of lsquotruersquo cases inrelation to clinical diagnoses has been described in terms of sensitivity andspecificity To make it easy for clinicians and researchers to judge childrenrsquosfunctioning each scale score of a screening instrument is only relevant whenit refers to percentiles and T-scores that enable to compare a specific childrsquosraw score with normative samples For the specific scale scores of the CBCLa borderline clinical range refers to the 93rd till 97th percentile lower scoresrefer to the normal range while scores above the 97th percentile were definedas clinical and indicate that the person who filled in the questionnaire reportedenough problems of clinical concern So cutpoints were important markersfor identifying an at risk child Also although Achenbach suggests that a T-score on the broad-band scales greater than 63 is generally indicative of prob-lem behaviour specificity and sensitivity still vary across different studieswith a generally estimated sensitivity of 66 and an estimated specificity of83 indicating that numbers of false positives and false negatives are stillquite large The use of a lsquomultiple stagersquo strategy in the assessment of psycho-pathology has been recommended (Kendall Cantwell amp Kazdin 1989) Thisapproach involves the use of a screening test such as a questionnaire to selectpotential cases for further assessment by means of a cutpoint score (which



meets adequate criteria of sensitivity and specificity) A next assessmentperiod for those participants exceeding the cutpoint score involves a secondadministration of the questionnaire along with a structured interview to assessDiagnostic and Statistical Manual for Mental Disorders (DSM-IV APA1994) diagnoses By following this strategy not only the core symptoms ofpsychopathology are assessed but also the duration of a particular constella-tion of symptoms as well as the severity and interference with daily function-ing

Careful attention was given to compose a study sample that met most cri-teria for representativeness Besides an equal distribution between both sexesand a sufficient number of participants in all age groups comparison analyses(see footnote 1) with recent norm data for the Flemish community also revealthat also both regional spreading and level of urbanisation largely correspondto the proportions in the Flemish Community except for the Eastern region(Limburg) (Source Studiedienst Vlaamse Regering FOD Economy ndashDepartment of Statistics Population statistics Population of childrenbetween 0 and 17 years in Flanders) With respect to the social economicalstatus of the families based on job status of the mother (Source Reynders etal 2005 LOA-report ndeg 31) and relying on the schema classification ofErickson Goldthorpe and Portocarero (1979) the study sample can be con-sidered as representative especially for the lower social class (20 of thesample) However compared to statistics collected in 2002 the upper SESclass participated slightly less in the 1frac12-5 years sample and slightly more inthe 6-18 years sample This skewed distribution can however partially beexplained by a non-classified rest group who preferred to remain anonymousFinally also representativeness for family composition was explored basedon comparisons with PSBH (Panel Studie van Belgische Huishoudens) 2002statistics (Source Koning Boudewijnstichting 2008) The findings reflect agood distribution of the different families according to their current composi-tion and are comparable to what can be expected now in the Flemish commu-nity To conclude the random sample met most criteria for representativenessalthough some caution is warranted regarding SES

Several limitations to this study can be noted First the described psycho-metric properties were based on only one Flemish community sample of chil-dren and replication or extending the study by doubling the sample size iswarranted Although much effort was made to compose a random sample andalthough the sample met different criteria regarding representativeness theauthors failed to show that SES distribution is completely conform Flemishcommunity statistics as SES data were somewhat blurred by strict privacydemands Also specifically recruiting families for the youngest children ofthe CBCL1frac12-5 years outside schools was difficult Also other scholarsreported low response rates for this age group (Rescorla et al 2007) Never-



theless also in this sample representativeness according to our criteria wasmore or less satisfying

The low correlations found in other studies between different mother-father versions further indicated that child problems are not effectively cap-tured by only one informant (Achenbach McConaughy amp Howell 1987 vander Ende 1999) and all informants can provide a unique contribution to theassessment (Grietens Onghena Prinzie Gadeyne Van Assche Ghesquiegravereet al 2004) In order to enhance the homogeneity of our norm group we pre-ferred to analyse the mother reports for all participants It is not totally clearhow many mothers and fathers were involved in the US norms and whetherparental US norms were different when analysed separately for father ormother reports In future research the authors recommend to explore poten-tial differences between two informants (father versus mother parent versusteacher and parent versus child) and the surplus value of consulting multipleinformants in screening psychopathology Finally the utility of the CBCL inclinical children remains also to be investigated

To conclude it must be recognised that careful screening of mental healthproblems in children affects the responsibility of each clinician and that it isonly possible when the screening instrument is carefully chosen based on itspsychometric properties Despite its limitations the present study indicatesthat the translated Dutch version of the CBCL has promising characteristicsalthough it can be questioned whether at the moment good and reliable normsare available

References

Achenbach TM (1991) Manual for the child behavior checklist4-18 and 1991 pro-file Burlington VT University of Vermont Department of Psychiatry

Achenbach TM Becker A Doumlpfner M Heiervang E Roessner V SteinhausenHC et al (2008) Multicultural assessment of child and adolescent psychopa-thology with ASEBA and SDQ instruments Research findings applicationsand future directions Journal of Child Psychology and Psychiatry 49 251-275

Achenbach TM McConaughy SH amp Howell CT (1987) Child adolescentbehavioral and emotional problems ndash Implications of cross-informant correla-tions for situational specificity Psychological Bulletin 101 213-232

Achenbach TM amp Rescorla LA (2001) Manual for the ASEBA school-age formsamp profiles Burlington VT University of Vermont Research Center for Chil-dren Youth amp Families

Achenbach TM amp Rescorla LA (2007) Multicultural supplement to the manualfor the ASEBA school-age forms amp profiles Burlington VT University of Ver-mont Research Center for Children Youth amp Families

American Psychiatric Association (1994) Diagnostic and statistical manual of mentaldisorders (4th Edition) Washington DC American Psychiatric Association(APA)



Boushel M (2000) Childrearing across cultures In M Boushel M Fawcett amp JSelwyn (Eds) Focus on early childhood Principles and realities (pp 65-77)Oxford Blackwell Science

Braet C amp van Aken MAG (2006) Developmental psychopathology Substantivemethodological and policy issues International Journal of Behavioral Develop-ment 30 2-4

Burns B Philips S Wagner R Barth R Kolko D Campbell Y amp LandsverkJ (2004)

Mental health need and access to mental health services by youths involved with childwelfare A national survey American Academy of Child and Adolescent Psychi-atry 43 960-970

Costello EJ amp Angold AC (2000) Developmental epidemiology In AJ Samer-point M Lewis amp L Miller (Eds) Handbook of developmental psychopathol-ogy Second Edition New-York Plenum Publishers

Crijnen AAM Achenbach TM amp Verhulst FC (1997) Comparisons of prob-lems reported by parents of children in 12 cultures Total problems externalizingand internalizing Journal of the American Academy of Child and AdolescentPsychiatry 36 1269-1277

Culbertson JL (1993) Clinical child psychology in the 1990s Broadening ourscope Journal of Clinical Psychology 22 116-122

De Groot A Koot HM amp Verhulst F (1994) Cross-cultural generalizability of thechild behavior checklist cross-informant syndromes Psychological Assessment6 225-230

De Groot A Koot HM amp Verhulst F (1996) Cross-cultural generalizability of theyouth self report and teacherrsquos report form cross-informant syndromes Journalof Abnormal Child Psychology 24 651-664

