Background
Methods
Study site and population
Translation of CBCL into local languages
Sample size determination
Administration of CBCL
Ethics, consent and permissions
Statistical analysis
Results
General description
CBCL median scores
Subscales | Scores for all children (IQR) | Scores for boys (IQR) | Scores for girls (IQR) | P value* |
---|---|---|---|---|
Emotionally reactive | 1.0 (0–2.0) | 1.0 (0–2.0) | 1.0 (0–3.0) | 0.286 |
Anxiously depressed | 2.0 (0–5.0) | 2.0 (0–5.0) | 2.0 (0–5.0) | 0.419 |
Somatic complaints | 2.0 (0–4.0) | 2.0 (0–3.0) | 2.0 (0–4.0) | 0.363 |
Withdrawn | 2.0 (0–3.0) | 1.0 (0–2.0) | 2.0 (0–3.0) | 0.198 |
Sleep problems | 2.0 (0–3.0) | 2.0 (0–3.0) | 2.0 (0–3.0) | 0.841 |
Attention problems | 2.0 (1.0–4.0) | 2.0 (1.0–4.0) | 2.0 (1.0–4.0) | 0.453 |
Aggressive behaviour | 4.0 (1.0–9.0) | 4.0 (1.0–9.0) | 4.0 (1.0–9.0) | 0.992 |
Internalising subscales | 7.0 (3.0–14.0) | 7.0 (3.0–12.0) | 7.0 (4.0–15) | 0.312 |
Externalising subscales | 6.0 (3.0–12.0) | 6.0 (3.0–11.0) | 6.0 (3.0–14.0) | 0.898 |
Associations of pregnancy/birth, socioeconomic and medical factors with behavioural/emotional scores
Test–retest reliability
Inter-informant agreement
Internal consistency
Subscales | Cronbach’s alpha: all children (95 % CI) | Cronbach’s alpha: boys (95 % CI) | Cronbach’s alpha: girls (95 % CI) | RMSEA: all children | CFI: all children | TLI: all children |
---|---|---|---|---|---|---|
Emotionally reactive | 0.70 (0.65–0.75) | 0.71 (0.64–0.78) | 0.68 (0.61–0.75) | 0.039 | 0.97 | 0.96 |
Anxiously depressed | 0.74 (0.70–0.77) | 0.77 (0.72–0.82) | 0.69 (0.62–0.76) | 0.050 | 0.97 | 0.95 |
Somatic complaints | 0.69 (0.65–0.73) | 0.67 (0.61–0.73) | 0.71 (0.65–0.77) | 0.054 | 0.94 | 0.92 |
Withdrawn | 0.53 (0.46–0.59) | 0.50 (0.40–0.60) | 0.55 (0.45–0.65) | 0.000 | 1.00 | 1.00 |
Sleep problems | 0.65 (0.60–0.70) | 0.72 (0.67–0.77) | 0.49 (0.37–0.61) | 0.061 | 0.97 | 0.93 |
Attention problems | 0.57 (0.50–0.64) | 0.59 (0.50–0.68) | 0.57 (0.47–0.67) | 0.000 | 1.00 | 1.00 |
Aggressive behaviour | 0.86 (0.84–0.88) | 0.87 (0.85–0.89) | 0.84 (0.80–0.88) | 0.077 | 0.83 | 0.80 |
Internalising subscales | 0.87 (0.85–0.89) | 0.87 (0.85–0.89) | 0.87 (0.84–0.90) | 0.030 | 0.97 | 0.95 |
Externalising subscales | 0.86 (0.84–0.88) | 0.88 (0.85–0.91) | 0.85 (0.81–0.89) | 0.039 | 0.92 | 0.90 |
Standard coefficients and fit indices of the seven-syndrome CBCL structure
Syndrome items | Standardised item loading coefficients (95 % CI) |
---|---|
Emotionally reactive | Overall: 0.47 (0.36–0.58) |
Disturbed by any change in routine | 0.35 (0.23–0.47) |
Nervous movements or twitching | 0.33 (0.21–0.45) |
Shows panic for no good reason | 0.58 (0.48–0.68) |
Rapid shifts between sadness and excitement | 0.23 (0.11–0.36) |
Sudden changes in mood or feelings | 0.53 (0.42–0.63) |
Sulks a lot | 0.63 (0.54–0.72) |
Upset by new people or situations | 0.42 (0.30–0.53) |
Whining | 0.59 (0.49–0.68) |
Worries | 0.60 (0.50–0.70) |
Anxious depressed | Overall: 0.53 (0.43–0.63) |
Clings to adults or too dependent | 0.44 (0.32–0.55) |
Feelings are easily hurt | 0.53 (0.43–0.63) |
Gets too upset when separated from parents | 0.50 (0.40–0.61) |
Looks unhappy without good reason | 0.68 (0.60–0.77) |
Nervous, high-strung, or tense | 0.51 (0.41–0.59) |
Self-conscious or easily embarrassed | 0.41 (0.29–0.52) |
Too fearful or anxious | 0.59 (0.50–0.69) |
