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. 2011 Sep;123(5):50-9.
doi: 10.3810/pgm.2011.09.2459.

Toward defining deficient emotional self-regulation in children with attention-deficit/hyperactivity disorder using the Child Behavior Checklist: a controlled study

Thomas J Spencer  1 , Stephen V Faraone, Craig B H Surman, Carter Petty, Allison Clarke, Holly Batchelder, Janet Wozniak, Joseph Biederman
Affiliations

Toward defining deficient emotional self-regulation in children with attention-deficit/hyperactivity disorder using the Child Behavior Checklist: a controlled study

Thomas J Spencer et al. Postgrad Med. 2011 Sep.

Abstract

Objective: Deficient emotional self-regulation (DESR) is characterized by deficits in self-regulating the physiological arousal caused by strong emotions. We examined whether a unique profile of the Child Behavior Checklist (CBCL) would help identify DESR in children with attention-deficit/hyperactivity disorder (ADHD).

Methods: Subjects included 197 children with ADHD and 224 children without ADHD. We defined DESR if a child had an aggregate cut-off score of > 180 but < 210 on the Anxiety/Depression, Aggression, and Attention scales of the CBCL (CBCL-DESR). This profile was selected because of: 1) its conceptual congruence with the clinical concept of DESR; and 2) because its extreme (> 210) form has been previously associated with severe forms of mood and behavioral dysregulation in children with ADHD. All subjects were comprehensively assessed with structured diagnostic interviews and a wide range of functional measures.

Results: Forty-four percent of children with ADHD had a positive CBCL-DESR profile versus 2% of controls (P < 0.001). The CBCL-DESR profile was associated with elevated rates of anxiety and disruptive behavior disorders, as well as significantly more impairments in emotional and interpersonal functioning.

Conclusions: The CBCL-DESR profile helped identify a subgroup of children with ADHD who had a psychopathological and functional profile consistent with the clinical concept of DESR.

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Figures

Figure 1
Figure 1
A. Rates of deficient emotional self-regulation (DESR, sum of CBCL attention, aggression, and anxious/depressed t-scores ≥180 and <210); (B) Percent of subjects with ADHD-associated severe impairment
Figure 2
Figure 2
Attention- Deficit/ Hyperactivity Disorder (ADHD) symptoms
Figure 3
Figure 3
DESR and psychopathology (A) Comorbid disorders; (B) Other Child Behavior Checklist (CBCL) scales
Figure 3
Figure 3
DESR and psychopathology (A) Comorbid disorders; (B) Other Child Behavior Checklist (CBCL) scales
Figure 4
Figure 4
Social Adjustment Inventory for Children and Adolescents (SAICA)
Figure 5
Figure 5
School and family functioning; (A) School functioning; (B) Family Environment Scale (FES)
See this image and copyright information in PMC

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