A Russian adaptation of the child behavior checklist: Psychometric properties and associations with...

Journal of Abnormal Child Psychology, Vol. 23, No. 6, 1995

A Russian Adaptation of the Child Behavior Checklist: Psychometric Properties and Associations with Child and Maternal Affective Symptomatology and Family Functioning

Alice S. Carter, 1,2,5 Elena L. Grigorenko, 1-3,4 and David L. Pauls 1,2,3

The Child Behavior Checklist's (CBCL) applicability to a sample of 105 Russian 9- and lO-year-old children was evaluated by examining the internal consistency of Russian adaptations of parent and teacher report forms. In addition, child behavior scores were correlated with child reports of internalizing symptoms and maternal reports of their own internalizing symptoms and general family functioning. Finally, rates of child behavior problems and patterns of interrater agreement were compared with U.S. normative data. The psychometric properties of the adaptations demonstrate the adequacy of these instruments for use in Russia. Internal consistency and interrater agreement were generally comparable to estimates obtained in U.S. normative samples. Further, an exploration of the construct validity of the Russian versions of the CBCL and Teacher Report Form (TRF) lends additional support to the adequacy of these instruments.

Epidemiologic studies utilizing standardized assessment p rocedures in different countries (e.g., Australia, the Netherlands, Jamaica, Thailand, and

Manuscript received in final form March 9, 1994. This work was supported in part by grants from the International Research Exchanges Board (IREX) (with funds provided by the Andrew Mellon Foundation, the National Endowment for the Humanities, and the U.S. Deiaartment of State) and the National Institute of Mental Health (MH-00508, an RSDA to D. Pauls). None of these organizations is responsible for the views expressed. In addition, the authors wish to thank Thomas Achenbach for his helpful comments and suggestions.

1Department of Psychology, Yale University, New Haven, Connecticut 06520. 2Child Study Center, Yale School of Medicine, New Haven, Connecticut. 3Department of Genetics, Yale School of Medicine, New Haven, Connecticut. 4psychological Institute of the Russian Academy of Education, Moscow, Russia. 5Address all correspondence to Alice S. Carter, Ph.D., Yale University, Department of Psychology, P.O. Box 208205, New Haven, Connecticut 06520-8205.

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0091-0627/95/120{}-0661507.50/0 © 1995 Plenum Publishing Corporation

662 Carter, Grigorenko, and Pauls

Puerto Rico) have documented interesting, albeit modest, differences in the frequency of behavioral and emotional problems that may reflect the contr ibution of cultural influences (Achenbach, Hensley, Phares, & Grayson, 1990; Achenbach, Verhulst, Baron, & Althaus, 1987; Achenbach, Verhulst, Edelbrock, Baron, & Akkerhuis, 1987; Brandenburg, Friedman, & Silver, 1990; Lambert, Weisz, & Knight, 1989; Rubio-Stipec, Bird, Can- ino, & Gould, 1990; Weisz, Suwanlert, Chaiyasit, & Walter, 1987; Weisz et al., 1989). This study was undertaken to examine the feasibility of utilizing the Child Behavior Checklist (CBCL) in a genetic-epidemiologic pro- ject in the greater Moscow area. Standardized assessment instruments for describing children's behavior are necessary for epidemiologic research (Rubio-Stipec et al., 1990). In addition, employing consistent assessment procedures across countries can inform our understanding of the gener- alizability of obtained findings (Achenbach, McConaughy, & Howell, 1987).

Previous research on the utility of the CBCL in cross-cultural settings has included an assessment of clinic-referred children and/or children who meet criteria for psychiatric diagnoses. In previous studies, diagnoses and clinic referral status were used as validity criterion for evaluating the sensitivity of the CBCL for detecting children's behavioral and emotional difficulties (e.g., Achenbach, Verhulst, Baron, & Althaus, 1987; Achenbach, Verhulst, Edel- bock, et al., 1987; Lambert et al., 1989; Rubio-Stipec et al., 1990; Weisz et al., 1989). A recent statistical report based on mental health services records suggested that only 4% of Russian children (ages 12 to 18) receive psychiatric diagnoses (Churkin, 1991) and the rate of referral for mental health services is low. Thus, a criterion of prevalence of diagnoses or mental health service utilization could greatly underestimate the presence of psychopathology in this population. Furthermore, Russia does not currently belong to the World Men- tal Health Association and utilizes an idiosyncratic psychiatric nosology. In addition, at the present time, no structured research diagnostic interview exists in Russian that is comparable to U.S. standardized procedures (e.g., DSM-IV, ICD-10) for the assessment of child psychiatric disorders. Therefore, it was not possible to include clinically relevant external criterion measures that have been employed in other countries. For this reason, child ratings of internalizing symptoms as well as maternal ratings of internalizing symptoms and family functioning were collected to obtain indices of the criterion-related and construct validity of the Russian adaptation of the CBCL forms.

