DSM-III-R and DSM-III criteria for conduct disorder in preadolescent girls: specific but insensitive.
- Authors
- Zoccolillo, M; Tremblay, R; Vitaro, F
- Year
- 1996
- Journal
- Journal of the American Academy of Child and Adolescent Psychiatry
- PMID
- 8919708
- DOI
- 10.1097/00004583-199604000-00012
OBJECTIVE: To determine whether DSM-III and DSM-III-R criteria for conduct disorder identify girls in the general population with early-onset, persistent, and pervasive antisocial behavior. METHOD: 2,251 girls, representative of all girls entering kindergarten in QΓΊebec, were assessed using parent and teacher ratings of antisocial behavior; a subsample was then rated for the next 6 years (ages 7 to 12) by parent and teacher. At age 10 years, the girls who been rated as antisocial in kindergarten, along with a random sample of those not rated as antisocial, were assessed for DSM-III and DSM-III-R diagnoses of conduct and oppositional defiant disorder using a structured psychiatric interview (Diagnostic Interview Schedule for Children) administered to the parent, teacher, and/or child (n = 381). RESULTS: Of the girls with early-onset, persistent, and pervasive antisocial behavior, 3% met DSM-III-R criteria and 22% met DSM-III criteria for conduct disorder. Conduct disorder was not diagnosed at all in girls who had not been initially rated as antisocial in kindergarten. Lowering the threshold for a DSM-III-R conduct disorder diagnosis to two symptoms and adding the criterion of violation of rules increased the rate of diagnosis to 35% in the pervasively antisocial girls but only to 1% in girls who did not have persistent antisocial behavior. CONCLUSIONS: DSM-III-R criteria for conduct disorder do not identify most preadolescent girls with early-onset, pervasive, and persistent antisocial behavior. Modifications to the DSM-III-R criteria resulted in increased sensitivity without a loss of specificity.
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