OBJECTIVE: The purpose of the field trials for oppositional defiant
disorder and conduct disorder was to select valid diagnostic thresholds for
these disorders and to compare the psychometric properties of DSM- IV
criteria for oppositional defiant disorder and conduct disorder with
previous DSM diagnostic formulations. METHOD: Structured diagnostic
interviews, standardized clinician's validation diagnoses, and multiple
measures of impairment were obtained for 440 clinic-referred children and
adolescents aged 4-17 years. RESULTS: A diagnostic threshold of four
symptoms of oppositional defiant disorder optimized identification of
impaired children, improved agreement somewhat with the clinician's
validation diagnosis, and had somewhat better test-retest agreement than
DSM-III-R. In the case of conduct disorder, the optimal time window for
ascertainment of symptoms was clarified. A diagnostic threshold of three
symptoms of conduct disorder maximized accurate identification of impaired
children and agreement with the clinician's validation diagnosis and
resulted in slightly better test-retest agreement than DSM-III-R. Compared
with the DSM-III-R definition, the DSM-IV definition of oppositional
defiant disorder was somewhat more prevalent, but the prevalence of conduct
disorder was essentially unchanged. CONCLUSIONS: DSM-IV definitions of
oppositional defiant disorder and conduct disorder are somewhat better than
DSM-III-R definitions in terms of internal consistency and test-retest
agreement, and the validity of the DSM-IV definition of oppositional
defiant disorder is slightly better than that of DSM-III-R.
Abstract Teaser