DEFINITION OF ACHENBACH CHILD BEHAVIOR CHECKLIST

The Achenbach Child Behavior Checklist (CBCL) [1,2], parent form, is likely to be the most widely used standardized behavior problem assessment tool of obese children and adolescents, aged 6 to 18 years. The scale takes about 15 minutes to complete and consists of 118 items or statements that describe specific behavioral and emotional problems, with two open-ended items for reporting additional problems. Parents rate their child for how true each item is now or within the last 6 months, using the following scale: 0 = not true; 1 = somewhat or sometimes true; 2 = very true. The CBCL can be hand or computer scored. A total behavior problem (T) score is obtained, as are T scores for two broad categories: internalizing (e.g., withdrawn, depressed) and externalizing (e.g., acting out, aggression). The CBCL is further divided into T scores for eight subcategories of problematic behavior: aggressive behavior, anxious/depressed, attention problems, rule-breaking behavior, social problems, somatic complaints, thought problems, and withdrawn/depressed. There are also six DSM -oriented scales: affective problems, anxiety problems, somatic problems, attention deficit/hyperactivity problems, oppositional defiant problems, and conduct problems. In general, a T score greater than 67 indicates significant behavior problems in that category. There is also a social competence scale that yields a total T score, as well as T scores for involvement in activities, social interactions, and school performance. A T score less than 33 on the social competence scale indicates problems. The CBCL has been well standardized, and norms exist for both clinic-referred and normative populations. The items of the CBCL were factor analyzed to empirically identify the forms of psychopathology that actually occur in children. Further, the scales are based on new factor analyses of parents’ ratings of 4994 clinically referred children and were normed on 1753 children aged 6 to 18 years. The normative sample was reportedly representative of the 48 contiguous states across socioeconomic status, ethnicity, region, and urban–suburban–rural residence. Children were excluded from the normative sample if they had been referred for mental health or special education services within the last year. The CBCL is also available in a newly revised Spanish version. A teacher version and youth self-report version are also available, but they have been used much less frequently.