Abstract
BACKGROUND: Challenging behaviour, especially in intellectual disability, covers a wide range that is in need of further evaluation. AIMS: To develop a short but comprehensive instrument for all aspects of challenging behaviour. METHOD: In the first part of a two-stage enquiry, a 28-item scale was constructed to examine the components of challenging behaviour. Following a simple factor analysis this was developed further to create a new short scale, the Problem Behaviour Checklist (PBCL). The scale was subsequently used in a randomised controlled trial and tested for interrater reliability. Scores were also compared with a standard scale, the Modified Overt Aggression Scale (MOAS). RESULTS: Seven identified factors - personal violence, violence against property, self-harm, sexually inappropriate, contrary, demanding and disappearing behaviour - were scored on a 5-point scale. A subsequent factor analysis with the second population showed demanding, violent and contrary behaviour to account for most of the variance. Interrater reliability using weighted kappa showed good agreement (0.91; 95% CI 0.83-0.99). Good agreement was also shown with scores on the MOAS and a score of 1 on the PBCL showed high sensitivity (97%) and specificity (85%) for a threshold MOASscore of 4. CONCLUSIONS: The PBCL appears to be a suitable and practical scale for assessing all aspects of challenging behaviour. DECLARATION OF INTEREST: None. COPYRIGHT AND USAGE: © 2016 The Royal College of Psychiatrists. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.