Abstract
Emotional dysregulation in childhood has been associated with various forms of later psychopathology, although no studies have investigated the personality related adolescent outcomes associated with early emotional dysregulation. The present study uses a typological approach to examine how the child behavior checklist-dysregulation profile (CBCL-DP) predicts DSM-5 pathological personality traits (as measured with the personality inventory for the diagnostic and statistical manual of mental disorders 5 or PID-5 by Krueger et al. (Psychol Med 2012)) across a time span of 4 years in a sample of 243 children aged 8–14 years (57.2 % girls). The results showed that children assigned to the CBCL-DP class are at risk for elevated scores on a wide range of DSM-5 personality pathology features, including higher scores on hostility, risk taking, deceitfulness, callousness, grandiosity, irresponsibility, impulsivity and manipulativeness. These results are discussed in the context of identifying early manifestations of persistent regulation problems, because of their enduring impact on a child’s personality development.
Similar content being viewed by others
Notes
Throughout this study, we will use this broad CBCL-DP label as interchangeable with the other labels that have previously been proposed for this specific profile of psychopathology.
References
Krueger RF, Derringer J, Markon KE, Watson D, Skodol A (2012) Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychol Med. doi:10.1017/S0033291711002674
American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders (DSM-IV-TR), 4th edn, Text revision Author, Washington
Coyle JT, Pine DS, Charney DS, Lewis L, Nemeroff CB, Carlson GA, Joshi PT, Reiss D, Todd RD, Hellander M (2003) Depression and bipolar support alliance consensus statement on the unmet needs in diagnosis and treatment of mood disorders in children and adolescents. J Am Acad Child Adolesc Psychiatry 42(12):1494–1503. doi:10.1097/01.chi.0000091945.28938.8f
Geller B, Luby J (1997) Child and adolescent bipolar disorder: a review of the past 10 years. J Am Acad Child Psychiatry 36(9):1168–1176. doi:10.1097/00004583-199709000-00008
Leibenluft E, Charney DS, Towbin KE, Bhangoo RK, Pine DS (2003) Defining clinical phenotypes of juvenile mania. Am J Psychiatry 160(3):430–437. doi:10.1176/appi.ajp.160.3.430
Biederman J, Wozniak J, Kiely K, Ablon S, Faraone S, Mick E, Mundy E, Kraus I (1995) CBCL clinical-scales discriminate prepubertal children with structured interview-derived diagnosis of mania from those with ADHD. J Am Acad Child Psychiatry 34(4):464–471. doi:10.1097/00004583-199504000-00013
Achenbach TM, Rescorla LA (2001) Manual for ASEBA school-age forms and profiles. University of Vermont, Research Center for Children, Youth, & Families, Burlington
Verhulst FC, Van der Ende J (2001) Handleiding voor de CBCL/6-18, YSR en TRF (Dutch manual for CBCL/6-18, YSR, and TRF). Erasmus Universiteit Rotterdam, Sophia Kinderziekenhuis, Rotterdam
Carlson GA, Kelly KL (1998) Manic symptoms in psychiatrically hospitalized children—what do they mean? J Affect Disord 51(2):123–135. doi:10.1016/s0165-0327(98)00211-0
Dienes KA, Chang KD, Blasey CM, Adleman NE, Steiner H (2002) Characterization of children of bipolar parents by parent report CBCL. J Psychiatr Res 36(5):337–345. doi:s0022-3956(02)00019-510.1016/s0022-3956(02)00019-5
Geller B, Warner K, Williams M, Zimerman B (1998) Prepubertal and young adolescent bipolarity versus ADHD: assessment and validity using the WASH-U-KSADS, CBCL and TRF. J Affect Disord 51(2):93–100. doi:10.1016/s0165-0327(98)00176-1
Hazell PL, Lewin TJ, Carr VJ (1999) Confirmation that child behavior checklist clinical scales discriminate juvenile mania from attention deficit hyperactivity disorder. J Paediatr Child H 35(2):199–203
Wals M, Hillegers MHJ, Reichart CG, Ormel J, Nolen WA, Verhulst FC (2001) Prevalence of psychopathology in children of a bipolar parent. J Am Acad Child Psychiatry 40(9):1094–1102. doi:10.1097/00004583-200109000-00019
Hudziak JJ, Althoff RR, Derks EM, Faraone SV, Boomsma DI (2005) Prevalence and genetic architecture of child behavior checklist-juvenile bipolar disorder. Biol Psychiatry 58(7):562–568. doi:10.1016/j.biopsych.2005.03.024
