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{F}=Female {M}=Male
Form Eval ID Age Informant Name Relationship Date Form Eval ID Age Informant Name Relationship Date
CBC1 002 11 J. Holcomb Biological Mother 12/04/2000
TRF2 004 11 H. Saunders Classroom Teacher {F} 12/01/2000
YSR3 003 11 Self Self 12/04/2000
ASEBA, University of Vermont
1 South Prospect St.
Burlington, VT 05401-3456
www.ASEBA.org
CBC TRF YSR CBC TRF YSR CBC TRF YSR
1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 6 7 8 5
Affective Problems Somatic Problems Oppositional Defiant Problems
5.EnjoysLittle 1 2 1 56a.Aches 0 0 2 0 0 1 3.Argues
14.Cries 0 0 0 56b.Headaches 0 0 2 0 0 1 23.DisbSchool
18.HarmSelf 0 0 0 56c.Nausea 0 0 0 2 2 2 86.Stubborn
35.Worthless 0 1 1 56d.EyeProb 0 0 0 2 0 1 95.Temper
52.Guilty 0 1 1 56e.SkinProb 0 0 2
54.Tired 1 1 1 56f.Stomach 0 0 0 Conduct Problems
91.Suicide 0 0 0 56g.Vomit 0 0 0 0 0 1 16.Mean
102.LacksEnergy 1 1 1 0 0 0 21.DestroyOther
103.Sad 2 1 0 ADH Problems 0 0 0 26.NoGuilt
4.FailsToFinish 2 2 1 0 0 1 28.BreaksRules
Anxiety Problems 8.Concentrate 1 2 1 0 0 0 37.Fights
11.Dependent 1 0 1 10.SitStill 0 1 0 0 0 0 39.BadFriends
29.Fears 0 0 0 41.Impulsive 0 2 0 0 0 1 43.LieCheat
30.FearSchool 0 1 0 78.Inattentive 0 1 1 0 0 0 57.Attacks
45.Nervous 0 1 2 93.TalkMuch 0 0 1 0 0 0 82.Steals
50.Fearful 0 1 2 104.Loud 0 0 0 0 0 0 90.Swears
112.Worries 1 1 0 0 0 1 97.Threaten
0 0 0 101.Truant
Copyright 2001 T.M. Achenbach
DSM-Oriented Cross-Informant Comparison - Problem Items Common to the CBCL/TRF/YSR
ID: 200105 Name: Catherine A. Holcomb Gender: Female Birth Date: 06/16/1989 Comparison Date: 03/04/2002
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Form Eval ID Age Informant Name Relationship Date Form Eval ID Age Informant Name Relationship Date
CBC1 002 11 J. Holcomb Biological Mother 12/04/2000
TRF2 004 11 H. Saunders Classroom Teacher {F} 12/01/2000
YSR3 003 11 Self Self 12/04/2000
B =Borderlineclinical range; C =Clinical range
Broken lines =Borderlineclinical range
{F}=Female {M}=Male
ASEBA, University of Vermont
1 South Prospect St.
Burlington, VT 05401-3456
www.ASEBA.org
S
C
O
R
E
T
S
C
O
R
E
T
73-C 72-C 63 54 67-B 50 50 66-B 59
CBC1 TRF2 YSR3 CBC1 TRF2 CBC1 TRF2 YSR3 YSR3
52 62 52 59 61 65-B 52 55 56
CBC1 TRF2 YSR3 CBC1 TRF2 YSR3 CBC1 TRF2 YSR3
Affective Problems Anxiety Problems
Attention Deficit/ Hyperactivity Problems Oppositional Defiant Problems
Somatic Complaints
Conduct Problems
Copyright 2001 T.M. Achenbach
DSM-Oriented Cross-Informant Comparison - Scale T Scores CBCL/TRF/YSR
nc =not calculated dueto insufficient data
ID: 200105 Name: Catherine A. Holcomb Gender: Female Birth Date: 06/16/1989 Comparison Date: 03/04/2002