beijing cab
TRANSCRIPT
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Clinical AssessmentClinical Assessment
of Behaviorof Behavior
Bruce A. Bracken, Ph.D.The College of William and Mary
Williamsburg, VA (USA)
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Problem Statement
To what extent are childrens and adolescents positive
(i.e., adaptive) and negative (i.e., clinical) behavior
ratings a result ofbasic demographic conditions (e.g.,age, gender, race/ethnicity)?
Are childrens behavioral ratings comparably reliable as a
result of these basic demographic conditions?
What percent of the variance in childrens behavioralratings is associated with basic demographic conditions?
To what extent do childrens behavioral ratings differ as a
result of race/ethnicity and gender?
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Method
Students behaviors were rated by their mothers orfathers
during the standardization ofa new behavior rating scale,
Clinical Assessment of Behavior(Bracken & Keith, 2004).
Students positive and negative (i.e., clinical) behaviors
were compared directly (i.e., mean score comparisons) and
indirectly (e.g., percent ofvariance accounted for bydemographic variables; internal consistency estimates)
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Instrument
Clinical Assessment of Behavior(CAB; Bracken & Keith,
2004).
Third-party behavior rating scale completed by parents and
teachers (Parent form used in this study)
Appropriate for children ages 2 - 18 years
Assesses Clinical behaviors (Psychopathology, sociopathy,
educational exceptionalities) and Adaptive behaviors
Used as triangulating element in multi-source, mult-
instrument clinical assessments
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Triangulation:Triangulation:
MultiMulti--source, Multiple Contextsource, Multiple Context
AssessmentAssessment
Self-Report
-Self-concept
-Sentence Completion Forms
Third-Party Report
- CAB Parent orTeacher- BASC, DSMD, SSRS
Achenbach, Connors
Behavioral
and
Psychosocial
Adjustment
Other Sources- Direct Observation
- Indirect Approaches
(e.g., Projective Techniques)
- Background Information
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CAB Assesses:
Critical Behaviors: low-incidence behaviors that define seriouspsychopathology and sociopathy
Psychotic experiences (e.g., hallucinations) Substance abuse
Satanic worship
Gang-related behaviors
Behaviors exhibited in medical and neuropsychological conditions
Attention-deficit/hyperactivity disorders Learning disabilities
Executive function strengths and limitations
Autistic spectrum behaviors
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CAB Assesses:
Behaviors that correspond to educational exceptionalities andconditions
Mental retardation Learning disabilities Gifted and talented Adaptive behaviors Social skills
Behaviors ofcurrent societal concern Aggression Anger management Bullying Conduct problems
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Clinical Scales
Internalizing Behaviors Scale (INT)
Assesses behaviors directed toward self (e.g., depression, anxiety,somatization, fear)
- cries easily; is easily startled; is emotionally fragile
Externalizing Behaviors Scale (EXT)
Assesses problematic conduct directed toward others (e.g., rule-breaking behaviors, vandalism, truancy)
- insults others; is difficult to manage; ignores rules
Critical Behaviors Scale (CRI)
Assesses behaviors associated with serious psychopathology andsociopathy
- usesill
egaldrugs; ha
lluc
inates; expresses an unusua
linterest
in Satan
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Adaptive Scales
Social Skills Scale (SOC)
Assesses interpersonal relations with peers and adults
- listens attentively toothers; is considerate ofothers; annoys others
Competence Scale (COM)
Focuses on ability to get needs met appropriately, learning, andcognitive and language development
- has poo
r judgment;is eas
ily c
onfused;
learns new th
ings eas
ily
Adaptive Behaviors Scale (ADB)
Assesses developmental progress and degree of personalindependence
- dresses self; reliably makes simple purchases; prepares simple
meals for self
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CAB Scale Structure and
Number ofItems
Scale CAB-PX CAB-P CAB-T
Clinical Scales
Internalizing 30 16 16Externalizing 30 18 18
Critical Behaviors 30 -- --
Adaptive Scales
Social Skills 30 18 18Competence 30 18 18
Adaptive Behaviors 20 -- --
Total Scale 170 70 70
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CAB Clusters and
Number ofItemsClusters CAB-PX CAB-P CAB-T
Clinical Clusters
Anxiety 23 11 11Depression 36 16 16Anger 15 9 9Aggression 25 13 13Bullying 36 13 13Conduct Problems 28 8 8Attention Deficit/Hyperactivity 21 20 20
Autistic Spectrum Behaviors 30 13 13Learning Disability 23 15 15Mental Retardation 25 12 12
Adaptive ClustersExecutive Function 17 13 13Gifted and Talented 27 17 17
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Theoretical Structure
of CAB
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U.S. Normative Sample
Sample Size Males Females Total
Parent Forms
- ages 2 6 309 291 600- ages 7 12 455 422 877
- ages 13 18 318 319 637
