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Oppositional defiant and conduct disorders: issues to be resolved for DSM-IV.
Summary
Oppositional defiant disorder (ODD) and conduct disorder (CD) show distinct patterns but share links to impairment and family history. Findings suggest ODD and CD may represent different severity levels of the same disorder.
Area of Science:
- Child and Adolescent Psychiatry
- Developmental Psychology
- Behavioral Science
Background:
- Oppositional defiant disorder (ODD) and conduct disorder (CD) are disruptive behavior disorders in youth.
- These disorders are characterized by patterns of hostility and defiance toward authority figures.
Purpose of the Study:
- To examine the distinctiveness and relationship between ODD and CD.
- To explore the developmental progression and hierarchical organization of these disorders.
Main Methods:
- Statistical analysis of symptom covariation and age of onset.
- Assessment of impairment and family history of antisocial behavior.
- Longitudinal observation of symptom development in clinic-referred youth.
Main Results:
- ODD and CD exhibit distinct symptom patterns and ages of onset.
- Both disorders correlate with impairment and family history of antisocial behavior, more strongly for CD.
- Youth with early-onset CD often exhibit prior ODD symptoms, indicating developmental progression.
- Some adolescent-onset CD cases appear independent of ODD, suggesting separate disorder classification.
Conclusions:
- ODD and CD may represent hierarchically organized, developmentally staged levels of severity of a single disorder.
- Distinct diagnostic categories in DSM-IV are supported by the independence of adolescent-onset CD and the fact that many ODD cases do not progress to CD.