The Child Behavior Checklist-Dysregulation Profile predicts substance use, suicidality, and functional impairment: a longitudinal analysis

• Published in: Journal of child psychology and psychiatry Vol. 52; no. 2; pp. 139 - 147
• Main Authors: Holtmann, Martin, Buchmann, Arlette F., Esser, Guenter, Schmidt, Martin H., Banaschewski, Tobias, Laucht, Manfred
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.02.2011; Wiley-Blackwell; Blackwell
• Subjects: Addictive behaviors; ADHD; Adolescent; Adolescents; Adult and adolescent clinical studies; Age Factors; At Risk Persons; Behavior disorders; Behavior Rating Scales; Biological and medical sciences; bipolar; Bipolar affective disorder; Bipolar Disorder - diagnosis; Bipolar Disorder - epidemiology; CBCL; Check Lists; Checklist - utilization; Child; Child & adolescent psychiatry; Child Behavior; Child Behavior Checklist; Child, Preschool; Childhood; Children; Comorbidity; Correlation; Depression; Drug use; Dysregulation; Educational Attainment; Family Income; Female; Follow-Up Studies; Humans; Infant; irritability; longitudinal; Longitudinal Studies; Male; Measures (Individuals); Medical sciences; Mental Disorders; Miscellaneous; Mood disorders; Parent Background; Personality Tests - standards; Predictive Value of Tests; Profiles; Psychiatric Status Rating Scales - standards; Psychiatry; Psychological tests; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk; Risk factors; Scores; Self Control; Substance Abuse; substance use; Substance-Related Disorders - diagnosis; Substance-Related Disorders - epidemiology; Suicidal behaviour; suicidality; Suicide; Suicide - statistics & numerical data; Suicides & suicide attempts; Symptoms (Individual Disorders); Young Adult; Young Adults; ADHD; Questionnaire; Irritability; Child Behavior Checklist Achenbach Edelbrock; Suicide; CBCL; Attention disorder with hyperactivity; Child; Human; Mood disorder; suicidality; childhood; Dysregulation; Psychometrics; Depression; Substance abuse; substance use; Concomitant disease; comorbidity; Follow up study; Dysfunction; Young adult; bipolar; Predictive factor; Suicide ideation; longitudinal
• ISSN: 0021-9630; 1469-7610
• DOI: 10.1111/j.1469-7610.2010.02309.x

Background:  Recent studies have identified a Child Behavior Checklist profile that characterizes children with severe affective and behavioral dysregulation (CBCL‐dysregulation profile, CBCL‐DP). In two recent longitudinal studies the CBCL‐DP in childhood was associated with heightened rates of comorbid psychiatric disorders, among them bipolar disorder, an increased risk for suicidality, and marked psychosocial impairment at young‐adult follow‐up. This is the first study outside the US that examines the longitudinal course of the CBCL‐DP. Methods:  We studied the diagnostic and functional trajectories and the predictive utility of the CBCL‐DP in the Mannheim Study of Children at Risk, an epidemiological cohort study on the outcome of early risk factors from birth into adulthood. A total of 325 young adults (151 males, 174 females) participated in the 19‐year assessment. Results:  Young adults with a higher CBCL‐DP score in childhood were at increased risk for substance use disorders, suicidality and poorer overall functioning at age 19, even after adjustment for parental education, family income, impairment and psychiatric disorders at baseline. Childhood dysregulation was not related to bipolar disorder in young adulthood. The CBCL‐DP was neither a precursor of a specific pattern of comorbidity nor of comorbidity in general. Conclusions:  Children with high CBCL‐DP values are at risk for later severe, psychiatric symptomatology. The different developmental trajectories suggest that the CBCL‐DP is not simply an early manifestation of a single disease process but might rather be an early developmental risk marker of a persisting deficit of self‐regulation of affect and behavior.