ical Range
6
Normal Range
60
CBCL/1%-5 DSM-Oriented Scales for Boys and Girls
i
]100 Name.
4 Date filled
ID#. out
Obcoy Oai Age.
lo Filled out by
q Information About the DSM-Oriented Soeles
‘The DSW/oriontad seales. comoriso problems judged
85 consistent wit diagnostic categories ofthe dh Eon of
tho Amorican Psychic Assodtation’s (1988) Diagnastio
8nd Stalisical Manual CDSMAV').Chikd psyervatats
® “Jao and psychologists rom nine cultures rated each tem as
‘ot Gonsisten, samewhat consistent, or very consistant
" 5] with DSM aiagnoses. Based on tems that wore rated a5
S75 very consistent wih particular diagnoses, the DSM:
1, AFFECTIVE PROBLEMS
2. ANXIETY PROBLEMS
9. PERVASIVE DEVELOP-
uid bag ent enostene
24, Doesn't Eat Well 22. Doesnt Want To — 3. Afraid To Try New
acerca seen Tees Ee Cote
Se, ele Sere ee ilterse = = aeeeeaes
és Overeating Sina vette
pe oye Ter pei Sopnntan 21 athe Oman
71, Little Interest — 47. Nervous, a
= tse Beet hea
— 74, Sleeps Little. — i With Peers.
89, Underactive —51. Panics 63. Rocks Head, Body
Ton sed eres patel sept aston
_ Total =i Wore, 70. Little Affection
Trl
‘Copyright 200 T Achonbaeh&L Resco
ASEBA, Univer of Vermont
"South Prospect i, Burgin, VEOSAOY 3456
Web: ntes/ASEBA em es
UNAUTHORIZED COPYING i ILLEGAL
— 76. Speech Problem
20. strange Behavior
92. Upset By New
98. Withcrawn,
— Total
4, ATTENTION DEFICIT/
HYPERACTIVITY PROBLEMS
— 5.Canit Concentrate
— 6.Cant sit si
— 8.Can't Stand Waiting
— 16. Demands Must Be Met
= 36. Gets nto Everything
59, Quickly shits
— Total
Broken lines =
borderline clinical range
5. OPPOSITIONAL.
DEFIANT PROBLEMS
— 15. Detiant
— 20, Disobeciont
— 44, Angry Moods
— 81. Stubborn
85. Temper
— 88. Uncooperative
Total
7-28-00 Eudition-602
‘oriented scales correspond tothe diagnoses listed bolow.
1. Affective Problems—Dysthymia, Major
Doprossion
2. Anxiety Problems—Generalized Anxiety
Disorder, Separation Anxiety Disorder, Specie Phobia
3. Pervasive Developmental Problems—Asperger
Disorder, Autistic Disorder
4, Attention DeticitHyperactivity Problems—
HyperactivesImpuisive Type, Inattentive Type
5, Oppositional Detiant Probloms—Oppositional
Detant Disorder
‘Scales 1-4 correspond to multiple clagnoses because of
‘overlaps among OSM criteria and among ASEBA items
tated as very consistent withthe clagnoses,
To compute scale scores:
(1) Copy item scores fom the CBCUI%-5 in the
spaces beside the lems beneath the profile (card-
board templates are available hat you place over the
CBCL/1¥55 to indicate the scale on which to enter
‘each item score)
(2) Sum the { and 2 scores to obtain the TOTAL
‘scoro for each scale,
(3) Inthe column above the scale, circle the number
corresponding tothe TOTAL score for the scale.
(4) Connect the circled numbers to form a profile.
For each scale score, you can see the corresponding
percentile for the normative sample at the lft and the T
coro at tho right, Scores above the top broken line are
in the clinical range, indicating more problems than were
reported for 97% of the normative sample. Scores
‘between the broken lines are in the borderline range
(@3rd-971h parcentie of the normative sample). For
applications othe DSM-oriened scales, see the Manual
for the ASEBA Preschool Forms.Boy ici Age.
CBCL/11/2-5 Empirically Based Scales for Boys and Girls eames ek ser tt py 2S
Inernalizng Extornalizing
ae % ra rr i @ [arse
21 a” aa—
He 1 20 ye a ee
- ie “4 ® % Conouatons Le
f
4 8 13 34 2
si 4 i aa
$ ne
2 a a 0 2 ra 2 Leyes ae
E 6 “ 2 Ay, Terai
3 i 4 4 a ale VI
E 19 1 a 10 " 2 | a
& ® a 2 x 10 = Exteral 1]
28 (ner Probe
eee | eee
75 Tot Prob —]1[—]
26
3
a oO OTHER
BR PROBLEMS
Pe ‘ald To Try Now
" s 5 : 3 acto Tye
3 5 i Socks Hop
e H a 3 1" Gres
« 3 % ‘Gre To Animals
3 5 5 4 Destroys Own
i 3 rn Doesnt Get ong
5 rc Weors
by 2 3 4 s i, _ 26, NioFun
sof #4 o1 é a Se 50 — hoor
7 1 ML W Vv I Vil aa
EMOTIONALLY _ANXIOUS/ SOMATIC WITHDRAWN SLEEP ATTENTION AGGRESSIVE eee
REACTIVE DEPRESSED COMPLAINTS. PROBLEMS PROBLEMS BEHAVIOR aoe |
21. Disturbed By —_10. Clings. 1. Aches: 2. Acts Too Young _22. Doesn't Want _5. Cant Concentrate _8, Can't Stand Weiting 36. Gets info Everything
Change” 39, Foolngs tun = — 7 Ga Sand 4. Aas yo, ToSeopeno — 6 Cant Stal 16. Dotan A Hols Broan
46, Twos 37. Upset by Sep. Sihngs Ou oF Contact, 98, Trouble Seping 56. Chimay Tie: Demands Met AS, Overeating
Bt. Panis Tad: Looks Uniepny Pace _23, BossntAnsvor #8. Netimares””" 89, Gueky shite 18. Bestoye Omens’ —B0. overted
Tio. Shite Between —A7 Nenous” 42. Consipatod 2. Rees Acne’ 64 RessleBed 95, Wanders Avey Deobedient 54. Pes Stn
Sadesste 68. Seltconscous 19. Dannea Games