Erikson RJ Goldthorpe JH amp Portocarero L (1979) Intergenerational classmobility in three Western European societies British Journal of Sociology 30415-441

Goodman R (1997) The strengths and difficulties questionnaire A research noteJournal of Child Psychology and Psychiatry 38 581-586

Grietens H Onghena P Prinzie P Gadeyne E Van Assche V Ghesquiegravere Pamp Hellinckx W (2004) Comparison of mothersrsquo fathersrsquo and teachers reportson problem behavior in 5- to 6-year-old children Journal of Psychopathologyand Behavioral Assessment 26 137-146

Gross D Fogg L Young M Ridge A Cowell JM Richardson R amp Sivan A(2006) The equivalence of the child behavior checklist across parent raceeth-nicity income level and language Psychological assessment 18 313-323

Harkness S amp Super CM (2006) Themes and variations Parental ethnotheories inWestern cultures In KH Rubin amp OB Chung (Eds) Parenting believesbehaviors and parent child relationships (pp 61-80) New York Taylor amp Fran-cis Group

Hellinckx W Grietens H amp Verhulst F (1994) Competence and behavioral prob-lems in 6-year-old to 12-year-old children in Flanders (Belgium) and Holland ndashA cross-national comparison Journal of Emotional and Behavioral Disorders2 130-142



Ivanova MY Achenbach TM Dumenci L Almqvist F Weintraub S Bilen-berg N et al (2007) Testing the 8-syndrome structure of the child behaviorchecklist in 30 societies Journal of Clinical Child and Adolescent Psychology36 405-417

Janssens A amp Deboutte D (2009) Screening for psychopathology in child welfareThe strengths and difficulties questionnaire (SDQ) compared with the Achen-bach system of empirically based assessment (ASEBA) European Child andAdolescent Psychiatry 18 691-700

Jensen AL amp Weisz JR (2002) Assessing match and mismatch between practi-tioner-generated and standardized interview-generated diagnoses for clinic-referred children and adolescents Journal of Consulting and Clinical Psychol-ogy 70 158-168

Kendall PC Cantwell DP amp Kazdin AE (1989) Depression in children and ado-lescents ndash Assessment issues and recommendations Cognitive Therapy andResearch 13 109-146

Koning Boudewijnstichting (2008) Samen werken aan een betere samenleving Hetkind in een nieuw samengesteld gezin November 2008 74

Oosterlaan J Baeyens D Scheres A Antrop I Roeyers H amp Sergeant JA(2008) Handleiding bij de vragenlijst voor gedragproblemen bij kinderen van 6tot en met 16 jaar (VvGK6-16) [Manual for the questionnaire for behaviouraldisorders in children from 6 to 16 years] Amsterdam The Netherlands Har-court Test Publishers

Petot D Petot JM amp Achenbach TM (2008) Behavioral and emotional problemsof Algerian children and adolescents as reported by parents European Journalof Child and Adolescent Psychiatry 17 200-2008

Rescorla LA Achenbach TM Ivanova MY Dumenci L Almqvist F Bilen-berg N et al (2007) Behavioral and emotional problems reported by parents ofchildren ages 6 to 16 in 31 societies Journal of Emotional and Behavioral Dis-orders 15 130-142

Reynders T Nicaise I amp Van Damme J (2005) Longitudinaal onderzoek in hetbasisonderwijs De constructie van een SES-variabele voor het SIBO-onder-zoek LOA-rapport 31 Leuven Steunpunt loopbanen doorheen onderwijs naararbeidsmarkt

Rubin KH amp Chung OB (2006) Parenting believes behaviors and parent childrelationships New York Taylor amp Francis Group

Schittekatte M Bos A Spruyt K Germeijs V amp Stinissen H (2003) Rondvraagnaar het diagnostisch instrumentarium en de noden in Vlaanderen [Reports andqueries about the diagnostic instrumentarium and the needs in Flanders] Tijd-schrift voor Orthopedagogiek Kinderpsychiatrie en Klinische Kinderpsycholo-gie 28 50-62

Studiedienst Vlaamse Regering (2008) Populatie kinderen tussen 0 en 17 jaar inVlaanderen [Population children between 0 and 17 years old in Flanders] FODEconomie ndash Afdeling Statistiek Bevolkingsstatistieken Retrieved January 7th2010 from httpwww4vlaanderenbedarsvrCijfersPagesExcelaspx



Tick NT van der Ende J amp Verhulst FC (2007) Twenty-year trends in emotionaland behavioral problems in Dutch children in a changing society Acta Psychiat-rica Scandinavia 116 473-482

Timbremont B Braet C amp Roelofs J (2008) Handleiding childrenrsquos depressioninventory (herziene versie) [Manual childrenrsquos depression inventory (revisedversion)] Amsterdam The Netherlands Pearson Assessment and InformationBV

van der Ende J (1999) Multiple informants multiple views In HM Koot AAMCrijnen amp RF Ferdinand (Eds) Child psychiatric epidemiology Accomplish-ments and future directions (pp 39-52) Assen Van Gorcum

Van Leeuwen K Meerschaert T Bosmans G De Medts L amp Braet C (2006)The strengths and difficulties questionnaire in a community sample of youngchildren in Flanders European Journal of Psychological Assessment 22 189-197

van Widenfeldt BM Goedhart AW Treffers PDA amp Goodman R (2003)Dutch version of the strengths and difficulties questionnaire (SDQ) EuropeanChild and Adolescent Psychiatry 12 281-289

Warnick EM Weersing VR Scahill L amp Woolston JL (2009) Selecting meas-ures for use in child mental health services A scorecard approach Administra-tion and Policy in Mental Health and Mental Health Services Research 36 112-122

Received February 22 2010Revision received January 14 2011

Accepted June 28 2011



children mental health professionals need reliable and valid screening meth-ods for behavioural and emotional problems in children However screeningthrough observation or interview is a great burden and these methods are gen-erally neither very reliable nor cost-effective (Jensen amp Weisz 2002) There-fore rating scales with clear cutpoints are seen as lsquogolden standardsrsquo for mon-itoring youth with mental problems and to select potential cases for furtherassessment However the appropriateness of these instruments is still understudy

Determining cutpoints for screening instruments implies they have beentested on their sensitivity and specificity to identify cases whereby thenumber of false positives and false negatives is kept as low as possible More-over the norm group upon which they rely must meet the highest criteriaregarding representativeness according to the community they refer toAlthough for the Flemish community (Dutch speaking part of Belgium) normgroups are already available for some small-band problems like disruptivebehaviour disorders (Oosterlaan Baeyens Scheres Antrop Roeyers amp Ser-geant 2008) or depression (Timbremont Braet amp Roelofs 2008) hardly anynorm groups are available for broad-band screening instruments in Dutchspeaking samples Up to now only one study (Van Leeuwen MeerschaertBosmans De Medts amp Braet 2006) discussed the use of a general screeninginstrument and provided norms for 4- to 7-year-old children In the meantime screening instruments developed in US are widely used in clinical prac-tice without investigating empirically whether the norms and cutpoints ofthese instruments are appropriate for the Flemish community Although someimpressive studies already tested the robustness of screening instrumentsacross diverse cultures (Achenbach Becker Doumlpfner Heiervang RoessnerSteinhausen et al 2008 Crijnen Achenbach amp Verhulst 1997 IvanovaAchenbach Dumenci Almqvist Weintraub Bilenberg et al 2007 Res-corla Achenbach Ivanova Dumenci Almqvist Bilenberg et al 2007) sev-eral authors are convinced that as long as norm groups for specific popula-tions with specific instruments are lacking the assumption cannot beaccepted that norms are omnicultural (Petot Petot amp Achenbach 2008) Thisis specifically relevant in the 21st century characterised by new economicproblems new family structures millions of immigrants and blending of dif-ferent subcultures within and between communities (Achenbach et al 2008)