Biederman J, Petty CR, Monuteaux MC, Evans M, Parcell T, Faraone SV, Wozniak J (2009) The child behavior checklist-pediatric bipolar disorder profile predicts a subsequent diagnosis of bipolar disorder and associated impairments in ADHD youth growing up: a longitudinal analysis. J Clin Psychiatry 70(5):732–740
Galanter CA, Carlson GA, Jensen PS, Greenhill LL, Davies M, Li W, Chuang SZ, Elliott GR, Arnold LE, March JS, Hechtman L, Pelham WE, Swanson JM (2003) Response to methylphenidate in children with attention deficit hyperactivity disorder and manic symptoms in the multimodal treatment study of children with attention deficit hyperactivity disorder titration trial. J Child Adol Psychop 13(2):123–136. doi:10.1089/104454603322163844
Boomsma DI, Rebollo I, Derks EM, van Beijsterveldt TCEM, Althoff RR, Rettew DC, Hudziak JJ (2006) Longitudinal stability of the CBCL-juvenile bipolar disorder phenotype: a study in Dutch twins. Biol Psychiatry 60(9):912–920. doi:10.1016/j.biopsych.2006.02.028
Althoff RR, Rettew DC, Ayer LA, Hudziak JJ (2010) Cross-informant agreement of the dysregulation profile of the child behavior checklist. Psychiatry Res 178(3):550–555. doi:10.1016/j.psychres.2010.05.002
Faraone SV, Althoff RR, Hudziak JJ, Monuteaux M, Biederman J (2005) The CBCL predicts DSM bipolar disorder in children: a receiver operating characteristic curve analysis. Bipolar Disord 7(6):518–524. doi:10.1111/j.1399-5618.2005.00271.x
Mick E, Biederman J, Pandina G, Faraone SV (2003) A preliminary meta-analysis of the child behavior checklist in pediatric bipolar disorder. Biol Psychiatry 53(11):1021–1027. doi:10.1016/s0006-3223(03)00234-8
Althoff RR, Ayer LA, Rettew DC, Hudziak JJ (2010) Assessment of dysregulated children using the child behavior checklist: a receiver operating characteristic curve analysis. Psychol Assess 22(3):609–617. doi:10.1037/a0019699
Althoff RR, Rettew DC, Faraone SV, Boomsma DI, Hudziak JJ (2006) Latent class analysis shows strong heritability of the child behavior checklist-juvenile bipolar phenotype. Biol Psychiatry 60(9):903–911. doi:10.1016/j.biopsych.2006.02.025
Ayer L, Althoff R, Ivanova M, Rettew D, Waxler E, Sulman J, Hudziak J (2009) Child behavior checklist juvenile bipolar disorder (CBCL-JBD) and CBCL posttraumatic stress problems (CBCL-PTSP) scales are measures of a single dysregulatory syndrome. J Child Psychol Psychiatry 50(10):1291–1300. doi:10.1111/j.1469-7610.2009.02089.x
Diler RS, Birmaher B, Axelson D, Goldstein B, Gill M, Strober M, Kolko DJ, Goldstein TR, Hunt J, Yang M, Ryan ND, Iyengar S, Dahl RE, Dorn LD, Keller MB (2009) The child behavior checklist (CBCL) and the CBCL-bipolar phenotype are not useful in diagnosing pediatric bipolar disorder. J Child Adolesc Psychopharmacol 19(1):23–30. doi:10.1089/cap.2008.067
Meyer SE, Carlson GA, Youngstrom E, Ronsaville DS, Martinez PE, Gold PW, Hakak R, Radke-Yarrow M (2009) Long-term outcomes of youth who manifested the CBCL-pediatric bipolar disorder phenotype during childhood and/or adolescence. J Affect Disord 113(3):227–235. doi:10.1016/j.jad.2008.05.024
Hazell PL, Carr V, Lewin TJ, Sly K (2003) Manic symptoms in young males with ADHD predict functioning but not diagnosis after 6 years. J Am Acad Child Psychiatry 42(5):552–560. doi:10.1097/01.chi.0000046830.95464.33
Holtmann M, Buchmann AF, Esser G, Schmidt MH, Banaschewski T, Laucht M (2011) The Child Behavior Checklist-dysregulation profile predicts substance use, suicidality, and functional impairment: a longitudinal analysis. J Child Psychol Psychiatry 52(2):139–147. doi:10.1111/j.1469-7610.2010.02309.x
Althoff RR, Verhulst FC, Rettew DC, Hudziak JJ, van der Ende J (2010) Adult outcomes of childhood dysregulation: a 14 year follow-up study. J Am Acad Child Adolesc Psychiatry 49(11):1105–1116. doi:10.1016/j.jaac.2010.08.006
Althoff RR, Rettew DC, Boomsma DI, Hudziak JJ (2009) Latent class analysis of the child behavior checklist obsessive-compulsive scale. Compr Psychiatry 50(6):584–592. doi:10.1016/j.comppsych.2009.01.005
Althoff RR, Ayer LA, Crehan ET, Rettew DC, Baer JR, Hudziak JJ (2012) Temperamental profiles of dysregulated children. Child Psychiatry Hum Dev 43(4):511–522. doi:10.1007/s10578-012-0280-7
