THE CHILDREN'S BEHAVIOR DISORDERS TEST (CBDT)
(also known as the "Childhood Bipolar Disorder Test")

With increasing frequency since the mid-1990's, scores of children are being diagnosed with Bipolar I Disorder, Bipolar II Disorder, Bipolar Disorder NOS, or Mood Disorder NOS (MD-NOS, which is now the preferred diagnosis that the National Institute for Mental Health and the American Psychiatric Association advise that clinicians use to diagnose these children with). However, there seems to be little agreement between clinicians as to what the symptoms of MD-NOS are, what diagnostic criteria to use when diagnosing MD-NOS, and how to understand the causes and symptoms of MD-NOS. Until recently, there have been no well-researched and standardized tests to assess for MD-NOS. Dr. Liz Randolph began researching what was then called Childhood-Onset Bipolar Disorder (or COBD) in the late 1990's, and also began to work on developing a standardized test to assess for the presence of COBD that could be researched and validated. This research led to the publication of The COBD Screening Test (or CST) in 2003. However, since the diagnostic focus has moved away from one of Bipolar Disorder to one of a Mood Disorder NOS, and research with the CST began to indicate that there appears to be a continuum of behaviors that are usually classified as Pervasive Developmental Disorders and what was then called COBD.

The CST has evolved into a test that's designed to assess for all of the behavior disorders of childhood, including MD-NOS, Attachment Disorder (AD), Oppositional Defiant Disorder (ODD), Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD), and Pervasive Developmental Disorder (PDD), as many of the symptoms of these disorders are similar to each other, making differential diagnosis of behavior problem children a difficult proposition. In addition, these disorders often co-exist in the same child, thus complicating the diagnostic picture even further. As a result of this change in the focus of the test, it has been re-named the "Children's Behavior Disorders Test", or CBDT, but continues to have the sub-title of the "Children's Bipolar Disorder Test", as many clinicians have ignored the change in diagnosis recommended by the APA and the NIMH and continue to refer to this disorder as COBD.

The CBDT is a 200-item inventory that can be completed by parents, or by the staff in a group home or residential treatment setting that's designed to be used with children between ages 3 and 18 years, and which uses a 5-point Likert-type response system of "usually true", "more true than false", "neither true nor false", "more false than true", and "usually false". It consists of eight scales, and seven sub-scales that assess for different symptoms of MD-NOS:

1. the "Fake Bad" scale, which indicates if parents are exaggerating their child's problems; this scale has three sub-scales to help to determine if the parents' perceptions of their child's problems are a part of the problem, or if a child is likely to have a wide variety of disorders that falsely elevate this scale; 15 items
   
2. the Attachment Disruption scale, which determines whether a child has a history of early life events that predispose the child to developing AD; five items.
3. the ODD scale, which was developed using the diagnostic criteria of the DSM-IV, and which has a sub-scale that indicates the number of diagnostic criteria for ODD that are present for a given child; 16 items
   
4. the ADHD scale, which was also developed using the diagnostic criteria of the DSM-IV, and which has sub-scales for Impulsivity, Overactivity, and Distractibility; 31 items
   
5. the AD scale, which uses completely different items from those used in the other standardized test that assess for AD (the RADQ), whose items were identified using a factor analysis that identified the items on this scale, and whose items are designed to specifically differentiate AD from MD-NOS and ADHD; 45 items; this scale has four sub-scales that were identified using a factor analysis that are useful in determining if the Core Symptoms of AD are present, or if other symptoms are present
   
6. the MD-NOS scale, which is designed to assess for the primary symptoms of MD-NOS, and particularly the symptoms that distinguish MD-NOS from AD, ODD, and ADHD, and whose items were identified using a factor analysis to identify which items of this test clustered together to distinguish MD-NOS from other behavior disorders; 52 items; this scale also has four sub-scales that were identified using a factor analysis that identifies categories of MD-NOS behaviors
   
7. the CD scale, which is comprised of items that were identified using a statistical test for differential validity, and which is designed to diagnose for CD; 15 items
   
8. the PDD scale, which is also comprised of items that were identified using a statistical test for differential validity, and which is designed to differentiate between the symptoms of a PDD and the symptoms of MD-NOS; 32 items There are seven sub-scales of the MD-NOS scale which assess for different realms of the behavior problems that are seen in children with MD-NOS. These seven sub-scales are:
   
   1. Sleep Problems
   2. Sensory Defensiveness
   3. Irritability
   4. Moodiness
   5. Inflexibility
   6. Excessive Need for Parents, and
   7. Grandiosity

   Extensive reliability and validity research was conducted with the CBDT prior to its publication, and this information is available in the CBDT Manual, as are instructions for the administration, scoring, and interpretation of the results of the CBDT. This includes test-retest and internal consistency reliability, as well as content, construct, and discriminant validity using a subject group of over 3,000 children. Some sample write-ups of how to interpret and write about the results of the CBDT are also provided in the manual. The CBDT kit comes complete with this manual, with 10 CBDT questionnaires, 50 answer sheets, 50 scoring sheets, 50 Optional Scales Scoring Sheets, and a set of scoring templates to assist with the process of scoring the CBDT. You must initially purchase the entire CBDT kit, and can then order replacement questionnaires in sets of 10 tests, and/or replacement answer sheets and scoring sheets in packages of 50 or 100. The manual can be purchased separately only by those who may be interested in conducting research using the CBDT. You need to contact Dr. Randolph by e-mail or phone to discuss your prospective research project in order to purchase the CBDT Manual separately. The CBDT has been extensively proven to be able to distinguish quite well between children who have ODD, ADHD, AD, MD-NOS, CD, and PDDs, as well as to determine when theses disorders exist as co-morbid conditions. It has been very well-received by psychologists and master's level therapists in states where master's level therapists can use psychological testing. It is by far the best researched test that assesses for MD-NOS, and has the best reliability and validity statistics.