Toward Construct Validity in the Childhood Disruptive Behavior Disorders

Classification and Diagnosis in DSM-IV and Beyond
  • Irwin D. Waldman
  • Scott O. Lilienfeld
  • Benjamin B. Lahey
Chapter
Part of the Advances in Clinical Child Psychology book series (ACCP, volume 17)

Abstract

The number and coverage of child psychopathological disorders have expanded greatly since their rather cursory representation as adjustment reactions in the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) (American Psychiatric Association, 1952). The division of childhood disorders into the multitude of diagnoses that appear in the DSM-III-R (American Psychiatric Association, 1987) and the forthcoming DSM-IV (American Psychiatric Association, 1993) justifiably raises questions regarding the validity of these diagnostic distinctions. In the case of the disruptive (i.e., externalizing) disorders—which include the Attention Deficit Disorders (most notably, Attention-Deficit Hyperactivity Disorder, or ADHD), Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD)—research generally has supported the differentiation of these disorders from internalizing disorders, such as anxiety and depressive disorders (Achenbach & Edelbrock, 1978) and, to a lesser extent, the finer distinction among dimensions of inattention, hyperactivity, and impulsivity on the one hand and aggression, oppositional behaviors, and more serious conduct problems on the other (Hinshaw, 1987; Loney & Milich, 1982). It should be noted, however, that both sets of distinctions have been challenged, and that despite a flurry of research activity concerning these disorders, many questions remain regarding their validity.

Keywords

Construct Validity Oppositional Defiant Disorder ADHD Symptom Conduct Disorder Disruptive Behavior Disorder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Achenbach, T. M., & Edelbrock, C. (1978). The classification of child psychopathology: A review and analysis of empirical efforts. Psychological Bulletin, 85, 1275–1301.PubMedCrossRefGoogle Scholar
  2. Achenbach, T. M., McConaughy, S. H., & Howell, C. T. (1987). Child/adolescent behavioral and emotional problems: Implications of cross-informant correlations for situational specificity. Psychological Bulletin, 101, 213–232.PubMedCrossRefGoogle Scholar
  3. American Psychiatric Association. (1952). Diagnostic and statistical manual of mental disorders (1st Edition). Washington, DC: Author.Google Scholar
  4. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd Edition). Washington, DC: Author.Google Scholar
  5. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd Edition, Revised). Washington, DC: Author.Google Scholar
  6. American Psychiatric Association. (1993). DSM-IV draft criteria. Washington, DC: Author.Google Scholar
  7. Anastasi, A. (1990). Psychological testing. New York: Macmillan.Google Scholar
  8. Angold, A., Cox, A., Prendergast, M., Rutter, M., & Simonoff, E. (1989). The child and adolescent psychiatric assessment. MRC Child Psychiatry Unit, University of London and Developmental Epidemiology Program, Duke University.Google Scholar
  9. Applegate, B., Lahey, B. B., Hart, E. L., Waldman, I., Biederman, J., Hynd, G. W., Barkley, R. A., Ollendick, T., Frick, P. J., Greenhill, L., McBurnett, K., Newcorn, J., Kerdyk, L., & Garfinkel, B. (1994). Age of onset and pervasiveness criteria for DSM-IV attention deficit/hyperactivity disorder: Report of the DSM-IV field trials. Manuscript in preparation.Google Scholar
  10. Applegate, B., Waldman, I., Lahey, B. B., Frick, P. J., Ollendick, T., Garfinkel, B., Biederman, J., Hynd, G. W., Barkley, R. A., Greenhill, L., McBurnett, K., Newcorn, J., Kerdyk, L., & Hart, E. L. (1994). DSM-IV field trials for disruptive and attention deficit disorders: Factor analysis of potential symptoms. Manuscript in preparation.Google Scholar
  11. Baldessarini, R. J., Finkelstein, S., & Arana, G. W. (1983). The predictive power of diagnostic tests and the effect of prevalence of illness. Archives of General Psychiatry, 40, 569–573.PubMedCrossRefGoogle Scholar
  12. Bechtoldt, H. P. (1959). Construct validity: A critique. American Psychologist, 14, 619–629.CrossRefGoogle Scholar
