Title: A Comparative Analysis of the Child Behavior Checklist Scores of Traumatized Youth With and Without PTSD Relative to Nontraumatized Controls
Description: This study compared the CBCL scores of clinically referred youth with PTSD to the CBCL scores of clinically referred traumatized youth without PTSD. It also compared the CBCL scores of youth with PTSD, as well as those of traumatized youth without PTSD, to those of a nontraumatized comparison group. Participants included a total of 123 youth aged 7 through 18 who were tested at Bellevue Hospital in New York City: 34 youth with PTSD, 56 traumatized youth without PTSD, and 33 nontraumatized controls. Participants in the PTSD and traumatized PTSD-negative groups were referred to the study subsequent to exposure to a variety of traumatic events (e.g., sexual assault, physical assault, motor vehicle accident, dog attack). Among the PTSD-positive group, 8 participants met DICA-R criteria for major depression, and 1 met criteria for substance dependence. Of the traumatized PTSD-negative participants, 2 met DICA-R criteria for major depression, 2 met criteria for CD, and 1 met criteria ADHD. Youth with a history of abuse or neglect were excluded.

Additional exclusionary criteria included intellectual disability (i.e., IQ â‰¤ 69), the inability to speak or understand English, a history of significant head trauma, and the use of medication that could influence cognitive functioning. An ANOVA was used to compare the groups on standardized CBCL Total score, and a MANOVA was performed to test for group differences in standardized CBCL Internalizing and Externalizing aggregate scale scores. A MANCOVA procedure was performed with age, gender, and SES as covariates, to identify significant group differences in CBCL syndrome scale raw scores. Results of all analyses indicated significant differences between groups. The PTSD group had significantly higher CBCL Total and Internalizing aggregate scale scores than both comparison groups and significantly higher Externalizing aggregate scale scores than traumatized PTSD-negatives. No significant differences were observed between the mean CBCL Total, Internalizing aggregate scale, and Externalizing aggregate scale scores of the traumatized PTSD-negatives and nontraumatized controls.

The scores of the PTSD-positive group significantly exceeded the scores of both comparison groups on the following CBCL syndrome scales: Anxious/Depressed, Delinquent Behavior, Attention Problems, Thought Problems, and Other Problems. The scores of the PTSD-positives were significantly higher than those of the traumatized PTSD-negatives on the Withdrawn and Somatic Complaints syndrome scales; they significantly exceeded those of nontraumatized controls on the Aggressive Behavior and Social Problems syndrome scales. The CBCL syndrome scale scores of traumatized PTSD-negatives and nontraumatized controls did not significantly differ. The results of this study suggest that parent-reported internalizing and externalizing behavior problems are associated with PTSD and not with exposure to trauma alone. Its findings also suggest that exposure to trauma in the absence of PTSD is not associated with higher estimates of psychiatric morbidity. As such, this study provides powerful empirical support for the differential validity of the DSM-IV PTSD classification as it applies to children and adolescents.