A team of researchers from Brazil and Uruguay tested a variety of predictors of CBCL/4-18 problem scores in a sample of 634 children drawn from a study of 5,304 hospital births in Pelotas, Brazil (Anselmi et al., 2004). A prevalence rate of 24% was found for CBCL Total Problems scores in the combined borderline and clinical ranges. This prevalence rate was similar to the rates found in other studies of Brazilian children.

Candidate predictors of problems were grouped according to Urie Bronfenbrenner’s bio-ecological model of development. In a hierarchical regression analysis, the following variables significantly predicted Total Problems on the CBCL: (1) Social demographic factors present at the child’s birth–CBCL problem scores were lower for children whose mothers were older and had higher levels of education; (2) child factors-CBCL problem scores were higher for children who had the most hospitalizations from age 1 to 4 years; (3) family factors-CBCL problem scores were higher for children who had more younger siblings and whose mothers scored higher on self-reported psychiatric problems; and (4) home environment quality-CBCL problem scores were higher for children with worse home environments, as assessed with Caldwell’s Home Observation for Measurement of the Environment (HOME).

The authors concluded that “The findings corroborate the perspective of multi-determination of children’s behaviour problems, suggesting that they are the result of the interaction of factors of different origins which operate concomitantly” (p. 786).

Reference: Anselmi, L., Piccinini, C.A., Barros, F.C., & Lopes, R.S. (2004). Psychosocial determinants of behaviour problems in Brazilian preschool children. Journal of Child Psychology and Psychiatry, 45, 779-788.