Multiple studies have reported identification and correlates of a pattern of CBCL/6-18 syndrome scale scores designated as the Dysregulation Profile (DP). The DP is defined by elevated scores on the Anxious/Depressed, Attention Problems, and Aggressive Behavior syndromes of the CBCL/6-18. Children identified as having the DP have elevated rates of several disorders, suicidality, and substance abuse. Behavior genetic studies have indicated significant heritability for the profile itself, over and above genetic influences on each of the constituent syndromes.

A Dutch team analyzed CBCL/1½-5 and C-TRF scores for 247 clinically referred and typically developing 3½-5-year-olds (Geeraerts et al., 2015). Confirmatory factor analyses showed that a bifactor model fitted the parent- and teacher-ratings better than other factor models for detecting the DP, plus the Anxious/Depressed, Attention Problems, and Aggressive Behavior syndromes. Validity analyses showed that the DP was concurrently and longitudinally associated with multiple markers of dysregulation.

The markers included poor inhibition, poor general level of functioning, emotional reactivity, sleep problems, observed externalizing behavior, and symptoms of DSM externalizing disorders. Moreover, scores on each of the three constituent syndromes were differentially associated with other external validity criteria. For example, scores on the Anxious/Depressed syndrome were associated with emotional reactivity, while scores on the Attention Problems syndrome were associated with ADHD symptoms. Scores on the Aggressive Behavior syndrome were associated with symptoms of oppositional defiant disorder and conduct disorder. The authors concluded that “DP is best conceptualized as a broad syndrome of dysregulation that exists in addition to specific anxious/depressed, aggressive behavior, and attention problem syndromes.

Reference: Geeraerts, B., et al. (2015) The Child Behavior Checklist Dysregulation Profile in preschool children: A broad dysregulation syndrome. Journal of the American Academy of Child & Adolescent Psychiatry, 54, 595-602.