Internalizing Behavior Checklist for Children

Internalizing behaviors refer to a broad class of behaviors in which children direct feelings and emotions inward. Internalizing behavior is commonly contrasted to externalizing behavior, which is the expression of feelings and emotional responses into behaviors that are directed outward into delinquent or aggressive behavior, as noted in the "Journal of Child and Adolescent Psychiatric Nursing. 2"

Internalizing Behavior Checklist

Psychologist Thomas Achenbach developed several highly regarded and widely utilized paper and pencil rating scales that counselors, psychologists, clinicians and researchers employ to identify and measure problem behaviors in children. These questionnaires, such as the Child Behavior Checklist (CBCL), list over one hundred problem behaviors. In some versions of the CBCL children rate themselves, while in other versions parents or teachers rate the extent to which a child displays these behaviors. CBCL subscales measure the severity of three classes of internalizing behavior including withdrawn, somatic and anxious/depressed behavior.


Nine items indicate withdrawn behavior, including items that measure whether the child: prefers to be alone, won't talk, sulks, stares, or is secretive, sad, shy, withdrawn or underactive. Children who score above the 98th percentile according to age- and sex-based norms potentially have clinically significant problems with being withdrawn. High scores are considered to be consistent with a diagnosis of avoidant disorder, according to U.S. Department of Health.

Somatic Complaints

The somatic complaints subscale includes nine items that cover a range of body aches, pains and problems, including: feeling dizzy, tired, aches or pains, headaches, nausea, problems with eyes, rashes or other skin problems, stomach aches or cramps, vomiting or other somatic problems.include:

  • The somatic complaints subscale includes nine items that cover a range of body aches
  • pains
  • problems
  • including: feeling dizzy
  • tired
  • aches or pains
  • headaches
  • nausea
  • problems with eyes
  • rashes or other skin problems
  • stomach aches or cramps
  • vomiting or other somatic problems

Children afflicted with chronic health problems, such as asthma, tend to score high on the somatic complaints subscale, according to Psychosomatic Medicine. The U.S. Department of Health indicates that high scores on the somatic complaints subscale corresponds to a diagnosis of somatization disorder


The anxious/depressed subscale corresponds to symptoms consistent with several possible diagnoses including overanxious disorder, major depression or dysthymia, according to U.S. Department of Health. Items on the checklist assess the extent to which the child feels lonely, guilty, worthless, nervous, fearful, suspicious, unloved, self-conscious or sad. Further items evaluate behaviors including crying and perfectionism. Subscale scores in the clinical range do not necessarily indicate a psychiatric diagnosis, but rather suggest that the child has problems in that area of emotional functioning, and would likely benefit from a full clinical evaluation.