Behavior problems in children with diabetes: disentangling possible scoring confounds on the Child Behavior Checklist

Area of Science:

• Pediatric Psychology
• Child Psychiatry
• Endocrinology

Background:

• The Child Behavior Checklist (CBCL) is widely used to assess child behavior.
• Children with diabetes may present with behavioral differences that could be confounded by physiological symptoms.
• Distinguishing true behavioral disturbances from somatic complaints is crucial for accurate assessment.

Purpose of the Study:

• To investigate potential confounds in CBCL scores for children with diabetes.
• To determine if physiological symptoms influence behavioral ratings in diabetic children.
• To assess the behavioral profile of children with diabetes compared to controls.

Main Methods:

• Utilized the Child Behavior Checklist (CBCL) for behavioral assessment.
• Employed two methods to control for confounds: deletion of the Somatic Complaints scale or deletion of specific Diabetes Items.
• Compared behavioral ratings between children with and without diabetes.

Main Results:

• Children with diabetes consistently scored higher on Internalizing and Total Behavior Problem scales compared to controls.
• This difference in scores remained significant even after removing the Somatic Complaints scale or Diabetes Items.
• Elevated scores were observed across six of the eight CBCL scales for the diabetes group.

Conclusions:

• The mildly elevated behavioral scores in children with diabetes are not solely due to physiological symptomatology.
• The CBCL appears to capture a genuine behavioral profile in children with diabetes, independent of somatic complaints.
• These findings support the use of the CBCL in assessing behavioral disturbances in pediatric diabetes populations.