title: Severity of the aggression/anxiety-depression/attention child behavior checklist profile discriminates between different levels of deficits in emotional regulation in youth with attention-deficit hyperactivity disorder.
abstract: OBJECTIVE
  We examined whether severity scores (1 SD vs 2 SDs) of a unique profile of the Child Behavior Checklist (CBCL) consisting of the Anxiety/Depression, Aggression, and Attention (AAA) scales would help differentiate levels of deficits in children with attention-deficit hyperactivity disorder (ADHD).
  
  
  METHODS
  Subjects were 197 children with ADHD and 224 without ADHD. We defined deficient emotional self-regulation (DESR) as an aggregate cutoff score of >180 but <210 (1 SD) on the AAA scales of the CBCL (CBCL-DESR) and Severe Dysregulation as an aggregate cutoff score of ≥210 on the same scales (CBCL-Severe Dysregulation). All subjects were assessed with structured diagnostic interviews and a range of functional measures.
  
  
  RESULTS
  Thirty-six percent of children with ADHD had a positive CBCL-DESR profile versus 2% of controls (p < .001) and 19% had a positive CBCL-Severe Dysregulation profile versus 0% of controls (p < .001). The subjects positive for the CBCL-Severe Dysregulation profile differed selectively from those with the CBCL-DESR profile in having higher rates of unipolar and bipolar mood disorders, oppositional defiant and conduct disorders, psychiatric hospitalization at both baseline and follow-up assessments, and a higher rate of the CBCL-Severe Dysregulation in siblings. In contrast, the CBCL-DESR was associated with higher rates of comorbid disruptive behavior, anxiety disorders, and impaired interpersonal functioning compared with other ADHD children.
  
  
  CONCLUSIONS
  Severity scores of the AAA CBCL profiles can help distinguish 2 groups of emotional regulation problems in children with ADHD.
authors.affiliation: Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Yawkey Center for Outpatient Care, Boston, MA, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
authors.forename: Carter R
authors.initials: CR
authors.lastname: Petty
authors.forename: Helen
authors.initials: H
authors.lastname: Day
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Goldin
authors.forename: Thomas
authors.initials: T
authors.lastname: Spencer
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Faraone
authors.forename: Craig B H
authors.initials: CB
authors.lastname: Surman
authors.forename: Janet
authors.initials: J
authors.lastname: Wozniak
mesh_terms: D000293:Adolescent; D000328:Adult; D000374:Aggression / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010290:Parents / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D035781:Siblings / Q000523:psychology