2.2 Adolescent Emotional/Behavioral Problems

As indicated above in the Introduction, the adolescent mental health module was adopted from the YSR Checklist and Profile developed by Thomas M. Achenbach and his colleagues (1991). The YSR was designed to assess the emotional and behavioral problems of adolescents (aged 11-18) in a standardized format. The self-report checklist comprises 118 items concerning the psychological functioning of the adolescent over the preceding six-month period. Responses to these items can be evaluated independently; in addition, these responses can also be used to construct syndrome scales in order to evaluate the adolescent for emotional and behavioral syndromes. Eight of these syndromes were calculated from the NHSDA responses: Withdrawn, Somatic Complaints, Anxious/Depressed, Social Problems, Thought Problems, Attention Problems, Delinquent Behavior, and Aggressive Behavior.

Following Achenbach (1991), psychosocial problems were also distinguished as "externalizing" and "internalizing." The externalizing scale measures overt behavioral problems, and is the combination of the scores on the Aggressive Behavior and Delinquent Behavior scales. The internalizing scale summarizes emotional problems that may not be overtly evident. It is the combination of scores on the Withdrawn, Somatic Complaints, and Anxious/Depressed subscales. For all scales, severity was determined using values recommended by Achenbach. These cutoff points have been found to distinguish clinical (adolescents experiencing significant distress) from nonclinical (normal) populations.4

There have been many changes in formal classification of adolescent disorders over time. The YSR syndromes are empirically derived and correspond to well-established clinical symptoms. The YSR syndromes demonstrate significant associations with DSM diagnostic categories (Weinstein, Noam, Grimes, Stone, & Schwab-Stone, 1990). Figure 2-1 presents DSM-IIIR diagnoses and corresponding YSR syndromes as summarized by Achenbach (1991). The YSR syndromes have approximate counterparts within the revised criteria of DSM-IV as well. For example, the DSM-IV (1994) diagnosis of Conduct Disorder corresponds to the syndromes Delinquent Behavior and Aggressive Behavior, Attention Deficit-Hyperactivity Disorder corresponds to Attention Problems, and DSM-IV symptoms for Depression or Anxiety disorders correspond to Anxious/Depressed Syndrome. Other syndromes are represented in the DSM-IV as well.

Source: Achenbach, 1991, page 156, Table 9.2.

Table 2.1 presents the sample size of each age group overall (combined 1994-1996 NHSDAs) and the sample size for each age group by gender subgroup. Tables 2.2 and 2.3 present the estimated population sizes and percentages respectively for each of these age by gender subgroups.

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4 The cutoffs are Achenbach's T=60 or more for psychosocial problems and the behavioral ("externalizing") and emotional ("internalizing") scores, and T=67 or more for the individual syndromes such as "withdrawn." See Achenbach, T.M., Manual for the Youth Self-Report and 1991 Profile, Burlington, VT: University of Vermont Department of Psychiatry (1991).

This page was last updated on August 05, 2008.

SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.