The most frequently used method in Flanders to screen for behaviouraland emotional problems is Achenbachrsquos Empirically Based Assessment sys-tem (ASEBA) (Schittekatte Bos Spruyt Germeijs amp Stinissen 2003) Thesystem which is based on observation of children in US epidemiologicalstudies (Achenbach amp Rescorla 2001) comprises different versions of childparent and teacher instruments according to the age of the child in order toallow for multi-informant assessment For children between 6 and 18 years

psychobelg2011_3-4book 14 Tuesday November 8 2011 1041 AM









Method

Participants






Instruments

















Procedure





Analyses






Age GroupGender

TotalBoys Girls

1frac12 - 05 84 86 17006 - 11 183 229 41212 - 18 131 175 306

Total 398 490 888



Results

Scale reliability











ScalesUnited States

(N = 700)

Flemisha sample

(N = 170)



































Tabl

e3

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

boys

t-te

sts f

or

raw

scor

es

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

esG

ende

rB

oys

Boy

sA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

387

N =

527

N =

183

N =

131

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

28

(27

)2

6 (2

7)

34

(39

)3

0 (3

6)

-18

726

547

062

-11

916

650

237

With

draw

nD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

11

(16

)1

9 (2

2)

14

(18

)1

5 (2

0)

-20

156

80

451

8965

50

59So

mat

ic C

ompl

aint

sM

ean

and

(SD

) raw

scor

e1

1 (1

7)

11

(18

)1

5 (2

0)

13

(19

)-2

33

305

910

21-1

12

653

265

Soci

al P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

24

(26

)1

8 (2

3)

20

(25

)1

7 (2

4)

174

568

083

044

656

659

Thou

ght P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

18

(20

)1

6 (1

9)

18

(21

)1

6 (1

9)

000

567

10

000

656

10

Atte

ntio

n Pr

oble

ms

Mea

n an

d (S

D) r

aw sc

ore

38

(34

)4

0 (3

7)

34

(33

)3

6 (3

4)

132

568

186

112

656

261

Rule

-Bre

akin

g Be

havi

our M

ean

and

(SD

) raw

scor

e1

9 (2

1)

28

(34

)1

2 (1

5)

18

(21

)4

5548

092

lt00

14

2432

093

lt00

1Ag

gres

sive

Beh

avio

urM

ean

and

(SD

) raw

scor

e4

7 (4

3)

47

(48

)3

9 (4

4)

35

(39

)2

0656

80

403

0023

799

003

Inte

rnal

isin

gM

ean

and

(SD

) raw

scor

e5

1 (4

8)

56

(53

)6

3 (6

5)

58

(62

)-2

23

279

210

27-0

34

178

287

35Ex

tern

alis

ing

Mea

n an

d (S

D) r

aw sc

ore

66

(60

)7

5 (7

5)

51

(55

)5

3 (5

6)

285

559

005

374

259

04lt

001

Tota

l Pro

blem

sM

ean

and

(SD

) raw

scor

e23

4 (1

69)

237

(19

0)21

3 (1

80)

204

(17

5)1

3656

81

76 1

81

656

071


225

Tabl

e4

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

girl

s t-

test

s for

ra

w sc

ores

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

eG

ende

rG

irls

Gir

lsA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

390

N =

449

N =

229

N =

175

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n en

(SD

) raw

scor

e3

2 (2

9)

32

(31

)3

0 (3

3)

30

(34

)0

7642

985

447

070

622

482

With

draw

nD

epre

ssed

Mea

n en

(SD

) raw

scor

e1

4 (1

7)

19

(21

)1

1 (1

8)

17

(21

)2

0761

70

391

0762

22

86So

mat

ic C

ompl

aint

sM

ean

en (S

D) r

aw sc

ore

13

(17

)1

4 (1

9)

13

(19

)1

5 (2

0)

000

616

10

-05

861

95

63So

cial

Pro

blem

sM

ean

en (S

D) r

aw sc

ore

26

(26

)1

8 (2

3)

21

(26

)1

5 (1

9)

231

61

70

211

6738

122

096

Thou

ght P

robl

ems

Mea

n en

(SD

) raw

scor

e1

7 (1

8)

14

(17

)1

6 (2

0)

17

(22

)0

6461

75

22-1

62

258

971

05At

tent

ion

Prob

lem

sM

ean

en (S

D) r

aw sc

ore

32

(31

)2

7 (3

1)

32

(31

)3

2 (3

2)

000

617

10

-17

962

20

73Ru

le-B

reak

ing

Beha

viou

rM

ean

en (S

D) r

aw sc

ore

16

(18

)2

2 (3

0)

13

(16

)1

7 (2

0)

215

523

380

322

4147

201

016

Aggr

essi

ve B

ehav

iour

Mea

n en

(SD

) raw

scor

e4

5 (4

3)

44

(47

)4

0 (4

6)

35

(38

)1

3661

71

742

4838

956

014

Inte

rnal

isin

gM

ean

en (S

D) r

aw sc

ore

60

(50

)6

5 (5

7)

54

(60

)6

1 (6

2)

128

411

732

030

7762

24

43Ex

tern

alis

ing

Mea

n en

(SD

) raw

scor

e6

1 (5

6)

66

(70

)5

3 (5

8)

51

(54

)1

6961

70

912

8640

850

005

Tota

l Pro

blem

sM

ean

en (S

D) r

aw sc

ore

229

(16

6)22

0 (1

82)

201

(18

0)20

1 (1

80)

196

617

050

118

622

240












Discussion





(N = 170)


(N =718)N r N r





- - 554 60 p lt 001



























References

























































Method

Participants






Instruments

















Procedure





Analyses






Age GroupGender

TotalBoys Girls

1frac12 - 05 84 86 17006 - 11 183 229 41212 - 18 131 175 306

Total 398 490 888



Results

Scale reliability











ScalesUnited States

(N = 700)

Flemisha sample

(N = 170)



































Tabl

e3

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

boys

t-te

sts f

or

raw

scor

es

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

esG

ende

rB

oys

Boy

sA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

387

N =

527

N =

183

N =

131

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

28

(27

)2

6 (2

7)

34

(39

)3

0 (3

6)

-18

726

547

062

-11

916

650

237

With

draw

nD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

11

(16

)1

9 (2

2)

14

(18

)1

5 (2

0)

-20

156

80

451

8965

50

59So

mat

ic C

ompl

aint

sM

ean

and

(SD

) raw

scor

e1

1 (1

7)

11

(18

)1

5 (2

0)

13

(19

)-2

33

305

910

21-1

12

653

265

Soci

al P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

24

(26

)1

8 (2

3)

20

(25

)1

7 (2

4)

174

568

083

044

656

659

Thou

ght P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

18

(20

)1

6 (1

9)

