Robert R. Althoff, MD, PhD; Lynsay A. Ayer, BA; David C. Rettew, MD;

1. ASSESSMENT OF DYSREGULATED CHILDREN USING THE CHILD BEHAVIOR CHECKLIST: A RECEVIER OPERATING CHARACTERISTIC CURVE ANALYSIS Robert R. Althoff, MD, PhD; Lynsay A. Ayer, BA; David C. Rettew, MD; Ana Kuny, BA; & James J. Hudziak, MD Vermont Center for Children, Youth, & Families, University of Vermont College of Medicine Introduction Analyses ROC Results Boys Girls Disorders of self-regulatory behavior are common reasons for referral to child and adolescent clinicians. Following up on finding of Ayer et al (JCPP, 2009), we sought to compare two methods of empirically-based assessment of children with problems in self-regulatory behavior. • Latent Class Analysis (LCA) was performed on the attention problems, aggressive behavior, and anxious-depressed items from the entire sample with sex and age as covariates • Membership in the 7 latent classes that emerged were compared with scores on the CBCL-PTSP scale • Receiver operating characteristic curve analysis was performed to determine the accuracy of the CBCL-PTSP scale to predict membership in the various latent classes. Sample • Score on the CBCL-PTSP scale predict membership in Classes 6 and 7. • Removing overlapping items between the CBCL-DP and the CBCL-PTSP, the AUC remained high [Girls: AUC = 0.92 (0.89 – 0.94); Boys: AUC = 0.93 (0.90 – 0.96)] in Class 6 but dropped in Class 7 [Girls: AUC = 0.85 (0.82-0.87); Boys: AUC = 0.83 (0.78-0.87)]. Parental reports on 2028 children (53% boys) from a U.S. national probability sample of the Child Behavior Checklist. Children ranged in age from 6 to18, with an overall mean age of 11.98 (SD = 3.53). Latent Class Results Measures Comparisons were made between the CBCL-Dysregulation Profile (elevations on Attention Problems, Aggressive Behavior, and Anxious-Depression scales of the CBCL) and the CBCL-Post Traumatic Stress Problems scale. Specifically, we examined membership in a CBCL-DP latent class as it compares to scores on the CBCL-PTSP scale which has been demonstrated to have sensitivity to detect children with PTSD, but not tremendous specificity. Conclusions Similar to Ayer et al (2009) using structural equation modeling, ROC analysis demonstrates that the CBCL-PTSP scale predicts the same children as elevations on Attention Problems, Aggressive Behavior, and Anxious-Depression on the CBCL. This is consistent with a conceptualization that both this profile and this scale are measuring broadly dysregulated children. A 7-class model with sex as a covariate fit best. Two classes demonstrated elevations on all three scales: Classes 6 and 7, which differed in the level of relational versus direct aggression.