The CBCL Dysregulation Profile at Age 8 Predicts Substance Use, Suicidality, and Functional Impairment Among German Adults

A CBCL profile pattern characterized by extreme elevations of the Anxious/Depressed, Attention Problems, and Aggressive Behavior syndromes has been interpreted as reflecting severe affective and behavioral dysregulation. To determine whether this pattern predicts adult psychopathology, Holtmann et al. (2011) used the Structured Clinical Interview for DSM-IV (SCID) and several other instruments to compare age 19 psychopathology among 325 participants in a German longitudinal study whose age 8 CBCL profiles were classified as fitting versus not fitting the dysregulation pattern. At age 8, the CBCL dysregulation pattern was significantly associated with psychiatric disorders among the children and with low family SES.

After controlling for these and other possible risk factors, Holtmann et al. found that the dysregulation profile pattern significantly predicted elevated rates of substance use disorders, nicotine dependence, suicidal ideation, and suicide attempts. The authors concluded that–rather than functioning as a one-to-one precursor of particular psychiatric disorders–“severe dysregulation seems to represent an early risk marker of a persisting deficit of self-regulation of affect and behavior underlying different psychiatric disorders” (pp. 143-144).

Reference: Holtmann, M., Buchmann, A.F., Esser, G., Schmidt, M.H., Banaschewski, T., & Laucht, M. (2011). The Child Behavior Checklist-Dysregulation Profile predicts substance use, suicidality, and functional impairment: a longitudinal analysis. Journal of Child Psychology and Psychiatry, 52, 139-147.