Several U.S. studies have explored patterns of intercorrelations between teacher, parent, and child reports of child behavior problems and parent reports of internalizing symptoms. A meta-analysis of cross-informant agreement of child and adolescent behavioral and emotional problems indicated that the mean correlation between parent and teacher was .27 (Achenbach, McConaughy, & Howell, 1987). Agreement between parents,

Russian Adaptation of the Child Behavior Checklist 663

teachers, and children tends to be better for externalizing than internalizing symptoms (Breslau, Davis, & Prabucki, 1988; Briggs, Carter, & Schwab- Stone, 1993; Cytryn, McKnew, & Bunney, 1980; Edelbrock, Costello, DUl- can, Conover, & Kalas, 1986; Hodges, 1990; Jensen, Traylor, Xenakis, & Davis, 1988; Orvaschel, Weissman, Padian, & Lowe, 1981; Reich, Herjanic, Welner, & Ghancy, 1982). Agreement patterns appear to differ based on the gender of the child (Achenbach & Edelbrock, 1979; Jensen, Xenakis, Davis, & DeGroot, 1988). Furthermore, there is evidence that parental psychopathology and family factors influence parental reporting of child behavior and emotional difficulties (Angold et al., 1987; Breslau et al., 1988; Emery & O'Leary, 1984; Jensen, Taylor, et al., 1988a; Moretti, Fine, Haley, & Marriage, 1985; Schaughency & Lahey, 1985). Finally, family functioning is associated with teacher and parent reports of child behavior problems (Achenbach, Howell, Aoki, & Rauch, 1993; Briggs et al., 1993; Donenberg & Baker, 1993). Evidence of cross-national similarity in patterns of interrater agreement patterns would lend additional support for the construct validity of the Russian adaptation of the CBCL. On the other hand, the use of higher thresholds for identifyi0g behavior problems in Russia as compared to the U.S., as well as the greater continuity of teacher-child relations in the Russian educational system as compared to the U.S. educational system, could lead to different patterns of intercorrelations across Russian and U.S. raters. The adaptation of standardized instruments to assess children's behavioral and emotional difficulties should make it possible to examine more carefully children's mental health needs in Russia and to stimulate the development and delivery of appropriate services for children in need.

This paper presents preliminary psychometric information on Russian adaptations of parent and teacher forms of the Child Behavior Checklist (Achenbach, 1991a, 1991b). Rates of child behavior problems in an unselected sample of school-aged children in a typical school in an industrial region of central Russia are presented and compared to (1) child reports of internalizing symptoms, (2) maternal reports of internalizing symptoms, (3) maternal reports of family functioning, and (4) U.S. normative referred and nonreferred data. In addition, patterns of agreement between parents and teachers are presented.

METHODS

Subjects

The Russian sample was drawn from a typical school in Voronezh, an industrial city in central Russia. The composition of the majority of cities


in Russia, including Voronezh, is such that each school district includes all levels of socioeconomic and educational strata. Children are assigned to schools on the basis of their addresses within districts, which results in very heterogeneous school populations. Consistent with this, the sample included in this study is extremely mixed in terms of financial, educational, and cultural backgrounds and represents the equivalent of a random sam- piing of Russian society. Less than 1% of mothers and 1.8% of fathers obtained fewer than 10 years of schooling; 25% of mothers and 32.5% of fathers obtained blue collar or technical degrees (e.g., electrician, plumber, cook) that are typically associated with 11 years of education; 32.6% of mothers and 21.9% of fathers obtained white collar or professional degrees (e.g., retail management, accounting) that typically involve 12 to 13 years of education; 41.7% of mothers and 43.8% of fathers obtained higher-level degrees (e.g., engineering, computer science, military officers, teachers) that typically involve 15 to 18 years of education. Eighty-two percent of the parents in the sample were married, 16% were divorced, and 2% were widowed. Forty-four percent of the sample had one child, 49% of the sample had two children, and 6% of the sample had three children.

