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Classification of behavior disorders in adolescence: scaling methods, predictive validity, and gender differences.
David M Fergusson1, Joseph M Boden, L John Horwood
1Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand. dm.fergusson@otago.ac.nz
Journal of Abnormal Psychology
|September 22, 2010
Summary
Dimensional measures of adolescent behavior disorders, including conduct disorder (CD), oppositional defiant disorder (ODD), and attention-deficit/hyperactivity disorder (ADHD), better predict long-term outcomes than DSM categories. Developmental consequences did not differ by gender.
Area of Science:
- Child and Adolescent Psychiatry
- Developmental Psychology
- Behavioral Science
Background:
- Diagnostic criteria for adolescent behavior disorders are outlined in the DSM.
- Understanding the validity and predictive power of these criteria is crucial for effective intervention.
Purpose of the Study:
- To examine the measurement and discriminant validity of DSM diagnostic criteria for conduct disorder (CD), oppositional defiant disorder (ODD), and attention-deficit/hyperactivity disorder (ADHD).
- To model associations between adolescent behavior disorders and later life outcomes.
Main Methods:
- Utilized data from a birth cohort of 995 New Zealand individuals followed to age 25.
- Analyzed associations between behavior disorders (ages 14-16) and outcomes (crime, substance use, mental health, partnership, education, employment) to age 25.
- Adjusted for comorbid disorders and confounding factors.
Main Results:
- Dimensional measures of behavior disorder showed stronger correlations with outcomes than categorical DSM measures.
- Conduct disorder, ODD, and ADHD each demonstrated distinct patterns of association with long-term consequences.
- No evidence indicated gender differences in the developmental consequences of CD, ODD, and ADHD.
Conclusions:
- DSM diagnostic domains show general validity, but dimensional approaches offer greater predictive power.
- Future revisions (DSM-V) should incorporate methods to assess disorder severity and subclinical symptoms.
- Findings support the utility of dimensional assessments for understanding adolescent behavior disorders and their long-term impact.
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