Structure of DSM-III-R criteria for disruptive childhood behaviors: confirmatory factor models.

OBJECTIVE

The aims of this analysis were to examine the extent to which DSM-III-R criteria for disruptive behavior patterns were consistent with the system of diagnoses proposed. Particular attention was paid to (1) whether oppositional defiant disorder is factorially distinct from conduct disorder (CD) and (2) the extent to which CD can be further classified into overt and covert CD behaviors.

METHOD: Data were gathered on DSM-III-R criteria for disruptive behavior patterns for a sample of 739 New Zealand 15-year-olds using data provided by parental and self-report. These data were supplemented by officially recorded police contact data.

RESULTS

Application of methods of confirmatory factor analysis suggested that the diagnostic criteria in DSM-III-R reflected a constellation of distinct but highly correlated behavioral domains, with these domains corresponding to oppositional defiant disorder, overt CD (aggression, violence), covert CD (theft, dishonesty), and attention-deficit hyperactivity disorder behavior. Results of second-order factor analysis methods suggested that these dimensions reflected two general higher-order factors, with the first factor reflecting the extent to which the individual displayed behavioral symptoms of oppositional defiant disorder and attention-deficit hyperactivity disorder and the second reflecting the extent to which the individual expressed antisocial, conduct-disordered behaviors.

CONCLUSIONS

The results of confirmatory factor analysis generally support and validate the diagnostic classifications proposed in DSM-III-R but suggest possible refinements that draw distinctions between overt and covert expressions of CD.