All fifth-grade students (ages 9 to 10; N = 105) in one school and their mothers were asked to participate in a study of children's behavioral and emotional problems. While a small number of children were absent from school on the day that the data were collected, all parents who were approached agreed to allow their children to participate and all children whose parents provided consent participated willingly. The four fifth-grade coordinating teachers 6 were asked to provide information about emotional and behavioral problems for each child in their class. Teachers were all female and were 27, 30, 50, and 52 years of age. Each teacher began her professional career at approximately age 26. Teachers were asked to rate each of the students in their class following alphabetical order. On average, teachers had 2 weeks to rate 26 children.

Measures

Each of the instruments included in the present study was translated into Russian with the help of professional linguists, psychologists, and psy- chiatrists. Every effort was made to translate items so that each referred as

6The Russian educational system differs from the American system in that students typically attend 11 years of school in one setting. Further, students are with the same group of children throughout this time and have contact with the same group of teachers who specialize in different subjects. One teacher, the coordinating teacher (klassnyi rukovoditer in Russian), is responsible for interacting with teachers and parents to ensure proper communication across teachers and between family and school.


specifically as possible to the same behaviors and constructs as the U.S. versions. In addition, an independent group of investigators in Israel have back- translated the Russian version of the CBCL employed in this study. Fewer than 10 items evidenced difficulty in direct backtranslation. The wording of each of these items had been adapted to provide a culturally specific context, as some phrases were not meaningful in Russian when translated directly. For example, sets fires was adapted to often plays with fire, sets fires, and withdrawn was adapted to does not maintain contact with children or adults.

The Child Behavior Check List (Achenbach, 1991a) is a standardized measure of children's adaptive competencies and problem behaviors that is widely used in clinical and research settings. The revised version of the measure consists of 20 competence items and 118 items describing behavioral/emotional problems. The competence items include the sports and nonsports activities the child most likes to take part in; ratings for the amount and quality of participation in these activities; participation in organizations; jobs and chores; friendships; how well the child gets along with siblings, parents, and other children; how well the child plays and works alone; ratings for academic performance; reports of special class placement and repeating grades; and an open-ended item for describing other school problems.

The 118 problem items describe a wide array of problems that most parents can report with minimal inference. Examples include "Acts too young for his or her age"; "Argues a lot"; "Cruel to animals"; "Aches or pains (without known medical cause)"; "Sets fires"; and "Unhappy, sad, or depressed." There is also an open-ended item for adding other physical problems without known medical cause and an item for adding any other problems. The problem behaviors are scored on eight factor-based narrowband scales: Withdrawn, Somatic Complaints, Anxious/Depressed, Social Problems, Thought Problems, Attention Problems, Delinquent Behavior, and Aggressive Behavior. In addition, two broadband scales can also be scored: The internalizing scale includes items from the Withdrawn, So- matic, and Anxious/Depressed subscales while the Externalizing scale includes items from the Delinquent Behavior and Aggressive Behavior scales. There is also a Total Problem Score that provides an overall index of the number and severity of reported problem behaviors.

The Teacher Report Form (TRF; Achenbach, 1991b) includes demo- graphic questions, questions about the child's adaptive functioning and academic performance, standardized test scores, and a list of 118 specific problems, the majority of which correspond to the CBCL and several of which are adapted to the school environment (for details, see Achenbach, 1991b), plus two open-ended problem items ("other physical problems" or "other problems").


The scoring format for both TRF and CBCL involve scoring each item 0 (not true of the child), 1 (somewhat or sometimes true), or 2 (very true or often true).

The Children's Depression Inventory (CDI; Kovacs & Beck, 1977) consists of 27 multiple-choice items that are completed by the child (e.g., "I feel like crying everyday," "All bad things are my fault"). The CDI cor- relates with both global clinician ratings (Kovacs & Beck, 1977) and diagnosis of depress ion (Carlson & Cantwell, 1980). The psychometric properties are adequate (Smucker, Craighead, Craighead & Gree, 1986).

The Revised Children's Manifest Anxiety Scale (RCMAS; Reynolds & Richmond, 1978) is a 37-item true/false scale designed to measure vari- ous types of childhood anxiety. The questionnaire is completed by the child.