Teacher Form- ages 5 6 145 95 240
- ages 7 12 471 288 759
- ages 13 18 391 299 690
Race/Ethnicity (Percent Representation)
Whites Blacks Hispanics Other
65 71% 12 17% 9 12% 6 8%
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Normative Sample
Education Level CAB-P CAB-T
< 11 years 3.9% 3.2%
12 years 23.9% 2.5%13 - 15 years 38.7% 11.4%16 years 14.6% 17.5%
> 17 years 18.8% 65.2%Unknown 0.1% 0.2%
Geographic Region
Midwest 21 25% 17 22%Northeast 13 22% 22 25%
South 35 45% 36 39%West 19 22% 17 20%
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CAB-PXTotal Sample
Internal ConsistencyScales r
Internalizing Behaviors(INT) .95
Externalizing Behaviors(EXT) .97
Critical Behaviors (CRI) .91
SocialSk
ills (SOC) .95
Competence (COM) .94
Adaptive Behaviors (ADB) .92
Total (CBI) .98
Clusters r
Anxiety (ANX) .93
Depression (DEP) .95
Anger (ANG) .93
Aggression (AGG) .95
Bullying (BUL) .97
Conduct Problems (CP) .92
Attentio
n-Deficit (ADH) .94
Autistic Spectrum (AUT) .92
Learning Disability (LD) .92
Mental Retardation (MR) .91
Executive Function (EF) .91
Gifted and Talented (GAT) .94
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CAB PXStability
Scale CAB-PX
Internalizing .89
Externalizing .90
Critical Behaviors .77
Social Skills .92
Competence .92
Adaptive Behaviors .87
CAB Behavioral Index .94
CAB Clusters .83 - .94
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CAB Inter-rater
Coefficients
Scale CAB-PX*
Internalizing .78
Externalizing .81
Critical Behaviors .41
Social Skills .62
Competence .79
Adaptive Behaviors .53
CAB Behavioral Index .82
CAB Clusters .70 - .90
* Parent - Parent
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AnalysesAnalyses
Estimates of total scale internal consistency by race
Esti
matesof
percent scal
ev
ari
ance acco
untedfo
r bybasic demographic variables
Scale and cluster mean score comparisons for basic
demographic variables
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Comparative Reliabilities byComparative Reliabilities by
Ethnic Group, Across Age LevelsEthnic Group, Across Age LevelsCaucasian Afr ican-American Hispanic
ClinicalInternalizing .94 - .95 .93 - .96 .91 - .96
Externalizing .96 - .97 .96 - .97 .93 - .98Critical Behaviors .71 - .92 .80 - .98 .42 - .92
AdaptiveSocial Skills .92 - .96 .92 - .95 .89 - .96
Competence .91 - .95 .92 - .95 .89 - .97Adaptive Behavior .79 - .89 .82 - .90 .84 - .89
Total ScaleCBI .97 - .99 .98 - .99 .96 - .99
Clusters .84 - .97 .85 - .97 .78 - .97
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Scale Variance Associated
With Demographic Variables
Age Gender Race Parent Ed
Clinical
Internalizing .35 .08 .59 .21Externalizing .19 2.82 .01 .42Clinical Behaviors 4.93 .53 .36 .72
Adaptive
Social Skills 1.44 2.69 .03 .67Competence 2.69 2.96 .01 .81Adaptive Behaviors 49.70 1.80 .01 .03
Total Scale (CBI) 2.86 2.31 .01 .61
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Cluster Variance Associated
With Demographic Variables
Age Gender Race Parent Ed
Anxiety .00 .35 .26 .22
Depression .71 .40 .37 .29
Anger .79 2.07 .32 .45
Aggression 1.37 4.45 .10 .67
Bullying .49 2.34 .00 .58
Attention Deficit .90 3.84 .03 .42
Autistic Spectrum 5.15 1.72 .00 .61
Learning Disability .46 2.19 .00 .58
Mental Retardation 12.60 2.86 .04 .77
Executive Function 2.76 4.16 .00 .57
Gifted and Talented 3.10 3.46 .06 .94
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Gender DifferencesM
ain Effect for Gender by Race ANOVA(No significant gender by race interactions)
nsTotal (CBI)
nsAdaptive Behaviors (ADB)
nsCompetence (COM)
nsSocial Skills (SOC)
nsCritical Behaviors (CRI)
nsExternalizing Behaviors(EXT)
nsInternalizing Behaviors(INT)
pScales
nsExecutive Function (EF)
nsGifted and Talented (GAT)
nsMental Retardation (MR)
nsLearning Disability (LD)
nsAutistic Spectrum (AUT)nsAttent
ion-De
ficit (ADH)
nsConduct Problems (CP)
nsBullying (BUL)
nsAggression (AGG)
nsAnger (ANG)
nsDepression (DEP)nsAnxiety (ANX)
pClusters
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Race/Ethnicity Differences**Main effect for Race/ethnicity, with no interactions
Only INTrevealed differences on post hoc analyses due to
conservative nature of Scheffe
nsTotal (CBI)
nsAdaptive Behaviors
nsCompetence
nsSocial Skills
.05Critical Behaviors
nsExternalizing Behaviors
.05Internalizing BehaviorsWhites > Blacks
pScales
nsExecutive Function (EF)
nsGifted and Talented (GAT)
nsMental Retardation (MR)
nsLearning Disability (LD)
nsAutistic Spectrum (AUT)nsAttent
ion-De
fici
t (ADH)
nsConduct Problems (CP)
nsBullying (BUL)
nsAggression (AGG)
nsAnger (ANG)
.05Depression (DEP)
.05Anxiety (ANX)
pClusters
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ConclusionsConclusions
Minimalvariance in clinical and adaptive behaviors due
to basic demographic variables (except age in
developmental conditions - - adaptive behavior)
CAB produces minimal mean score differences as a
result ofbasic demographic variables (gender,
race/ethnicity)
Behaviors assessed by the CAB, both adaptive andpathological, appear to be normally distributed within the
greater population.
CAB appears to produce highly reliable assessment of
the behaviorofyouth regardless ofage, race, or gender