  13. Blashfield, R. K., & Livesley, W. J. (1991). Metaphorical analysis of psychiatric classification as a psychological test. Journal of Abnormal Psychology, 100, 262–270.PubMedCrossRefGoogle Scholar
  14. Bollen, K., & Lennox, R. (1991). Conventional wisdom on measurement: A structural equation perspective. Psychological Bulletin, 110, 305–314.CrossRefGoogle Scholar
  15. Boring, E. G. (1923). Intelligence as the tests test it. The New Republic, June 6, 35–37.Google Scholar
  16. Bridgman, P. W. (1927). The logic of modern physics. New York: Macmillan.Google Scholar
  17. Campbell, D. T., & Fiske, D. W. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. Psychological Bulletin, 56, 81–105.PubMedCrossRefGoogle Scholar
  18. Carnap, R. (1936). Testability and meaning. Philosophy of Science, 3, 420–471.CrossRefGoogle Scholar
  19. Caron, C., & Rutter, M. (1991). Comorbidity in child psychiatry: Concepts, issues, and research strategies. Journal of Child Psychology and Psychiatry, 32, 1063–1080.PubMedCrossRefGoogle Scholar
  20. Clogg, C. C (1977). Unrestricted and restricted maximum likelihood latent structure analysis: A manual for users. Working paper 1977–09, Pennsylvania State University, Population Issues Research Center.Google Scholar
  21. Cloninger, C. R. (1989). Establishment of diagnostic validity in psychiatric illness: Robins and Guze’s method revisited. In L. N. Robins & J. E. Barrett (Eds.), The validity of psychiatric diagnosis (pp. 9–16). New York: Raven.Google Scholar
  22. Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37–46.CrossRefGoogle Scholar
  23. Cole, D. A., Howard, G. S., & Maxwell, S. E. (1981). Effects of mono- versus multiple-operationalization in construct validation efforts. Journal of Consulting and Clinical Psychology, 49, 395–405.CrossRefGoogle Scholar
  24. Cook, T. D., & Campbell, D. T. (1979). Quasi-experimentation: Design and analysis for field settings. Chicago, Rand McNally.Google Scholar
  25. Costello, A. J., Edelbrock, C S., Duncan, M. K., & Kalas, R. (1984). Testing of the NIMH Diagnostic Interview Schedule for Children (DISC) in a clinical population (Contract No. DB-81–0027). Final report to the Center for Epidemiological Studies, National Institute for Mental Health. Pittsburgh, PA: University of Pittsburgh.Google Scholar
  26. Cronbach, L. J., & Meehl, P. E. (1955). Construct validity in psychological tests. Psychological Bulletin, 52, 281–302.PubMedCrossRefGoogle Scholar
  27. Eaves, L. J., Silberg, J. L., Hewitt, J. K., Rutter, M., Meyer, J. M., Neale, M. C., & Pickles, A. (1993). Analyzing twin resemblance in multisymptom data: Genetic applications of a latent class model for symptoms of conduct disorder in juvenile boys. Behavior Genetics, 23, 5–19.PubMedCrossRefGoogle Scholar
  28. Elder, R. W. (1993). Group differences among situationally and pervasively hyperactive children reexamined: The influence of reliability. Unpublished manuscript.Google Scholar
  29. Faust, D., & Miner, R. A. (1986). The empiricist and his new clothes: DSM-III in perspective. American Journal of Psychiatry, 143, 962–967.PubMedGoogle Scholar
  30. Feinstein, A. R. (1970). The pretherapeutic classification of comorbidity in chronic disease. Journal of Chronic Disease, 23, 455–468.CrossRefGoogle Scholar
  31. Fergusson, D. M., & Horwood, L. J. (1989). Estimation of method and trait variance in ratings of conduct disorder. Journal of Child Psychology and Psychiatry, 30, 365–378.PubMedCrossRefGoogle Scholar
  32. Fergusson, D. M., Horwood, L. J., & Lloyd, M. (1991). Confirmatory factor models of attention deficit and conduct disorder. Journal of Child Psychology and Psychiatry, 32, 257–274.PubMedCrossRefGoogle Scholar
  33. Frances, A. J., Widiger, T. A., & Fyer, M. R. (1990). The influence of classification methods on comorbidity. In J. D. Maser & C. R. Cloninger (Eds.), Comorbidity of mood and anxiety disorders (pp. 41–59). Washington, DC: American Psychiatric Press.Google Scholar
  34. Frances, A. J., Widiger, T. A., & Pincus, H. A. (1989). The development of DSM-IV. Archives of General Psychiatry, 46, 373–375.PubMedCrossRefGoogle Scholar
  35. Frick, P. J., Lahey, B. B., Applegate, B., Kerdyk, L., Ollendick, T., Hynd, G. W., Garfinkel, B., Greenhill, L., Biederman, J., Barkley, R. A., McBurnett, K., Newcorn, J., & Waldman, I. (in press). DSM-IV field trials for the disruptive behavior disorders: Symptom utility estimates. Journal of the American Academy of Child and Adolescent Psychiatry. Google Scholar