The Beck Depression Inventory (BDI; Beck, Ward, Mendelson, & Erbaugh, 1961) is a widely used measure of depressive symptomatology (Beck, Steer, & Garbin, 1988). The instrument includes 21 questions derived from clinical observations about the attitudes and symptoms fre- quently experienced by depressed psychiatric patients. The instrument is scored by summing the ratings given to each of the 21 items.

The Beck Anxiety Inventory (BAI; Beck, Epstein, Brown, & Steer, 1988) consists of a set of statements that describe common symptoms of anxiety. An adult is asked to indicate how much he/she has been bothered by each symptom lately. Score is on a 4-point scale: 0 = not at all, 1 = mildly, 2 = moderately, and 3 = severely bothered. The instrument is scored by adding up the subject's ratings. The psychometric properties are adequate (Borden, Peterson, & Jackson, 1991).

The Family Assessment Device (FAD; Epstein, Baldwin, & Bishop, 1983) is a self-report scale that asks family members to rate how well each of 60 items describes their family's functioning on a 4-point scale. The FAD was designed to assess overall level of family functioning by assessing structural and organization properties of the family group as well as the patterns of transactions among family members that discriminate between healthy and unhealthy families. The 12-item General Functioning Scale (GFS) of the FAD provides on overall assessment of family functioning and measures the overall health/pathology of the family. The GFS was derived from item analyses conducted in testing the psychometric properties of the FAD.

Procedures

Children were asked to complete the Children's Depression Inventory (Kovacs & Beck, 1977) and the Revised Children's Manifest Anxiety Scale


(Reynolds & Richmond, 1978) during a class period. The coordinating teacher read the directions for each instrument and one of the authors (E.L.G.) was present to answer questions. In addition, mothers were asked to complete the parent form of the CBCL (Achenbach, 1991a), the Beck Depression Inventory (Beck et al., 1961), the Beck Anxiety Inventory (Beck et al., 1988), and the General Functioning Scale of the Family Assessment Device (Epstein et al., 1983). In order to control for completion effects, the presentation of specific scales was randomized across mothers and children. Finally, teachers were asked to fill out the Teacher Report Form (Achenbach, 1991b) of the CBCL on each child in their class in alphabetical order. Mothers and teachers were given monetary compensation for their efforts.

RESULTS

Because of the small number of teachers who participated (N = 4), all of the teacher data should be interpreted with caution and considered very preliminary. However, a visual analysis of the frequencies of 0s, ls, and 2s reported by teachers across the alphabetical distribution of students was inconsistent with the presence of order of completion effects. This pattern suggests that teachers were equally attentive to completing the TRF questionnaires across all students, independents of how many questionnaires or items they had already responded to.

Internal Consistency

The internal consistency of the broadband and narrowband scales of both the parent and teacher report forms of the CBCL was examined sepa- rately for boys and girls (see Tables II and III). The Cronbach's alpha statistics for the broadband scales for boys and girls ranged between .90 and .97 for parents and .88 and .97 for teachers. These values are comparable to U.S. normative sample data. For the narrowband scales, internal consistency statistics ranged from .38 to .94 for parental ratings of boys. With one exception (Thought Problems, Cronbach's alpha = .38), all scales achieved adequate reliability (.74 to .94). Internal consistency statistics for the narrowband scales of parental ratings of girls ranged from .34 to .92. With two exceptions (Delinquent Behavior, Cronbach's alpha = .34, and Thought Problems, Cronbach's alpha = .58), all scales achieved adequate reliability (.65 to .92). The reliabilities of the teacher ratings of boys were similar to those of parents. For the narrowband scales, internal consistency statistics ranged from -.12 to .90. Similar to parental ratings, teacher ratings


of Thought Problems (Cronbach's alpha = -.12) showed no internal consistency. In contrast to parents, teacher ratings of Somatic Complaints (Cronbach's alpha = .17) also had a lower reliability than the other narrowband scales (.68 to .90). For girls, the internal consistency statistics for teacher ratings of the narrowband scales ranged from .27 to .95. Similar to parental ratings of girls, Thought Problems (Cronbach's alpha = .30) had low reliability. In contrast to parents, teachers' ratings of Somatic Com- plaints (Cronbach's alpha = .27) also had a low reliability. All other teacher ratings of the narrowband scales (.69 to .95) had adequate reliabilities. The internal consistency of the validation measures adapted for use in this study ranged from .77 to .84, suggesting adequate reliabilities (see Table I).

