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. 2021 Jun:138:477-484.
doi: 10.1016/j.jpsychires.2021.04.028. Epub 2021 Apr 30.

The child behavior checklist can aid in characterizing suspected comorbid psychopathology in clinically referred youth with ADHD

Joseph Biederman  1 , Maura DiSalvo  2 , Carrie Vaudreuil  3 , Janet Wozniak  3 , Mai Uchida  3 , K Yvonne Woodworth  2 , Allison Green  2 , Abigail Farrell  2 , Stephen V Faraone  4
Affiliations

The child behavior checklist can aid in characterizing suspected comorbid psychopathology in clinically referred youth with ADHD

Joseph Biederman et al. J Psychiatr Res. 2021 Jun.

Abstract

Objective: To examine the utility of the Child Behavior Checklist (CBCL) to aid in the identification of comorbid psychopathological conditions affecting referred youth with suspected ADHD prior to the evaluation. The CBCL is an easy-to-use assessment tool that may provide invaluable information regarding the severity and characteristics of the presenting complaints.

Methods: The sample included 332 youths consecutively referred to an ADHD program for the assessment of suspected ADHD. Parents completed the CBCL, parent-rated ADHD Self-Report Scale (ASRS), Social Responsiveness Scale (SRS), and Behavior Rating Inventory of Executive Function (BRIEF). Because of the established association between the CBCL Attention Problems scale and a structured diagnostic interview of ADHD, all youths analyzed had abnormal Attention Problems T-scores (≥60).

Results: Seventy-six percent of youths with elevated Attention Problems T-scores had ≥3 additional abnormal CBCL scales, suggesting they were likely affected with multiple comorbid psychopathological conditions. Moreover, 44% had ≥1 CBCL clinical scale with a T-score more severe than their Attention Problems T-score, suggesting the putative comorbid condition was more severe than the ADHD symptoms. Additional CBCL scale elevations were associated with more severe functional impairments as assessed by the ASRS, SRS, BRIEF, and CBCL competence scales.

Conclusion: The CBCL obtained before the clinical assessment identified high rates of comorbid psychopathology in youths referred for the assessment of ADHD. It provided detailed information about the types and severity of suspected psychopathological conditions impacting a particular youth, which is critical to guide the assessing clinician on likely differing needs of the affected child.

Keywords: ADHD; Child behavior checklist; Comorbid psychopathology; Pediatric.

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Conflict of interest statement

Conflict of Interest Disclosures

Dr. Joseph Biederman is currently receiving research support from the following sources: AACAP, Feinstein Institute for Medical Research, Food & Drug Administration, Genentech, Headspace Inc., NIDA, Pfizer Pharmaceuticals, Roche TCRC Inc., Shire Pharmaceuticals Inc., Sunovion Pharmaceuticals Inc., Tris, and NIH. Dr. Biederman’s program has received departmental royalties from a copyrighted rating scale used for ADHD diagnoses, paid by Bracket Global, Ingenix, Prophase, Shire, Sunovion, and Theravance; these royalties were paid to the Department of Psychiatry at MGH. In 2020: Through MGH corporate licensing, Dr. Biederman has a US Patent (#14/027,676) for a non-stimulant treatment for ADHD, a US Patent (#10,245,271 B2) on a treatment of impaired cognitive flexibility, and a patent pending (#61/233,686) on a method to prevent stimulant abuse. He receives honoraria from the MGH Psychiatry Academy for tuition-funded CME courses. In 2019, Dr. Biederman was a consultant for Akili, Avekshan, Jazz Pharma, and Shire/Takeda. He received research support from Lundbeck AS and Neurocentria Inc. Through MGH CTNI, he participated in a scientific advisory board for Supernus. He received honoraria from the MGH Psychiatry Academy for tuition-funded CME courses. In 2018, Dr. Biederman was a consultant for Akili and Shire. He received honoraria from the MGH Psychiatry Academy for tuition-funded CME courses.

Dr. Carrie Vaudreuil is currently receiving research support from the Louis V. Gerstner III Research Scholar Program.

Dr. Janet Wozniak receives research support from PCORI and Demarest Lloyd, Jr. Foundation. In the past, Dr. Wozniak has received research support, consultation fees or speaker’s fees from Eli Lilly, Janssen, Johnson and Johnson, McNeil, Merck/Schering-Plough, the National Institute of Mental Health (NIMH) of the National Institutes of Health (NIH), Pfizer, and Shire. She is the author of the book Is Your Child Bipolar published May 2008, Bantam Books.

In the past year, Dr. Faraone received income, potential income, travel expenses continuing education support and/or research support from Rhodes, OnDosis, Tris, Otsuka, Arbor, Ironshore, Takeda, Akili, Sunovion, Supernus and Genomind. With his institution, he has US patent US20130217707 A1 for the use of sodium-hydrogen exchange inhibitors in the treatment of ADHD. In previous years, he received support from: Shire, Ironshore, Enzymotec, Neurovance, Alcobra, Rhodes, CogCubed, KemPharm, Enzymotec, Akili, Neurolifesciences, Lundbeck/Takeda, Otsuka, McNeil, Janssen, Novartis, Pfizer and Eli Lilly. He also receives royalties from books published by Guilford Press: Straight Talk about Your Child’s Mental Health, Oxford University Press: Schizophrenia: The Facts and Elsevier: ADHD: Non-Pharmacologic Interventions. He is principal investigator of www.adhdinadults.com.

Dr. Mai Uchida is partially supported by a K award, grant number 1K23MH122667-01.

Ms. Maura DiSalvo, Ms. K. Yvonne Woodworth, Ms. Abigail Farrell, and Ms. Allison Green do not have any financial relationships to disclose.

Figures

Figure 1.
Figure 1.
Clinical Scores on the Parent-ASRS, CBCL Competence, BRIEF, and SRS Scales in Youths Referred for the Assessment of ADHD with Elevated CBCL Attention Problems T-scores (≥60) (N=332)
Figure 2.
Figure 2.
Additional CBCL Findings in Youths Referred for the Assessment of ADHD with Elevated CBCL Attention Problems T-scores (≥60)(N=332)
Figure 3.
Figure 3.
Percent of Referred Youths with Elevated CBCL Attention Problems T-scores (≥60) with Clinical Scores on the BRIEF, SRS, and CBCL Competence Scales Stratified by the Number of Additional Elevated CBCL Clinical Scales (N=332)
See this image and copyright information in PMC

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