18

(21

)1

6 (1

9)

000

567

10

000

656

10

Atte

ntio

n Pr

oble

ms

Mea

n an

d (S

D) r

aw sc

ore

38

(34

)4

0 (3

7)

34

(33

)3

6 (3

4)

132

568

186

112

656

261

Rule

-Bre

akin

g Be

havi

our M

ean

and

(SD

) raw

scor

e1

9 (2

1)

28

(34

)1

2 (1

5)

18

(21

)4

5548

092

lt00

14

2432

093

lt00

1Ag

gres

sive

Beh

avio

urM

ean

and

(SD

) raw

scor

e4

7 (4

3)

47

(48

)3

9 (4

4)

35

(39

)2

0656

80

403

0023

799

003

Inte

rnal

isin

gM

ean

and

(SD

) raw

scor

e5

1 (4

8)

56

(53

)6

3 (6

5)

58

(62

)-2

23

279

210

27-0

34

178

287

35Ex

tern

alis

ing

Mea

n an

d (S

D) r

aw sc

ore

66

(60

)7

5 (7

5)

51

(55

)5

3 (5

6)

285

559

005

374

259

04lt

001

Tota

l Pro

blem

sM

ean

and

(SD

) raw

scor

e23

4 (1

69)

237

(19

0)21

3 (1

80)

204

(17

5)1

3656

81

76 1

81

656

071


225

Tabl

e4

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

girl

s t-

test

s for

ra

w sc

ores

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

eG

ende

rG

irls

Gir

lsA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

390

N =

449

N =

229

N =

175

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n en

(SD

) raw

scor

e3

2 (2

9)

32

(31

)3

0 (3

3)

30

(34

)0

7642

985

447

070

622

482

With

draw

nD

epre

ssed

Mea

n en

(SD

) raw

scor

e1

4 (1

7)

19

(21

)1

1 (1

8)

17

(21

)2

0761

70

391

0762

22

86So

mat

ic C

ompl

aint

sM

ean

en (S

D) r

aw sc

ore

13

(17

)1

4 (1

9)

13

(19

)1

5 (2

0)

000

616

10

-05

861

95

63So

cial

Pro

blem

sM

ean

en (S

D) r

aw sc

ore

26

(26

)1

8 (2

3)

21

(26

)1

5 (1

9)

231

61

70

211

6738

122

096

Thou

ght P

robl

ems

Mea

n en

(SD

) raw

scor

e1

7 (1

8)

14

(17

)1

6 (2

0)

17

(22

)0

6461

75

22-1

62

258

971

05At

tent

ion

Prob

lem

sM

ean

en (S

D) r

aw sc

ore

32

(31

)2

7 (3

1)

32

(31

)3

2 (3

2)

000

617

10

-17

962

20

73Ru

le-B

reak

ing

Beha

viou

rM

ean

en (S

D) r

aw sc

ore

16

(18

)2

2 (3

0)

13

(16

)1

7 (2

0)

215

523

380

322

4147

201

016

Aggr

essi

ve B

ehav

iour

Mea

n en

(SD

) raw

scor

e4

5 (4

3)

44

(47

)4

0 (4

6)

35

(38

)1

3661

71

742

4838

956

014

Inte

rnal

isin

gM

ean

en (S

D) r

aw sc

ore

60

(50

)6

5 (5

7)

54

(60

)6

1 (6

2)

128

411

732

030

7762

24

43Ex

tern

alis

ing

Mea

n en

(SD

) raw

scor

e6

1 (5

6)

66

(70

)5

3 (5

8)

51

(54

)1

6961

70

912

8640

850

005

Tota

l Pro

blem

sM

ean

en (S

D) r

aw sc

ore

229

(16

6)22

0 (1

82)

201

(18

0)20

1 (1

80)

196

617

050

118

622

240












Discussion





(N = 170)


(N =718)N r N r





- - 554 60 p lt 001



























References



















































Instruments

















Procedure





Analyses






Age GroupGender

TotalBoys Girls

1frac12 - 05 84 86 17006 - 11 183 229 41212 - 18 131 175 306

Total 398 490 888



Results

Scale reliability











ScalesUnited States

(N = 700)

Flemisha sample

(N = 170)



































Tabl

e3

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

boys

t-te

sts f

or

raw

scor

es

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

esG

ende

rB

oys

Boy

sA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

387

N =

527

N =

183

N =

131

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

28

(27

)2

6 (2

7)

34

(39

)3

0 (3

6)

-18

726

547

062

-11

916

650

237

With

draw

nD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

11

(16

)1

9 (2

2)

14

(18

)1

5 (2

0)

-20

156

80

451

8965

50

59So

mat

ic C

ompl

aint

sM

ean

and

(SD

) raw

scor

e1

1 (1

7)

11

(18

)1

5 (2

0)

13

(19

)-2

33

305

910

21-1

12

653

265

Soci

al P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

24

(26

)1

8 (2

3)

20

(25

)1

7 (2

4)

174

568

083

044

656

659

Thou

ght P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

18

(20

)1

6 (1

9)

18

(21

)1

6 (1

9)

000

567

10

000

656

10

Atte

ntio

n Pr

oble

ms

Mea

n an

d (S

D) r

aw sc

ore

38

(34

)4

0 (3

7)

34

(33

)3

6 (3

4)

132

568

186

112

656

261

Rule

-Bre

akin

g Be

havi

our M

ean

and

(SD

) raw

scor

e1

9 (2

1)

28

(34

)1

2 (1

5)

18

(21

)4

5548

092

lt00

14

2432

093

lt00

1Ag

gres

sive

Beh

avio

urM

ean

and

(SD

) raw

scor

e4

7 (4

3)

47

(48

)3

9 (4

4)

35

(39

)2

0656

80

403

0023

799

003

Inte

rnal

isin

gM

ean

and

(SD

) raw

scor

e5

1 (4

8)

56

(53

)6

3 (6

5)

58

(62

)-2

23

279

210

27-0

34

178

287

35Ex

tern

alis

ing

Mea

n an

d (S

D) r

aw sc

ore

66

(60

)7

5 (7

5)

51

(55

)5

3 (5

6)

285

559

005

374

259

04lt

001

Tota

l Pro

blem

sM

ean

and

(SD

) raw

scor

e23

4 (1

69)

237

(19

0)21

3 (1

80)

204

(17

5)1

3656

81

76 1

81

656

071


225

Tabl

e4

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

girl

s t-

test

s for

ra

w sc

ores

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

eG

ende

rG

irls

Gir

lsA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

390

N =

449

N =

229

N =

175

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n en

(SD

) raw

scor

e3

2 (2

9)

32

(31

)3

0 (3

3)

30

(34

)0

7642

985

447

070

622

482

With

draw

nD

epre

ssed

Mea

n en

(SD

) raw

scor

e1

4 (1

7)

19

(21

)1

1 (1

8)

17

(21

)2

0761

70

391

0762

22

86So

mat

ic C

ompl

aint

sM

ean

en (S

D) r

aw sc

ore

13

(17

)1

4 (1

9)

13

(19

)1

5 (2

0)

000

616

10

-05

861

95

63So

cial

Pro

blem

sM

ean

en (S

D) r

aw sc

ore

26

(26

)1

8 (2

3)

21

(26

)1

5 (1

9)

