The CBCL Dysregulation Profile is Associated with Psychosocial Adversity and Impairment among Clinically Referred German Children

Multiple studies have identified a CBCL/6-18 profile characterized by high scores on the Anxious/Depressed, Attention Problems, and Aggressive Behavior syndrome. Designated as the “Dysregulation Profile,” it has been found to be associated with genetic factors and poor outcomes. To investigate psychosocial aspects of the environments of children manifesting the Dysregulation Profile and also to assess the children’s psychosocial impairment, a German team compared the Psychosocial Adversity and Psychosocial Impairment scores of the International Classification of Disease-10th Edition (ICD-10) for 373 4-18-year-olds manifesting the Dysregulation Profile versus 8,651 other 4-18-year-olds (Jucksch et al., 2011). All the children had been referred to German university child psychiatry services. Children manifesting the Dysregulation Profile had significantly higher ICD-10 psychosocial adversity scores than children with clinically elevated scores on the Attention Problems and Anxious/Depressed syndromes and children with no clinically elevated syndrome scores.

However, psychosocial adversity scores did not differ significantly between children with the Dysregulation Profile and children with clinically elevated Aggressive Behavior syndrome scores. Nevertheless, children with the Dysregulation Profile obtained higher scores than all other groups on the portion of Psychosocial Adversity that reflects abnormal qualities of upbringing, including parental overprotection, inadequate parent supervision, experiential privation, and inappropriate parental pressures. Children with the Dysregulation Profile obtained significantly higher Psychosocial Impairment scores than children with no clinically elevated syndromes, but did not differ significantly from the other clinically referred children. Although Jucksch et al. acknowledged that children with the Dysregulation Profile “may behave in ways that predispose to life situations that provide risks for other disorders” (p. 692), they concluded that “Improving parental competence might be a fruitful target for intervention to prevent a detrimental course” (p. 693).

Reference: Jucksch, V., Salbach-Andrae, H., Lenz, K., Goth, K., Doepfner, M., Poustka, F., Freitag, C.M., Lehmkuhl, G., Lehmkuhl, U., & Holtmann, M. (2011). Severe affective and behavioural dysregulation is associated with significant psychosocial adversity and impairment. Journal of Child Psychology and Psychiatry, 52, 686-695.