Unhappy, sad, or depressed | 0.58 (0.48–0.68) |
Somatic complaints | Overall: 0.46 (0.35–0.57) |
Aches or pains (without medical cause) | 0.35 (0.24–0.48) |
Can’t stand having things out of place | 0.31 (0.19–0.43) |
Constipated, doesn’t move bowels (when not sick) | 0.51 (0.41–0.62) |
Diarrhoea or loose bowels (when not sick) | 0.59 (0.49–0.68) |
Doesn’t eat well | 0.27 (0.15–0.39) |
Headaches (without medical cause) | 0.63 (0.54–0.72) |
Nausea, feels sick (without medical cause) | 0.58 (0.48–0.68) |
Painful bowel movements (without medical cause) | 0.49 (0.37–0.58) |
Stomach-aches or cramps (without medical cause) | 0.70 (0.62–0.78) |
Too concerned with neatness or cleanliness | 0.20 (0.07–0.32) |
Vomiting, throwing up (without medical cause) | 0.44 (0.33–0.55) |
Withdrawn | Overall: 0.38 (0.28–0.52) |
Acts too young for age | 0.04 (0.00–0.18) |
Avoids looking other in the eye | 0.42 (0.28–0.55) |
Doesn’t answer when people talk to him or her | 0.38 (0.24–0.51) |
Refuses to play active games | 0.32 (0.18–0.45) |
Seems unresponsive to affection | 0.47 (0.33–0.61) |
Shows little affection toward people | 0.58 (0.44–0.73) |
Shows little interest in things around her | 0.48 (0.33–0.63) |
Withdrawn, doesn’t get involved with others | 0.32 (0.17–0.47) |
Sleep problems | Overall: 0.51 (0.40–0.61) |
Doesn’t want to sleep alone | 0.22 (0.09–0.34) |
Has trouble getting to sleep | 0.48 (0.37–0.59) |
Nightmares | 0.51 (0.40–0.62) |
Resists going to bed at night | 0.47 (0.36–0.58) |
Sleeps less than most kids during and/or night | 0.49 (0.37–0.60) |
Talks or cries out in sleep | 0.70 (0.61–0.80) |
Wakes up often at night | 0.67 (0.57–0.76) |
Attention problems | Overall: 0.45 (0.31–0.60) |
Can’t concentrate, can’t pay attention for long | 0.59 (0.46–0.73) |
Can’t sit still, restless, or hyperactive | 0.62 (0.48–0.76) |
Poorly coordinated or clumsy | 0.39 (0.24–0.54) |
Quickly shifts from one activity to another | 0.41 (0.27–0.55) |
Wanders away | 0.26 (0.11–0.40) |
Aggressive behaviour | Overall: 0.50 (0.40–0.59) |
Can’t stand waiting; wants everything now | 0.53 (0.44–0.62) |
Defiant | 0.52 (0.43–0.62) |
Demands must be met immediately | 0.52 (0.43–0.61) |
Destroys things belonging to his/her family or other children | 0.59 (0.51–0.68) |
Disobedient | 0.36 (0.25–0.47) |
Doesn’t seem to feel guilty after misbehaving | 0.49 (0.39–0.59) |
Easily frustrated | 0.51 (0.42–0.61) |
Gets in many fights | 0.62 (0.54–0.70) |
Hits others | 0.67 (0.60–0.74) |
Hurts animals or people without meaning to | 0.20 (0.08–0.31) |
Angry moods | 0.62 (0.54–0.70) |
Physically attacks people | 0.53 (0.44–0.63) |
Punishment doesn’t change his/her behaviour | 0.30 (0.19–0.42) |
Screams a lot | 0.61 (0.53–0.69) |
Selfish or won’t share | 0.54 (0.44–0.63) |
Stubborn, sullen or irritable | 0.60 (0.51–0.68) |
Temper tantrums or hot temper | 0.52 (0.43–0.61) |
Uncooperative | 0.27 (0.15–0.49) |
Wants a lot of attention | 0.38 (0.27–0.49) |
Syndrome | Items | Mean loadings: present study | Range of mean loadings: Achenbach and Rescorla |
---|---|---|---|
Emotionally reactive | 9 | 0.47 | 0.33–0.73 |
Anxious depressed | 8 | 0.53 | 0.21–0.76 |
Somatic complaints | 11 | 0.46 | 0.38–0.96 |
Withdrawn | 8 | 0.38 | 0.28–0.86 |
Sleep problems | 7 | 0.51 | 0.44–0.76 |
Attention problems | 5 | 0.45 | 0.39–0.59 |
Aggressive behaviours | 19 | 0.50 | 0.16–0.79 |