Influence of Parental Education

Multivariate analyses of variance were performed to determine whether parental education (conceptualized as an approximation of socioeconomic status) was associated with the measures employed in this study. For the parent form of the Child Behavior Checklist, maternal education and the interaction of maternal and paternal education were significant in the multivariate model [F(24, 81) = 1.6, p < .05; F(32, 73) = 1.9, p < .01, respectively]. Univariate followup analyses, including maternal education, paternal education, and their interaction, revealed that parental education was associated with the Somatization, Thought, and Delinquency scales of the CBCL [F(ll, 94) = 2.07, 4.14, and 5.05, p < .05, .001, and .0001, respectively]. Paternal education was significantly associated with the Soma- tization scale [F(3, 102) = 2.97, p < .05], maternal education was associated with the Thought scale [F(4, 101) = 4.57, p < .001], and both maternal and paternal education and their interaction were associated with the De-

Table I. Means, Standard Deviations, and Reliabilities of the Validation Instruments

American data Russian data

Cronbach's Cronbach's

Mean S D (x Mean S D tx

Revised Children's Manifest Anxiety Scale 16.6

Children's Depression Inventory 8.7

Beck Depression Inventory 7.3 Beck Anxiety Inventory 10.8 Family Assessment Device-- General Functioning 1.8

5.7 .83 15.2 5.5 .77

6.9 .94 11.1 5.8 .77 6.9 .83 9.6 7.3 .87 9.1 .91 7.5 6.3 .81

.39 .92 1.7 0.6 .84


linquency scale IF(4, 101) = 4.71, p < .005; F(3, 102) = 3.50, p < .05; F(4, 101) = 6.6, p < .001, respectively]. The multivariate model examining the effect of maternal education, paternal education, and their interaction was not significant for the TRF or any of the other parent- or child-rated validation instruments included in this study. While statistically significant, differences between parental education groups on the CBCL were not easily interpretable (i.e., a linear trend between increased levels of education and rates of child behavior problems did not emerge). Therefore, further analyses with a larger sample are indicated.

Russian and U.S. Comparative Analyses

Univariate Analyses of Means and Standard Deviations. The broadband and narrowband scale means in the Russian sample were compared to U.S. normative data for nonreferred and referred samples (Achenbach, 1991a, 1991b) utilizing t-tests (see Tables II, III, and IV). Univariate analyses were employed because the raw data for the U.S. sample were unavailable. The alpha level for interpreting statistically significant group differences was ad- justed utilizing a Bonferoni correction for 22 separate comparisons within each gender and rater (tx = 0.05/22 = 0.002). It is important to note that, in contrast to the U.S. sample, which ranged in age from 6 to 11 years, the Russian sample was comprised of children aged 9 to 10 years old.

Overall, Russian mothers and teachers reported significantly more Total Problem and Internalizing symptoms for both boys and girls than parents and teachers in the U.S. normative nonreferred sample. Of note is that the rates of Internalizing symptoms reported by Russian mothers and teachers were not significantly different than rates in the U.S. clinical sample. On the other hand, Russian parent and teacher reports of Exter- nalizing symptoms for both boys and girls were similar to the U.S. nonreferred normative sample and were significantly lower than the U.S. normative referred sample.

Comparisons by Gender. Russian mothers' ratings of their daughters were significantly higher than the comparable ratings for U.S. girls in the nonreferred sample in all of the internalizing narrowband scales with one exception (Table IV). Russian and U.S. mothers rated girls as having similar levels of Thought Problems. It is important to note that Russian mothers' ratings of their daughters' withdrawal, somatization, and attention problems were not significantly different than comparable ratings for the U.S. clinic-referred sample. Russian teacher ratings of gifts were also significantly higher than U.S. teacher ratings for nonreferred girls for the following internalizing narrowband scales: Withdrawn, Anxious/Depressed,


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The findings for maternal ratings of boys were remarkably similar to those for girls (Table IV). Russian mothers of boys reported higher levels for all of the Internalizing narrowband scales compared to the U.S. nonreferred sample of boys. Furthermore, the scores for Withdrawal, Somati- zation, and Attention Problems were not significantly different from those for the U.S. clinic-referred sample. In addition, there were no elevations for any externalizing narrowband scales. In contrast to Russian parents, teachers rated boys as higher in only the Withdrawn narrowband scale when compared to the U.S. nonreferred sample. This score was net significantly different from that reported for the U.S. clinic-referred sample.