  36. Garber, J., & Strassberg, Z. (1991). Construct validity: History and application to developmental psychopathology. In D. Cicchetti & W. G. Grove (Eds.), Thinking clearly about psychology: Essays in honor of Paul Everett Meehl (pp. 219–358). Minneapolis: University of Minnesota Press.Google Scholar
  37. Gibbons, R. D., & Young, M. A. (1989). Comparison of discrete and continuous latent structures. Unpublished manuscript.Google Scholar
  38. Goldstein, G., & Hersen, M. (1984). Historical perspectives. In G. Goldstein & M. Hersen (Eds.), Handbook of psychological assessment (pp. 3–13). New York: Pergamon Press.Google Scholar
  39. Goodman, L. A. (1974). The analysis of systems of qualitative variables when some of the variables are unobservable. American Journal Sociology, 79, 1179–1259.CrossRefGoogle Scholar
  40. Gorenstein, E. E. (1992). The science of mental illness. San Diego, CA: Academic Press.Google Scholar
  41. Grove, W. M., & Andreasen, N. (1986). Multivariate statistical analysis in psychopathology. In T. Millon & G. L. Klerman (Eds.), Contemporary directions in psychopathology (pp. 347–362). New York: Guilford.Google Scholar
  42. Grove, W. M., & Andreasen, N. (1987). Quantitative and qualitative distinctions between psychiatric disorders. In L. N. Robins & J. E. Barrett (Eds.), The validity of psychiatric diagnosis (pp. 127–139). New York: Raven.Google Scholar
  43. Grove, W. M., & Tellegen, A. (1991). Problems in the classification of personality disorders. Journal of Personality Disorders, 5, 31–41.CrossRefGoogle Scholar
  44. Hambleton, R. K., Swaminathan, H., & Rogers, H. J. (1991). Fundamentals of item response theory. Newbury Park, CA: Sage.Google Scholar
  45. Hinshaw, S. P. (1987). On the distinction between attention deficits/hyperactivity and conduct problems/aggression in child psychopathology. Psychological Bulletin, 101, 443–463.PubMedCrossRefGoogle Scholar
  46. Jensen, A. R. (1980). Bias in mental testing. New York: Free Press.Google Scholar
  47. Joreskog, K. G., & Sorbom, D. (1989). LISREL VII: User’s guide. Mooresville, IN: Scientific Software, Inc.Google Scholar
  48. Kaplan, M. H., & Feinstein, A. R. (1974). The imporance of classifying initial comorbidity in evaluating the outcome of diabetes mellitus. Journal of Chronic Disease, 27, 387–404.CrossRefGoogle Scholar
  49. Kazdin, A. E. (1983). Psychiatric diagnosis, dimensions of dysfunction, and child behavior therapy. Behavior Therapy, 14, 73–99.CrossRefGoogle Scholar
  50. Kirk, S. A., & Kutchins, H. (1992). The selling of DSM: The rhetoric of science in psychiatry. New York: Aldine deGruyter.Google Scholar
  51. Lahey, B. B., Applegate, B., Barkley, R. A., Garfinkel, B., McBurnett, K., Kerdyk, L., Greenhill, L., Hynd, G. W., Frick, P. J., Newcorn, J., Biederman, J., Ollendick, T., Hart, E. L., Perez, D., Waldman, I., & Shaffer, D. (1994). DSM-IV field trials for oppositional defiant disorder and conduct disorder in children and adolescents. American Journal of Psychiatry, 151, 1163–1171.PubMedGoogle Scholar
  52. Lahey, B. B., Applegate, B., McBurnett, K., Biederman, J., Greenhill, L., Hynd, G. W., Barkley, R. A., Newcorn, J., Jensen, P., Richters, J., Garfinkel, B., Kerdyk, L., Frick, P. J., Ollendick, T., Perez, D., Hart, E. L., Waldman, I., & Shaffer, D. (in press). DSM-IV field trials for attention-deficit/hyperactivity disorder in children and adolescents. American Journal of Psychiatry. Google Scholar
  53. Lahey, B. B., & Carlson, C. L. (1991). Evidence for a distinction between attention deficit disorder with and without hyperactivity. Journal of Learning Disabilities, 24, 110–120.PubMedCrossRefGoogle Scholar
  54. Lahey, B. B., Loeber, R., Quay, H. C., Frick, P. J., & Grimm, J. (1992). Oppositional defiant and conduct disorder: Issues to be resolved by DSM-IV. Journal of the American Academy of Child and Adolescent Psychiatry.Google Scholar
  55. Lilienfeld, S. O., & Marino, L. A. (1993). A critique of Wakefield’s “harmful dysfunction” analysis of disorder. Manuscript submitted for publication.Google Scholar