231

61

70

211

6738

122

096

Thou

ght P

robl

ems

Mea

n en

(SD

) raw

scor

e1

7 (1

8)

14

(17

)1

6 (2

0)

17

(22

)0

6461

75

22-1

62

258

971

05At

tent

ion

Prob

lem

sM

ean

en (S

D) r

aw sc

ore

32

(31

)2

7 (3

1)

32

(31

)3

2 (3

2)

000

617

10

-17

962

20

73Ru

le-B

reak

ing

Beha

viou

rM

ean

en (S

D) r

aw sc

ore

16

(18

)2

2 (3

0)

13

(16

)1

7 (2

0)

215

523

380

322

4147

201

016

Aggr

essi

ve B

ehav

iour

Mea

n en

(SD

) raw

scor

e4

5 (4

3)

44

(47

)4

0 (4

6)

35

(38

)1

3661

71

742

4838

956

014

Inte

rnal

isin

gM

ean

en (S

D) r

aw sc

ore

60

(50

)6

5 (5

7)

54

(60

)6

1 (6

2)

128

411

732

030

7762

24

43Ex

tern

alis

ing

Mea

n en

(SD

) raw

scor

e6

1 (5

6)

66

(70

)5

3 (5

8)

51

(54

)1

6961

70

912

8640

850

005

Tota

l Pro

blem

sM

ean

en (S

D) r

aw sc

ore

229

(16

6)22

0 (1

82)

201

(18

0)20

1 (1

80)

196

617

050

118

622

240












Discussion





(N = 170)


(N =718)N r N r





- - 554 60 p lt 001



























References




























































Procedure





Analyses






Age GroupGender

TotalBoys Girls

1frac12 - 05 84 86 17006 - 11 183 229 41212 - 18 131 175 306

Total 398 490 888



Results

Scale reliability











ScalesUnited States

(N = 700)

Flemisha sample

(N = 170)



































Tabl

e3

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

boys

t-te

sts f

or

raw

scor

es

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

esG

ende

rB

oys

Boy

sA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

387

N =

527

N =

183

N =

131

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

28

(27

)2

6 (2

7)

34

(39

)3

0 (3

6)

-18

726

547

062

-11

916

650

237

With

draw

nD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

11

(16

)1

9 (2

2)

14

(18

)1

5 (2

0)

-20

156

80

451

8965

50

59So

mat

ic C

ompl

aint

sM

ean

and

(SD

) raw

scor

e1

1 (1

7)

11

(18

)1

5 (2

0)

13

(19

)-2

33

305

910

21-1

12

653

265

Soci

al P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

24

(26

)1

8 (2

3)

20

(25

)1

7 (2

4)

174

568

083

044

656

659

Thou

ght P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

18

(20

)1

6 (1

9)

18

(21

)1

6 (1

9)

000

567

10

000

656

10

Atte

ntio

n Pr

oble

ms

Mea

n an

d (S

D) r

aw sc

ore

38

(34

)4

0 (3

7)

34

(33

)3

6 (3

4)

132

568

186

112

656

261

Rule

-Bre

akin

g Be

havi

our M

ean

and

(SD

) raw

scor

e1

9 (2

1)

28

(34

)1

2 (1

5)

18

(21

)4

5548

092

lt00

14

2432

093

lt00

1Ag

gres

sive

Beh

avio

urM

ean

and

(SD

) raw

scor

e4

7 (4

3)

47

(48

)3

9 (4

4)

35

(39

)2

0656

80

403

0023

799

003

Inte

rnal

isin

gM

ean

and

(SD

) raw

scor

e5

1 (4

8)

56

(53

)6

3 (6

5)

58

(62

)-2

23

279

210

27-0

34

178

287

35Ex

tern

alis

ing

Mea

n an

d (S

D) r

aw sc

ore

66

(60

)7

5 (7

5)

51

(55

)5

3 (5

6)

285

559

005

374

259

04lt

001

Tota

l Pro

blem

sM

ean

and

(SD

) raw

scor

e23

4 (1

69)

237

(19

0)21

3 (1

80)

204

(17

5)1

3656

81

76 1

81

656

071


225

Tabl

e4

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

girl

s t-

test

s for

ra

w sc

ores

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

eG

ende

rG

irls

Gir

lsA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

390

N =

449

N =

229

N =

175

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n en

(SD

) raw

scor

e3

2 (2

9)

32

(31

)3

0 (3

3)

30

(34

)0

7642

985

447

070

622

482

With

draw

nD

epre

ssed

Mea

n en

(SD

) raw

scor

e1

4 (1

7)

19

(21

)1

1 (1

8)

17

(21

)2

0761

70

391

0762

22

86So

mat

ic C

ompl

aint

sM

ean

en (S

D) r

aw sc

ore

13

(17

)1

4 (1

9)

13

(19

)1

5 (2

0)

000

616

10

-05

861

95

63So

cial

Pro

blem

sM

ean

en (S

D) r

aw sc

ore

26

(26

)1

8 (2

3)

21

(26

)1

5 (1

9)

231

61

70

211

6738

122

096

Thou

ght P

robl

ems

Mea

n en

(SD

) raw

scor

e1

7 (1

8)

14

(17

)1

6 (2

0)

17

(22

)0

6461

75

22-1

62

258

971

05At

tent

ion

Prob

lem

sM

ean

en (S

D) r

aw sc

ore

32

(31

)2

7 (3

1)

32

(31

)3

2 (3

2)

000

617

10

-17

962

20

73Ru

le-B

reak

ing

Beha

viou

rM

ean

en (S

D) r

aw sc

ore

16

(18

)2

2 (3

0)

13

(16

)1

7 (2

0)

215

523

380

322

4147

201

016

Aggr

essi

ve B

ehav

iour

Mea

n en

(SD

) raw

scor

e4

5 (4

3)

44

(47

)4

0 (4

6)

35

(38

)1

3661

71

742

4838

956

014

Inte

rnal

isin

gM

ean

en (S

D) r

aw sc

ore

60

(50

)6

5 (5

7)

54

(60

)6

1 (6

2)

128

411

732

030

7762

24

43Ex

tern

alis

ing

Mea

n en

(SD

) raw

scor

e6

1 (5

6)

66

(70

)5

3 (5

8)

51

(54

)1

6961

70

912

8640

850

005

Tota

l Pro

blem

sM

ean

en (S

D) r

aw sc

ore

229

(16

6)22

0 (1

82)

201

(18

0)20

1 (1

80)

196

617

050

118

622

240












Discussion





(N = 170)


(N =718)N r N r





- - 554 60 p lt 001



























References



















































Analyses






Age GroupGender

TotalBoys Girls

1frac12 - 05 84 86 17006 - 11 183 229 41212 - 18 131 175 306

Total 398 490 888



Results

Scale reliability











ScalesUnited States

(N = 700)

Flemisha sample

(N = 170)



































Tabl

e3

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

boys

t-te

sts f

or

raw

scor

es

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

esG

ende

rB

oys

Boy

sA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

387

N =

527

N =

183

N =

131

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

28

(27

)2

6 (2

7)

34

(39

)3

0 (3

6)

-18

726

547

062

-11

916

650

237

With

draw

nD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

11

(16

)1

9 (2

2)

14

(18

)1

5 (2

0)

-20

156

80

451

8965

50

59So

mat

ic C

ompl

aint

sM

ean

and

(SD

) raw

scor

e1

1 (1

7)

