Developing and Validating the ‘‘Composite Measure of Problem Behaviors’’ à Jessica Kingston, 1 Sue Clarke, 2 Timothy Ritchie, 3 and Bob Remington 1 1 University of Southampton 2 Bournemouth University in collaboration with Dorset HealthCare University NHS Foundation Trust 3 University of Limerick Clinicians frequently encounter problem behaviors such as self-harm, restrictive eating, binge eating, alcohol misuse, drug misuse, smoking, sexual promiscuity, internet addiction, excessive exercise, and aggression. Although these behaviors commonly co-occur, no scale exists to measure them concurrently. Based on data from two opportunity samples (N 5 691 and N 5 53), this study designed and validated a composite measure of the problem behaviors noted above. The Composite Measure of Problem Behaviors, developed using exploratory factor analysis, demonstrated good psychometric properties. Subsequent confirmatory factor analysis, using both the first (N 5 691) and a third sample (N 5 740), identified a common higher order factor that accounted for covariance between behaviors. Findings thus suggest that despite the formal dissimilarity of behaviors assessed, a common function may explain their covariation. & 2011 Wiley Periodicals, Inc. J Clin Psychol 67:1–16, 2011. Keywords: problem behaviors; questionnaire validation; structural equation modeling; behavioral function The phrase ‘‘problem behavior’’ is often used to describe a formally dissimilar range of risky behavior patterns such as substance use/misuse, disordered eating, and risky sexual practices (e.g., see Cooper, Wood, Orcutt, & Albino, 2003; Donovan & Jessor, 1985; Jessor & Jessor, 1977). Such activities are of social concern, and typically elicit ‘‘some kind of social control response’’ (Jessor & Jessor, 1977, p. 33). In terms of their formal characteristics, problem behaviors vary considerably. Indeed, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (American Psychiatric Association, 2000), which arranges clinical disorders on the basis of clustering symptoms, differentially associates these behaviors with various independent diagnoses (e.g., bulimia nervosa, substance disorders, personality disorders). This approach suggests that the various kinds of problem behavior require separate explanations, assessment tools, and treatment programs. In contrast to this syndromic approach, there has been increasing interest in the possibility that diverse behavior patterns share common causal mechanisms or fulfill a common function (Cooper et al., 2003; Donovan & Jessor, 1985). Several theories hypothesize about the nature of this mechanism or function (e.g., see Cooper et al.). One account proposes that problem behaviors function to reduce, or temporarily alleviate, aversive internal states such as unwanted thoughts, emotions, or memories (e.g., experiential avoidance; Hayes, Wilson, Gifford, Follette, & Stroshal, 1996). Another highlights the central role of impulsivity and, in particular, urgency–the tendency to act quickly without forethought for the negative consequences–as a personality characteristic that predisposes an individual to engage in risky behaviors (e.g., see Anestis, Selby, & Joiner, 2007; Zuckerman & Kuhlman, 2000). Furthermore, other theories have focused on the role of serotonin, such as the effect of à This article was reviewed and accepted under the editorship of Beverly E. Thorn. This project was funded by an ESRC Grant (PTA-033-2005-00018) awarded to Professor Bob Remington and Professor Susan Clarke and held by Jessica Kingston, PhD. This research was conducted at the University of Southampton. Correspondence concerning this article should be addressed to: Dr Jessica Kingston, Department of Clinical Psychology, Royal Holloway University of London, Egham, Surrey, TW20 0EX, UK; e-mail: Kingston_jessica@hotmail.com JOURNAL OF CLINICAL PSYCHOLOGY, Vol. 67(7), 1--16 (2011) & 2011 Wiley Periodicals, Inc. Published online in Wiley Online Library (wileyonlinelibrary.com/journal/jclp). DOI: 10.1002/jclp.20802