In contrast to the U.S. normative data, only two significant gender differences were obtained in teacher ratings of problem behaviors. Teachers rated girls higher than boys on the Anxious/Depressed scale (4.2 vs. 3.1, respectively, t = 3.5, p < .002) and on the Thought Problems scale (1.0 vs. 0.5, respectively, t = 3.4, p < .002). No gender differences emerged on broadband or narrowband parent ratings.

Interscale Correlations. Correlations between broadband and narrowband scales for within parent and teacher reports for the Russian and U.S. normative samples are presented in Tables V and VI. While the structure of the correlations in the Russian sample are generally consistent with the U.S. nonreferred normative data, a few exceptions are notable. Specifically, Russian teacher ratings of boys' Aggressive Behavior was negatively correlated with the Withdrawn (r = -0.44) and Anxious Behavior (r = -0.43).

Interrater Agreement. Correlations for parent-teacher agreement for both the broadband and narrowband scales are presented in Table VII. The mean interrater agreement between teachers and parents in the Rus- sian sample was .26 for boys and .23 for girls compared to .42 for boys and .28 for girls in the U.S. normative sample.

Russian Sample: ExtemaZ Validity. To address issues of criterion or external validity in this nonclinic sample, broadband and narrowband CBCL scale scores were correlated with child reports of internalizing symptoms and maternal reports of their own internalizing symptoms and general family functioning (see Table VIII).

Child Ratings of Internalizing Symptoms. Child self-ratings of anxiety symptoms did not correlate with parent or teacher ratings of internalizing or externalizing symptoms. However, child self-ratings of depressive symptomatology correlated with both parent and teacher ratings of Attention


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Table VIII. Intercorrelations Between the Parent Validation Ins t ruments

Carter, Grigorenko, and Pauls

and Teacher Forms and

Child Child Parent Parent General anxiety depression anxiety depression functioning

Parent 's report form Withdrawn .03 .18 .15 Somatic Complaints .08 .06 .31 c Anxious/Depressed .03 .08 .16 Social Problems .13 .12 .31 c Though t Problems .04 .27 b .04 At tent ion Problems .08 .23 a .07 Del inquent Behavior -.03 .17 -.04 Aggressive Behavior -.07 .24 a .16 Internalizing .09 .17 .24 a Externalizing -.07 .24 a .11 Total Problems .03 .21 a .20 a

Teacher 's report form Withdrawn .02 .00 .20 a Somatic Complaints .07 .15 .12 Anxious/Depressed .17 .14 .13 Social Problems .10 .28 b .20 a Though t Problems -.11 - .14 .02 At tent ion Problems .09 .26 b -.00 Del inquent Behavior .10 .14 .11 Aggressve Behavior .08 .02 -.23 a Internalizing .10 .09 .18 Externalizing .09 .04 -.18 Total Problems .09 .17 .01

Child anxiety .59 c .06 Child depression .11 Parent anxiety Parent depression

.18 .36 c

.28 b .28 b

.15 .25 b

.18 .09

.12 .24 b

.08 .11

.02 .29 b

.08 .23 b

.22 a .38 c

.07 .25 b

.20 a .31 c

.06 .16 -.04 .30 b -.01 .08

.04 .28 b - .00 .07

.02 .09

.10 .15 -.09 .05

.03 .19 a - .06 .08 -.00 .18

.10 .23 a - .02 .34 c

.64 c .36 c .44 c

< .05. P < .01. cp < .0Ol.

Problems (.23 and .26, respectively), parent ratings of Thought Problems (.27), Aggressive Behavior (.24), Externalizing behaviors (.24) and total problem behaviors (.21) and teacher ratings of social problems (.28).