11

(18

)1

5 (2

0)

13

(19

)-2

33

305

910

21-1

12

653

265

Soci

al P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

24

(26

)1

8 (2

3)

20

(25

)1

7 (2

4)

174

568

083

044

656

659

Thou

ght P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

18

(20

)1

6 (1

9)

18

(21

)1

6 (1

9)

000

567

10

000

656

10

Atte

ntio

n Pr

oble

ms

Mea

n an

d (S

D) r

aw sc

ore

38

(34

)4

0 (3

7)

34

(33

)3

6 (3

4)

132

568

186

112

656

261

Rule

-Bre

akin

g Be

havi

our M

ean

and

(SD

) raw

scor

e1

9 (2

1)

28

(34

)1

2 (1

5)

18

(21

)4

5548

092

lt00

14

2432

093

lt00

1Ag

gres

sive

Beh

avio

urM

ean

and

(SD

) raw

scor

e4

7 (4

3)

47

(48

)3

9 (4

4)

35

(39

)2

0656

80

403

0023

799

003

Inte

rnal

isin

gM

ean

and

(SD

) raw

scor

e5

1 (4

8)

56

(53

)6

3 (6

5)

58

(62

)-2

23

279

210

27-0

34

178

287

35Ex

tern

alis

ing

Mea

n an

d (S

D) r

aw sc

ore

66

(60

)7

5 (7

5)

51

(55

)5

3 (5

6)

285

559

005

374

259

04lt

001

Tota

l Pro

blem

sM

ean

and

(SD

) raw

scor

e23

4 (1

69)

237

(19

0)21

3 (1

80)

204

(17

5)1

3656

81

76 1

81

656

071


225

Tabl

e4

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

girl

s t-

test

s for

ra

w sc

ores

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

eG

ende

rG

irls

Gir

lsA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

390

N =

449

N =

229

N =

175

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n en

(SD

) raw

scor

e3

2 (2

9)

32

(31

)3

0 (3

3)

30

(34

)0

7642

985

447

070

622

482

With

draw

nD

epre

ssed

Mea

n en

(SD

) raw

scor

e1

4 (1

7)

19

(21

)1

1 (1

8)

17

(21

)2

0761

70

391

0762

22

86So

mat

ic C

ompl

aint

sM

ean

en (S

D) r

aw sc

ore

13

(17

)1

4 (1

9)

13

(19

)1

5 (2

0)

000

616

10

-05

861

95

63So

cial

Pro

blem

sM

ean

en (S

D) r

aw sc

ore

26

(26

)1

8 (2

3)

21

(26

)1

5 (1

9)

231

61

70

211

6738

122

096

Thou

ght P

robl

ems

Mea

n en

(SD

) raw

scor

e1

7 (1

8)

14

(17

)1

6 (2

0)

17

(22

)0

6461

75

22-1

62

258

971

05At

tent

ion

Prob

lem

sM

ean

en (S

D) r

aw sc

ore

32

(31

)2

7 (3

1)

32

(31

)3

2 (3

2)

000

617

10

-17

962

20

73Ru

le-B

reak

ing

Beha

viou

rM

ean

en (S

D) r

aw sc

ore

16

(18

)2

2 (3

0)

13

(16

)1

7 (2

0)

215

523

380

322

4147

201

016

Aggr

essi

ve B

ehav

iour

Mea

n en

(SD

) raw

scor

e4

5 (4

3)

44

(47

)4

0 (4

6)

35

(38

)1

3661

71

742

4838

956

014

Inte

rnal

isin

gM

ean

en (S

D) r

aw sc

ore

60

(50

)6

5 (5

7)

54

(60

)6

1 (6

2)

128

411

732

030

7762

24

43Ex

tern

alis

ing

Mea

n en

(SD

) raw

scor

e6

1 (5

6)

66

(70

)5

3 (5

8)

51

(54

)1

6961

70

912

8640

850

005

Tota

l Pro

blem

sM

ean

en (S

D) r

aw sc

ore

229

(16

6)22

0 (1

82)

201

(18

0)20

1 (1

80)

196

617

050

118

622

240












Discussion





(N = 170)


(N =718)N r N r





- - 554 60 p lt 001



























References


















































Results

Scale reliability











ScalesUnited States

(N = 700)

Flemisha sample

(N = 170)



































Tabl

e3

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

boys

t-te

sts f

or

raw

scor

es

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

esG

ende

rB

oys

Boy

sA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

387

N =

527

N =

183

N =

131

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

28

(27

)2

6 (2

7)

34

(39

)3

0 (3

6)

-18

726

547

062

-11

916

650

237

With

draw

nD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

11

(16

)1

9 (2

2)

14

(18

)1

5 (2

0)

-20

156

80

451

8965

50

59So

mat

ic C

ompl

aint

sM

ean

and

(SD

) raw

scor

e1

1 (1

7)

11

(18

)1

5 (2

0)

13

(19

)-2

33

305

910

21-1

12

653

265

Soci

al P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

24

(26

)1

8 (2

3)

20

(25

)1

7 (2

4)

174

568

083

044

656

659

Thou

ght P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

18

(20

)1

6 (1

9)

18

(21

)1

6 (1

9)

000

567

10

000

656

10

Atte

ntio

n Pr

oble

ms

Mea

n an

d (S

D) r

aw sc

ore

38

(34

)4

0 (3

7)

34

(33

)3

6 (3

4)

132

568

186

112

656

261

Rule

-Bre

akin

g Be

havi

our M

ean

and

(SD

) raw

scor

e1

9 (2

1)

28

(34

)1

2 (1

5)

18

(21

)4

5548

092

lt00

14

2432

093

lt00

1Ag

gres

sive

Beh

avio

urM

ean

and

(SD

) raw

scor

e4

7 (4

3)

47

(48

)3

9 (4

4)

35

(39

)2

0656

80

403

0023

799

003

Inte

rnal

isin

gM

ean

and

(SD

) raw

scor

e5

1 (4

8)

56

(53

)6

3 (6

5)

58

(62

)-2

23

279

210

27-0

34

178

287

35Ex

tern

alis

ing

Mea

n an

d (S

D) r

aw sc

ore

66

(60

)7

5 (7

5)

51

(55

)5

3 (5

6)

285

559

005

374

259

04lt

001

Tota

l Pro

blem

sM

ean

and

(SD

) raw

scor

e23

4 (1

69)

237

(19

0)21

3 (1

80)

204

(17

5)1

3656

81

76 1

81

656

071


225

Tabl

e4

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

girl

s t-

test

s for

ra

w sc

ores

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

eG

ende

rG

irls

Gir

lsA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

390

N =

449

N =

229

N =

175

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n en

(SD

) raw

scor

e3

2 (2

9)

32

(31

)3

0 (3

3)

30

(34

)0

7642

985

447

070

622

482

With

draw

nD

epre

ssed

Mea

n en

(SD

) raw

scor

e1

4 (1

7)

19

(21

)1

1 (1

8)

17

(21

)2

0761

70

391

0762

22

86So

mat

ic C

ompl

aint

sM

ean

en (S

D) r

aw sc

ore

13

(17

)1

4 (1

9)

13

(19

)1

5 (2

0)

