DSM-IV Diagnosis of Conduct Disorder and Oppositional Defiant Disorder: Implications and Guidelines for School Mental Health Teams

Abstract

The DSM-IV criteria for conduct disorder (CD) and oppositional defiant disorder (ODD) are reviewed. These diagnoses are compared with their counterparts in DSM-III-R, and the rationale and empirical support for changes in criteria are described. Generally, DSM-IV criteria appear better operationalized and more closely conform to empirical studies than do prior criteria. However, results from DSM-IV field trials indicate that interrater and test-retest reliability were only marginally improved compared to prior criteria and remained moderately low by psychometric standards. Studies confirming the importance of subtyping CD on age of onset are reviewed, and empirical evidence for the relationship between ODD and early-onset CD is described. These criteria highlight the importance of alerting clinicians to early intervention, especially for symptoms of ODD that are typically easier to modify than ones of CD. Although overlooked in DSM-IV criteria, community factors, gender differences, and academic functioning are important considerations in school-based assessments and interventions.

Additional information

Notes on contributors

Marc S. Atkins

Marc S. Atkins is an Associate Professor of Psychology and Director of Psychology Training at the Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago. His research interests include school-based services for ADHD and aggressive children, children's peer relations, and the development and evaluation of collaborative interventions with classroom teachers.

Mary McKernan McKay

Mary McKernan McKay is an Assistant Professor of Social Work and Director of Social Work Training at the Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago. Her research interests include the development and evaluation of mental health services for urban children and families.

Elizabeth Talbott

Elizabeth Talbott is an Assistant Professor in the Department of Education at the University of Illinois at Chicago. Her research interests include reducing classroom behavior difficulties of children by developing intensive academic interventions.

Patrice Arvanitis

Patrice Arvanitis is a Research Specialist at the Institute for Juvenile Research. She is a graduate from Loyola University of Chicago. Her area of professional interest is child clinical intervention research and practice.