Maternal Ratings of Internalizing Symptoms. Maternal self-ratings of depressive symptomatology were correlated with the mothers' own ratings of their children's broadband Internalizing symptoms (r = .28), Total Prob- lems (r = .20), and narrowband ratings of Somatic Complaints (r = .22). However, maternal self-ratings of depressive symptomatology were not correlated with any teacher-rated scales of child behavior problems. In addi-


tion, maternal self-ratings of anxiety symptoms were correlated with maternal ratings of children's broadband Internalizing symptoms (r = .24) and Total Problems (r = .20) and narrowband ratings of Somatic Complaints (r = .31) and Social Problems (r = .31), as well as with teacher ratings of Withdrawn (r = .20), Social Problems (r = .20), and Aggressive Behavior (r = .23).

Maternal Ratings of General Family Functioning. Maternal ratings of general family functioning were associated with both maternal and teacher ratings o f children's broadband Internalizing symptoms (r = .38 and .19, respectively) and narrowband Somatic Complaints (r = .28 and .30, respectively). In addition, maternal ratings of general family functioning were associated with maternal ratings of Withdrawn (r = .36), Anxious/Depressed (r = .25), Thought Problems (r = .24), Delinquent Behavior (r = .29), and Total Problems (r = .31) and with teacher ratings of Social Problems (r = .28).

The associations of maternal ratings of general family functioning and internalizing symptoms with child behavior problems were examined further with a series of regression analyses. When the level of general functioning was predicted by both maternal anxiety and depression, the overall model was significant [F(2, 101) = 5.6, p < .01, R 2 = .18], but only parent depression contributed significantly (t = 2.4, p < .05). When the level of parent-rated child internalizing symptoms was predicted from maternal anxiety, depression, and general family functioning, the overall model was significant [F(3, 101) = 2.9, p < .05, R 2 = .15], but only general family functioning contributed significantly (t = 2.2, p < .05). Similarly, when child-rated depressive symptomatology was predicted from maternal anxiety, depression, and general family functioning, the overall model was significant [F(3, 101) = 2.8, p '< .05, R 2 = .15], but only general family functioning contributed significantly (t = 2.5, p < .05). The overall models predicting child-rated anxiety, maternal-rated externalizing symptoms, and total behavior problems from maternal anxiety, depression, and general family functioning were not significant. While child gender was significantly associated with externalizing symptoms, adding child gender to these regression models did not improve the overall predictive power.

DISCUSSION

The obtained psychometric properties of the Russian adaptation of the CBCL and TRF demonstrate the adequacy of these instruments for use in a Russian population. However, as noted above, given the small sample size, the limited age range of the children, and the small number of teachers who completed ratings, these results should be interpreted with


caution and considered preliminary. The lack of independence of teacher ratings might restrict between-subject variability. Inspection of Tables II and III reveals that the range and standard deviations in the Russian teachers' ratings are comparable to those reported for U.S. teachers. Thus, the Russian teachers appear to be identifying differences between children similarly to U.S. teachers. Nevertheless, the small number of teachers rating the children is a limitation of the design and should be considered in the evaluation of the findings.

The above caveat notwithstanding, internal consistency and interrater agreement were generally comparable to estimates observed in U.S. normative samples. Further, the effort to explore the construct validity of the Russian versions of the CBCL and TRF lend additional support to the adequacy and applicability of these instruments.

A small number of scales did not achieve a level of reliability consistent with the U.S. normative sample internal consistency estimates. Spe- cifically, parent ratings on scales assessing thought problems for all children and delinquency for girls, along with teacher ratings on scales assessing thought problems and somatic complaints, showed low reliability coeffi- cients. The low estimates for parent and teacher ratings of thought problems for boys and girls and delinquency for girls most likely reflect the low occurrence of these behaviors in this nonreferred sample. Further work in clinical samples is needed to evaluate these scales adequately. In addition, the low rates of internal consistency for somatic behavior in teacher ratings may indicate that Russian children are more likely to share physical complaints with their parents than with their teachers. Russian teachers may also be most aware of behavioral difficulties that interfere with school performance and are more easily observed in school settings (e.g., attentional and social problems).

