EXPLORING THE MECHANISMS UNDERLYING THE CHILD BEHAVIOUR CHECKLIST'S DYSREGULATION PROFILE: A GUSTO COHORT STUDY

Abstract

Background: Prior studies have identified a group of dysregulated children with elevated scores in the Child Behaviour Checklist (CBCL)’s Anxious/Depressed (A/D), Aggressive Behaviours (AG), and Attention Problems (AP) scales called the CBCL-Dysregulated Profile (CBCL-DP). However, the mechanisms underlying the profile are not fully explored. Aims: This thesis, divided into two separate papers, aims to 1) explore an alternative conceptualization of the CBCL-DP construct which consists of the A/D, AP and splitting the AG scales into Physical and Non-Physical Aggression factors; 2) explore the possible physiological mechanisms underlying the construct. Methods: This thesis is based on a prospective cohort study from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) cohort. It focuses on preschool children and uses Latent Profile Analysis (LPA) to identify groups of children with homogeneous scores on the CBCL-DP scales mentioned. Results: The results of the first study suggest that the proposed model showed better model fits compared to conventional CBCL-DP model. Based on LPA, the CBCL-DP construct reflects a group of children with elevated scores on all three CBCL-DP syndrome scale with high physical aggression scores (Dysregulated-PA). This profile predicts poorer social adaptation scores at seven years old compared to children with the lowest scores on the syndrome scales. Results from the second study suggest that children who are more likely to be in the Dysregulated-PA latent profile are associated with dysregulated physiological responses during a frustration-eliciting task. Conclusions: The proposed 4-factor CBCL-DP factor structure may be better at discriminating dysregulated children in the general population compared to the conventional 3-factor CBCL-DP model.