possible that some cultures may have alternative ways of expressing psychopathology not captured by the DSM classification. By using the DSM symptoms in these studies, investigators may have imposed an appearance of cross cultural homogeneity that would not have appeared if cultural variations in symptoms had been allowed. Fourth, and perhaps most importantly, there is a need to evaluate the validity of ODD and CD symptoms across different cultures using several important external and clinical criteria, such as response to pharmacological or evidence based psychosocial treatment, developmental course, genetic aggregation in families, environmental risk factors (e.g., ineffective parenting) and biological/neuropsychological correlates.