The Russian sample evidenced consistent elevations in internalizing symptoms, especially somatic complaints, when compared to the U.S. normative sample. Sandberg, Meyer-Bahlburg, and Yager (1991) have argued against the use of Achenbach and Edelbrock's (1983) nonclinical normative data for comparison to unselected school samples. Indeed, they reported significant differences between a sample of unselected U.S. school-aged children and the normative data even when they removed children from their analyses who had been referred for clinical services. However, in contrast to the findings in the Russian sample, Sandberg and colleagues reported elevations on all of the broadband and almost all of the narrowband scales of the CBCL. In the current Russian sample, only internalizing symptoms were elevated. This difference most likely implies cultural rather than general sampling effects. While it would not be prudent to conduct comparative cross-cultural analyses on the basis of this preliminary sample, it


is interesting to note that the mean CBCL Total Problem scores are among the highest in the published literature (Achenbach et al., 1990) with few exceptions (e.g., Achenbach, Bird, et al., 1990).

Our findings comparing Russian and U.S. children correspond to the general patterns of children's psychological problems in different nations with the exception of higher rates of internalizing symptoms and the lack of gender differences. While preliminary, the significant cross-national differences that w e r e identified here are consonant with Russian cultural educational values and practices (Dunstan, 1992; Tomiak, 1983) and lend support to the importance of studying questions about the interplay of culturally mediated values, expectancies, child-rearing practices, and the development of certain types of child behavioral and emotional problems in Russia.

The findings that Russian children were elevated on Somatic Com- plaints relative to their U.S. peers suggests that Russian children may be more likely to internalize distress in the form of bodily rather than purely psychological "symptoms." In addition, Russian parents may be more aware of their children's physical complaints and medical needs than they are of their children's emotional difficulties or mental health needs. Further, there seems to be greater stigma associated with emotional difficulties in the Rus- sian culture as compared to U.S. (Kozulin, 1984). This is consistent with the higher cultural threshold that is employed for mental health referrals in Russia (Cherkin, 1991). The higher rates of internalizing symptoms among teacher's ratings may reflect the fact that the Russian school setting is more conservative with respect to expectations and standards for children's conduct than the U.S. school environment. Traditional Russian schooling places a greater emphasis on obedience, respect, and inhibition and may therefore foster the development of internalizing problems, at least in comparison with U.S. traditions and practices. While the present findings are suggestive of elevations in internalizing symptoms among Rus- sian as compared to U.S. school-aged children, a much larger representative sample would be necessary to make valid conclusions regarding cultural differences.

The lower estimates of interrater agreement between parents and teachers in the Russian sample may reflect differences in sampling procedures and/or the small number of teachers sampled. The U.S. normative sample included both referred and nonreferred children from a variety of sources (Achenbach, 1991c) while the Russian sample only included nonreferred children. Lower estimates are expected in nonreferred samples because of the lower base rates of occurrence of problem behaviors. When there is a low base rate of problem behaviors, agreement correlations may be lowered because of range restriction in scaling. For example, Jensen and


colleagues (Jensen, Traylor, et al., 1988; Jensen, Xenakis, et al., 1988), obtained mother-teacher interrater correlations on Internalizing, Externalizing, and Total Problem behaviors of -.80, 0.2, and 0.33, respectively, for girls and 0.27, 0.31, and 0.28, respectively, for boys in a nonreferred sample of comparable size (N = 100). Interestingly, the biggest discrepancy between the Russian sample and the Achenbach (1991a, 1991b) normative sample is in the externalizing domain for boys. This most likely reflects the lower rates of externalizing behaviors among the Russian boys described above.

The finding that maternal ratings of their own depression are not correlated with child ratings of depression or anxiety but are correlated with parental ratings of child internalizing symptoms is consistent with findings reported by Moretti and colleagues (1985). These investigators found a similar pattern for parent and child ratings of depressive symptomatology. However, regression analyses indicate that maternal ratings of family functioning are a stronger predictor of internalizing symptoms than are ratings of maternal depression. Further, family functioning was associated with both parent and child reports of internalizing symptomatology. Achenbach and colleagues (1993) reported similar findings. Investigating a sample comprised of 9-year-olds originally ascertained as normal and low-birth- weight infants and using the same measures of family functioning and child behavior problems employed in the present study, these investigators found significant associations of family functioning with 11 of 15 CBCL scales and 11 of the 17 TRF scales.

Overall, the data presented above support the feasibility of employing the Russian adaptations of the CBCL and TRF in a genetic-epidemiologic context. A larger, demographically representative sample will permit a more careful analysis of issues of cross-cultural differences in overall levels of child behavior problems, gender effects, and patterns of interrater agreement. Finally, further work including children referred to mental health services is planned.

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