000

616

10

-05

861

95

63So

cial

Pro

blem

sM

ean

en (S

D) r

aw sc

ore

26

(26

)1

8 (2

3)

21

(26

)1

5 (1

9)

231

61

70

211

6738

122

096

Thou

ght P

robl

ems

Mea

n en

(SD

) raw

scor

e1

7 (1

8)

14

(17

)1

6 (2

0)

17

(22

)0

6461

75

22-1

62

258

971

05At

tent

ion

Prob

lem

sM

ean

en (S

D) r

aw sc

ore

32

(31

)2

7 (3

1)

32

(31

)3

2 (3

2)

000

617

10

-17

962

20

73Ru

le-B

reak

ing

Beha

viou

rM

ean

en (S

D) r

aw sc

ore

16

(18

)2

2 (3

0)

13

(16

)1

7 (2

0)

215

523

380

322

4147

201

016

Aggr

essi

ve B

ehav

iour

Mea

n en

(SD

) raw

scor

e4

5 (4

3)

44

(47

)4

0 (4

6)

35

(38

)1

3661

71

742

4838

956

014

Inte

rnal

isin

gM

ean

en (S

D) r

aw sc

ore

60

(50

)6

5 (5

7)

54

(60

)6

1 (6

2)

128

411

732

030

7762

24

43Ex

tern

alis

ing

Mea

n en

(SD

) raw

scor

e6

1 (5

6)

66

(70

)5

3 (5

8)

51

(54

)1

6961

70

912

8640

850

005

Tota

l Pro

blem

sM

ean

en (S

D) r

aw sc

ore

229

(16

6)22

0 (1

82)

201

(18

0)20

1 (1

80)

196

617

050

118

622

240












Discussion





(N = 170)


(N =718)N r N r





- - 554 60 p lt 001



























References




















































ScalesUnited States

(N = 700)

Flemisha sample

(N = 170)



































Tabl

e3

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

boys

t-te

sts f

or

raw

scor

es

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

esG

ende

rB

oys

Boy

sA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

387

N =

527

N =

183

N =

131

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

28

(27

)2

6 (2

7)

34

(39

)3

0 (3

6)

-18

726

547

062

-11

916

650

237

With

draw

nD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

11

(16

)1

9 (2

2)

14

(18

)1

5 (2

0)

-20

156

80

451

8965

50

59So

mat

ic C

ompl

aint

sM

ean

and

(SD

) raw

scor

e1

1 (1

7)

11

(18

)1

5 (2

0)

13

(19

)-2

33

305

910

21-1

12

653

265

Soci

al P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

24

(26

)1

8 (2

3)

20

(25

)1

7 (2

4)

174

568

083

044

656

659

Thou

ght P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

18

(20

)1

6 (1

9)

18

(21

)1

6 (1

9)

000

567

10

000

656

10

Atte

ntio

n Pr

oble

ms

Mea

n an

d (S

D) r

aw sc

ore

38

(34

)4

0 (3

7)

34

(33

)3

6 (3

4)

132

568

186

112

656

261

Rule

-Bre

akin

g Be

havi

our M

ean

and

(SD

) raw

scor

e1

9 (2

1)

28

(34

)1

2 (1

5)

18

(21

)4

5548

092

lt00

14

2432

093

lt00

1Ag

gres

sive

Beh

avio

urM

ean

and

(SD

) raw

scor

e4

7 (4

3)

47

(48

)3

9 (4

4)

35

(39

)2

0656

80

403

0023

799

003

Inte

rnal

isin

gM

ean

and

(SD

) raw

scor

e5

1 (4

8)

56

(53

)6

3 (6

5)

58

(62

)-2

23

279

210

27-0

34

178

287

35Ex

tern

alis

ing

Mea

n an

d (S

D) r

aw sc

ore

66

(60

)7

5 (7

5)

51

(55

)5

3 (5

6)

285

559

005

374

259

04lt

001

Tota

l Pro

blem

sM

ean

and

(SD

) raw

scor

e23

4 (1

69)

237

(19

0)21

3 (1

80)

204

(17

5)1

3656

81

76 1

81

656

071


225

Tabl

e4

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

girl

s t-

test

s for

ra

w sc

ores

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

eG

ende

rG

irls

Gir

lsA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

390

N =

449

N =

229

N =

175

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n en

(SD

) raw

scor

e3

2 (2

9)

32

(31

)3

0 (3

3)

30

(34

)0

7642

985

447

070

622

482

With

draw

nD

epre

ssed

Mea

n en

(SD

) raw

scor

e1

4 (1

7)

19

(21

)1

1 (1

8)

17

(21

)2

0761

70

391

0762

22

86So

mat

ic C

ompl

aint

sM

ean

en (S

D) r

aw sc

ore

13

(17

)1

4 (1

9)

13

(19

)1

5 (2

0)

000

616

10

-05

861

95

63So

cial

Pro

blem

sM

ean

en (S

D) r

aw sc

ore

26

(26

)1

8 (2

3)

21

(26

)1

5 (1

9)

231

61

70

211

6738

122

096

Thou

ght P

robl

ems

Mea

n en

(SD

) raw

scor

e1

7 (1

8)

14

(17

)1

6 (2

0)

17

(22

)0

6461

75

22-1

62

258

971

05At

tent

ion

Prob

lem

sM

ean

en (S

D) r

aw sc

ore

32

(31

)2

7 (3

1)

32

(31

)3

2 (3

2)

000

617

10

-17

962

20

73Ru

le-B

reak

ing

Beha

viou

rM

ean

en (S

D) r

aw sc

ore

16

(18

)2

2 (3

0)

13

(16

)1

7 (2

0)

215

523

380

322

4147

201

016

Aggr

essi

ve B

ehav

iour

Mea

n en

(SD

) raw

scor

e4

5 (4

3)

44

(47

)4

0 (4

6)

35

(38

)1

3661

71

742

4838

956

014

Inte

rnal

isin

gM

ean

en (S

D) r

aw sc

ore

60

(50

)6

5 (5

7)

54

(60

)6

1 (6

2)

128

411

732

030

7762

24

43Ex

tern

alis

ing

Mea

n en

(SD

) raw

scor

e6

1 (5

6)

66

(70

)5

3 (5

8)

51

(54

)1

6961

70

912

8640

850

005

Tota

l Pro

blem

sM

ean

en (S

D) r

aw sc

ore

229

(16

6)22

0 (1

82)

201

(18

0)20

1 (1

80)

196

617

050

118

622

240












Discussion





(N = 170)


(N =718)N r N r





- - 554 60 p lt 001



























References



























































Tabl

e3

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

boys

t-te

sts f

or

raw

scor

es

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

esG

ende

rB

oys

Boy

sA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

387

N =

527

N =

183

N =

131

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

28

(27

)2

6 (2

7)

34

(39

)3

0 (3

6)

-18

726

547

062

-11

916

650

237

With

draw

nD

epre

ssed

Mea

n an

d (S

D) r

aw sc

ore

11

(16

)1

9 (2

2)

14

(18

)1

5 (2

0)

-20

156

80

451

8965

50

59So

mat

ic C

ompl

aint

sM

ean

and

(SD

) raw

scor

e1

1 (1

7)

11

(18

)1

5 (2

0)

13

(19

)-2

33

305

910

21-1

12

653

265

Soci

al P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

24

(26

)1

8 (2

3)

20

(25

)1

7 (2

4)

