Beyond Symptom Counts for Diagnosing Oppositional Defiant Disorder and Conduct Disorder?

Journal of Abnormal Child Psychology
Oliver LindhiemDustin A Pardini

Abstract

Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD) are among the most commonly diagnosed childhood behavioral health disorders. Although there is substantial evidence of heterogeneity of symptom presentations, DSM diagnoses of CD and ODD are formally diagnosed on the basis of symptom counts without regard to individual symptom patterns. We used unidimensional item response theory (IRT) two-parameter logistic (2PL) models to examine item parameters for the individual symptoms of CD and ODD using data on 6,491 adolescents (ages 13-17) from the National Comorbidity Study: Adolescent Supplement (NCS-A). For each disorder, the symptoms differed in terms of severity and discrimination parameters. As a result, some adolescents who were above DSM diagnostic thresholds for disruptive behavior disorders exhibited lower levels of the underlying construct than others below the thresholds, based on their unique symptom profile. In terms of incremental benefit, our results suggested an advantage of latent trait scores for CD but not ODD.

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Citations

Jan 5, 2016·European Child & Adolescent Psychiatry·Tijs JambroesArne Popma
Apr 21, 2019·European Child & Adolescent Psychiatry·Marcel AebiBelinda Plattner
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Sep 19, 2020·Child and Adolescent Psychiatry and Mental Health·Britt-Marie LjungströmUlf Axberg
Apr 21, 2020·Clinical Psychological Science : a Journal of the Association for Psychological Science·James W MadolePaige K Harden

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