title: The Problem Behaviour Checklist: short scale to assess challenging behaviours.
abstract: BACKGROUND
  Challenging behaviour, especially in intellectual disability, covers a wide range that is in need of further evaluation.
  
  
  OBJECTIVE
  To develop a short but comprehensive instrument for all aspects of challenging behaviour.
  
  
  METHODS
  In the first part of a two-stage enquiry, a 28-item scale was constructed to examine the components of challenging behaviour. Following a simple factor analysis this was developed further to create a new short scale, the Problem Behaviour Checklist (PBCL). The scale was subsequently used in a randomised controlled trial and tested for interrater reliability. Scores were also compared with a standard scale, the Modified Overt Aggression Scale (MOAS).
  
  
  RESULTS
  Seven identified factors - personal violence, violence against property, self-harm, sexually inappropriate, contrary, demanding and disappearing behaviour - were scored on a 5-point scale. A subsequent factor analysis with the second population showed demanding, violent and contrary behaviour to account for most of the variance. Interrater reliability using weighted kappa showed good agreement (0.91; 95% CI 0.83-0.99). Good agreement was also shown with scores on the MOAS and a score of 1 on the PBCL showed high sensitivity (97%) and specificity (85%) for a threshold MOASscore of 4.
  
  
  CONCLUSIONS
  The PBCL appears to be a suitable and practical scale for assessing all aspects of challenging behaviour.
  
  
  BACKGROUND
  None.
  © 2016 The Royal College of Psychiatrists. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
authors.affiliation: , FMedSci, Centre for Mental Health, Imperial College London, London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Tyrer
authors.affiliation: , MSc, CRF Health, Hammersmith, London, UK.
authors.forename: Jessica
authors.initials: J
authors.lastname: Nagar
authors.affiliation: , MSc, Harris Manchester College, University of Oxford, Oxford, UK.
authors.forename: Rosie
authors.initials: R
authors.lastname: Evans
authors.affiliation: , PhD, Centre for Mental Health, Imperial College London, London, UK.
authors.forename: Patricia
authors.initials: P
authors.lastname: Oliver
authors.affiliation: , MSc, FRSS, independent statistical consultant, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Bassett
authors.affiliation: , BSc, Western Psychiatric Institute, University of Pittsburg Medical Center, Pittsburg, California, USA.
authors.forename: Natalie
authors.initials: N
authors.lastname: Liedtka
authors.affiliation: , MSc, Centre for Mental Health, Imperial College London, London, UK.
authors.forename: Aris
authors.initials: A
authors.lastname: Tarabi