174

568

083

044

656

659

Thou

ght P

robl

ems

Mea

n an

d (S

D) r

aw sc

ore

18

(20

)1

6 (1

9)

18

(21

)1

6 (1

9)

000

567

10

000

656

10

Atte

ntio

n Pr

oble

ms

Mea

n an

d (S

D) r

aw sc

ore

38

(34

)4

0 (3

7)

34

(33

)3

6 (3

4)

132

568

186

112

656

261

Rule

-Bre

akin

g Be

havi

our M

ean

and

(SD

) raw

scor

e1

9 (2

1)

28

(34

)1

2 (1

5)

18

(21

)4

5548

092

lt00

14

2432

093

lt00

1Ag

gres

sive

Beh

avio

urM

ean

and

(SD

) raw

scor

e4

7 (4

3)

47

(48

)3

9 (4

4)

35

(39

)2

0656

80

403

0023

799

003

Inte

rnal

isin

gM

ean

and

(SD

) raw

scor

e5

1 (4

8)

56

(53

)6

3 (6

5)

58

(62

)-2

23

279

210

27-0

34

178

287

35Ex

tern

alis

ing

Mea

n an

d (S

D) r

aw sc

ore

66

(60

)7

5 (7

5)

51

(55

)5

3 (5

6)

285

559

005

374

259

04lt

001

Tota

l Pro

blem

sM

ean

and

(SD

) raw

scor

e23

4 (1

69)

237

(19

0)21

3 (1

80)

204

(17

5)1

3656

81

76 1

81

656

071


225

Tabl

e4

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

girl

s t-

test

s for

ra

w sc

ores

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

eG

ende

rG

irls

Gir

lsA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

390

N =

449

N =

229

N =

175

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n en

(SD

) raw

scor

e3

2 (2

9)

32

(31

)3

0 (3

3)

30

(34

)0

7642

985

447

070

622

482

With

draw

nD

epre

ssed

Mea

n en

(SD

) raw

scor

e1

4 (1

7)

19

(21

)1

1 (1

8)

17

(21

)2

0761

70

391

0762

22

86So

mat

ic C

ompl

aint

sM

ean

en (S

D) r

aw sc

ore

13

(17

)1

4 (1

9)

13

(19

)1

5 (2

0)

000

616

10

-05

861

95

63So

cial

Pro

blem

sM

ean

en (S

D) r

aw sc

ore

26

(26

)1

8 (2

3)

21

(26

)1

5 (1

9)

231

61

70

211

6738

122

096

Thou

ght P

robl

ems

Mea

n en

(SD

) raw

scor

e1

7 (1

8)

14

(17

)1

6 (2

0)

17

(22

)0

6461

75

22-1

62

258

971

05At

tent

ion

Prob

lem

sM

ean

en (S

D) r

aw sc

ore

32

(31

)2

7 (3

1)

32

(31

)3

2 (3

2)

000

617

10

-17

962

20

73Ru

le-B

reak

ing

Beha

viou

rM

ean

en (S

D) r

aw sc

ore

16

(18

)2

2 (3

0)

13

(16

)1

7 (2

0)

215

523

380

322

4147

201

016

Aggr

essi

ve B

ehav

iour

Mea

n en

(SD

) raw

scor

e4

5 (4

3)

44

(47

)4

0 (4

6)

35

(38

)1

3661

71

742

4838

956

014

Inte

rnal

isin

gM

ean

en (S

D) r

aw sc

ore

60

(50

)6

5 (5

7)

54

(60

)6

1 (6

2)

128

411

732

030

7762

24

43Ex

tern

alis

ing

Mea

n en

(SD

) raw

scor

e6

1 (5

6)

66

(70

)5

3 (5

8)

51

(54

)1

6961

70

912

8640

850

005

Tota

l Pro

blem

sM

ean

en (S

D) r

aw sc

ore

229

(16

6)22

0 (1

82)

201

(18

0)20

1 (1

80)

196

617

050

118

622

240












Discussion





(N = 170)


(N =718)N r N r





- - 554 60 p lt 001



























References

















































225

Tabl

e4

Mea

n en

stan

dard

dev

iatio

ns fo

r the

raw

scor

es o

f the

nor

m g

roup

CBC

L6-

18 y

ears

Uni

ted

Stat

es v

ersu

s Fle

mis

h sa

mpl

e ndash

girl

s t-

test

s for

ra

w sc

ores

Sam

ples

Uni

ted

Stat

esFl

ande

rs

Com

pari

son

US

and

Fle

mis

h sa

mpl

eG

ende

rG

irls

Gir

lsA

ge6-

1112

-18

6-11

12-1

8 6-

1112

-18

N =

390

N =

449

N =

229

N =

175

tdf

Sig

tdf

Sig

Scal

esAn

xiou

sD

epre

ssed

Mea

n en

(SD

) raw

scor

e3

2 (2

9)

32

(31

)3

0 (3

3)

30

(34

)0

7642

985

447

070

622

482

With

draw

nD

epre

ssed

Mea

n en

(SD

) raw

scor

e1

4 (1

7)

19

(21

)1

1 (1

8)

17

(21

)2

0761

70

391

0762

22

86So

mat

ic C

ompl

aint

sM

ean

en (S

D) r

aw sc

ore

13

(17

)1

4 (1

9)

13

(19

)1

5 (2

0)

000

616

10

-05

861

95

63So

cial

Pro

blem

sM

ean

en (S

D) r

aw sc

ore

26

(26

)1

8 (2

3)

21

(26

)1

5 (1

9)

231

61

70

211

6738

122

096

Thou

ght P

robl

ems

Mea

n en

(SD

) raw

scor

e1

7 (1

8)

14

(17

)1

6 (2

0)

17

(22

)0

6461

75

22-1

62

258

971

05At

tent

ion

Prob

lem

sM

ean

en (S

D) r

aw sc

ore

32

(31

)2

7 (3

1)

32

(31

)3

2 (3

2)

000

617

10

-17

962

20

73Ru

le-B

reak

ing

Beha

viou

rM

ean

en (S

D) r

aw sc

ore

16

(18

)2

2 (3

0)

13

(16

)1

7 (2

0)

215

523

380

322

4147

201

016

Aggr

essi

ve B

ehav

iour

Mea

n en

(SD

) raw

scor

e4

5 (4

3)

44

(47

)4

0 (4

6)

35

(38

)1

3661

71

742

4838

956

014

Inte

rnal

isin

gM

ean

en (S

D) r

aw sc

ore

60

(50

)6

5 (5

7)

54

(60

)6

1 (6

2)

128

411

732

030

7762

24

43Ex

tern

alis

ing

Mea

n en

(SD

) raw

scor

e6

1 (5

6)

66

(70

)5

3 (5

8)

51

(54

)1

6961

70

912

8640

850

005

Tota

l Pro

blem

sM

ean

en (S

D) r

aw sc

ore

229

(16

6)22

0 (1

82)

201

(18

0)20

1 (1

80)

196

617

050

118

622

240












Discussion





(N = 170)


(N =718)N r N r





- - 554 60 p lt 001



























References



























































Discussion





(N = 170)


(N =718)N r N r





- - 554 60 p lt 001



























References










































































References


























































psychobelg2011_3-4book 5 Tuesday November 8 2011 1041 AM

doi: psychologica

Documents