Rettew DC, Althoff RR, Dumenci L, Ayer L, Hudziak JJ (2008) Latent profiles of temperament and their relations to psychopathology and wellness. J Am Acad Child Adolesc Psychiatry 47(3):273–281. doi:10.1097/chi.0b013e318160b403
Halperin JM, Rucklidge JJ, Powers RL, Miller CJ, Newcorn JH (2011) Childhood CBCL bipolar profile and adolescent/young adult personality disorders: a 9-year follow-up. J Affect Disord 130(1–2):155–161. doi:10.1016/j.jad.2010.10.019
De Clercq B, De Fruyt F, Widiger TA (2009) Integrating a developmental perspective in dimensional models of personality disorders. Clin Psychol Rev 29(2):154–162. doi:10.1016/j.cpr.2008.12.002
Clark LA (2007) Assessment and diagnosis of personality disorder: perennial issues and an emerging reconceptualization. Annu Rev Psychol 58:227–257. doi:10.1146/annurev.psych.57.102904.190200
Widiger TA, Trull TJ (2007) Plate tectonics in the classification of personality disorder—shifting to a dimensional model. Am Psychol 62(2):71–83. doi:10.1037/0003-066x.62.2.71
Wright AGC, Thomas KM, Hopwood CJ, Markon KE, Pincus AL, Krueger RF (2012) The hierarchical structure of the DSM-5 pathological personality traits. J Abnorm Psychol 121(4):951–957. doi:10.1037/a0027669
Hopwood CJ, Thomas KM, Wright AGC, Markon KA, Krueger RF (2012) DSM-5 personality traits and DSM-IV personality disorders. J Abnorm Psychol 121(2):424–432. doi:10.1037/a0026656
De Bolle M, De Fruyt F, Decuyper M (2010) The affect and arousal Scales: psychometric properties of the Dutch version and multigroup confirmatory factor analyses. Assessment 17(2):241–258. doi:10.1177/1073191109358175
Goodman LA (1974) Exploratory latent structure-analysis using both identifiable and unidentifiable models. Biometrika 61(2):215–231. doi:10.1093/biomet/61.2.215
Muthén LK, Muthén BO (1998-2010) Mplus user’s guide. Sixth edn. CA: Muthén and Muthén, Los Angeles
Akaike H (1987) Factor-analysis and AIC. Psychometrika 52(3):317–332. doi:10.1007/bf02294359
Schwarz G (1978) Estimating dimension of a model. Ann Stat 6(2):461–464. doi:10.1214/aos/1176344136
Paris J (2003) Personality disorders over time: Precursors, course, and outcome. American Psychiatric Publishing, Inc., Washington
Jucksch V, Salbach-Andrae H, Lenz K, Goth K, Doepfner M, Poustka F, Freitag CM, Lehmkuhl G, Lehmkuhl U, Holtmann M (2011) Severe affective and behavioural dysregulation is associated with significant psychosocial adversity and impairment. J Child Psychol Psychiatry 52(6):686–695. doi:10.1111/j.1469-7610.2010.02322.x
Links PS, Gould B, Ratnayake R (2003) Assessing suicidal youth with antisocial, borderline or narcissistic personality disorder. Can J Psychiatry 48(5):301–310
Shaffer D, Widiger TA, Pincus HA (1998) DSM-IV child disorders, part II: final overview. In: Widiger TA, Frances AJ, Pincus HA et al. (eds) DSM-IV sourcebook, vol 4. American Psychiatric Association, Washington, pp 963–977
Penney SR, Moretti MM (2010) The roles of affect dysregulation and deficient affect in youth violence. Crim Justice Behav 37(6):709–731. doi:10.1177/0093854810365446
Cicchetti D, Crick NR (2009) Precursors and diverse pathways to personality disorder in children and adolescents. Dev Psychopathol 21(3):683–685. doi:10.1017/s0954579409000388
Bemporad JR, Smith HF, Hanson G, Cicchetti D (1982) Borderline syndromes in childhood—criteria for diagnosis. Am J Psychiatry 139(5):596–602
Wolke D, Waylen A, Samara M, Steer C, Goodman R, Ford T, Lamberts K (2009) Selective drop-out in longitudinal studies and non-biased prediction of behaviour disorders. Brit J Psychiatry 195(3):249–256. doi:10.1192/bjp.bp.108.053751
Cohen J (1988) Statistical power analysis for the behavioral sciences (second ed.). Lawrence Erlbaum Associates
Acknowledgments
The authors wish to thank Prof. Dr. Robert Althoff and Prof. Dr. Filip De Fruyt for their helpful comments on an earlier version of this manuscript. The quality of this manuscript improved secondary to the comments of the anonymous reviewers and we thank them for their efforts.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
De Caluwé, E., Decuyper, M. & De Clercq, B. The child behavior checklist dysregulation profile predicts adolescent DSM-5 pathological personality traits 4 years later. Eur Child Adolesc Psychiatry 22, 401–411 (2013). https://doi.org/10.1007/s00787-013-0379-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00787-013-0379-9