A cross-cultural comparison between samples of Brazilian and German children with ADHD/HD using the child behavior checklist

Abstract

This study aims to assess cross-cultural similarities and differences in broadband psychopathology in two naturalistic clinical samples of children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) combined type according to DSM-IV criteria or with Hyperkinetic Disorder (HD) according to ICD-10 criteria. We compared two clinical samples of children with ADHD combined type (Brazil, N = 248) and HD (Germany; N = 154) to controls (Brazil N = 71; Germany N = 135) using the Child Behavior Checklist (CBCL). ROC-curves (Receiver Operating Characteristic) were determined to evaluate the discriminating validity of the CBCL Attention Problem scale. A two-factorial ANOVA was computed across all 8 scales of the CBCL. Although Brazilian parents reported significantly higher scores on all CBCL scales than German parents (P < 0.05), a similar CBCL profile was detected in both cultures. Despite the use of different diagnostic systems (DSM-IV vs. ICD-10) and the presence of other clinical differences, the similar broadband psychopathological profile of the CBCL in the two samples provides evidence that dimensional symptoms associated with the categorical diagnosis of ADHD combined type might be comparable in two clinical settings with diverse cultural background.