  56. Lilienfeld, S. O., & Waldman, I. D. (1990). The relation between childhood attention-deficit hyperactivity disorder and adult antisocial behavior reexamined: The problem of heterogeneity. Clinical Psychology Review, 10, 699–725.CrossRefGoogle Scholar
  57. Lilienfeld, S. O., Waldman, I. D., & Israel, A. O. (1994). A critical note on the use of the term and concept of “comorbidity” in psychopathology research. Clinical Psychology: Science and Practice, 1, 71–83.CrossRefGoogle Scholar
  58. Loeber, R. (1990). Development and risk factors of juvenile antisocial behavior and delinquency. Clinical Psychology Review, 10, 1–41.CrossRefGoogle Scholar
  59. Loeber, R., Green, S. M., Lahey, B. B., & Stouthamer-Loeber, M. (1990). Optimal informants on childhood disruptive disorders. Development and Psychopathology, 1, 317–337.CrossRefGoogle Scholar
  60. Loeber, R., Keenan, K., Lahey, B. B., Green, S. M., & Thomas, C. (1993). Evidence for devel-opmentally based diagnoses of oppositional defiant disorder and conduct disorder. Journal of Abnormal Child Psychology, 21, 377–410.PubMedCrossRefGoogle Scholar
  61. Loevinger, J. (1957). Objective tests as instruments of psychological theory. Psychological Reports, 3, 635–694.Google Scholar
  62. Loney, J., & Milich, R. (1982). Hyperactivity, inattention, and aggression in clinical practice. In M. Wolraich & D. Routh (Eds.), Advances in behavioral pediatrics (Vol. 2), (pp. 113–147). Greenwich, CT: JAI Press.Google Scholar
  63. Lykken, D. T. (1968). Statistical significance in psychological research. Psychological Bulletin, 70, 151–159.PubMedCrossRefGoogle Scholar
  64. MacCorquodale, K., & Meehl, P. E. (1948). On a distinction between hypothetical constructs and intervening variables. Psychological Review, 55, 95–107.PubMedCrossRefGoogle Scholar
  65. Meehl, P. E. (1977). Specific etiology and other forms of strong influence: Some quantitative meanings. Journal of Medicine and Philosophy, 2, 33–53.CrossRefGoogle Scholar
  66. Meehl, P. E. (1978). Theoretical risks and tabular asterisks: Sir Karl, Sir Ronald, and the slow progress of soft psychology. Journal of Consulting and Clinical Psychology, 46, 806–834.CrossRefGoogle Scholar
  67. Meehl, P. E. (1986). Diagnostic taxa as open concepts: Metatheoretical and statistical questions about reliability and construct validity in the grand strategy of nosological revision. In T. Millon & G. L. Klerman (Eds.), Contemporary directions in psychopathology (pp. 215–231). New York: Guilford.Google Scholar
  68. Meehl, P. E. (1990). Appraising and amending theories: The strategy of Lakatosian defense and two principles that warrant it. Psychological Inquiry, 1, 108–141.CrossRefGoogle Scholar
  69. Meehl, P. E., & Golden, R. R. (1982). Taxometric methods. In P. C. Kendall & J. N. Butcher (Eds.), Handbook of research methods in clinical psychology (pp. 127–181). New York: Wiley.Google Scholar
  70. Messick, S. (1988). Validity. In R. L. Linn (Ed.), Educational measurement (3rd ed., pp. 13–103). New York: Macmillan.Google Scholar
  71. Mezzich, J. E. (1979). Patterns and issues in the multiaxial psychiatric diagnosis. Psychological Medicine, 9, 125–137.PubMedCrossRefGoogle Scholar
  72. Milich, R., Widiger, T. A., & Landau, S. (1987). Differential diagnosis of attention deficit and conduct disorders using conditional probabilities. Journal of Consulting and Clinical Psychology, 55, 762–767.PubMedCrossRefGoogle Scholar
  73. Morey, L. C. (1991). Classification of mental disorder as a collection of hypothetical constructs. Journal of Abnormal Psychology, 100, 289–293.PubMedCrossRefGoogle Scholar
  74. Pelham, W. E., & Bender, M. E. (1982). Peer interactions of hyperactive children: Assessment and treatment. In K. D. Gadow & I. Bialer (Eds.), Advances in learning and behavior difficulties (pp. 365–436). Greenwich, CT: JAI Press.Google Scholar
  75. Popper, K. R. (1959). The logic of scientific discovery. New York: Basic Books.Google Scholar
  76. Reich, T., James, J. W., & Morris, C. A. (1972). The use of multiple thresholds in determining the mode of transmission of semi-continuous traits. Annals of Human Genetics, 36, 163–184.PubMedCrossRefGoogle Scholar
  77. Reich, W., Herjanic, B., Welner, Z., & Gandhy, P. R. (1982). Development of a structured interview for children: Agreement on diagnosis comparing parent and child. Journal of Abnormal Child Psychology, 10, 325–336.PubMedCrossRefGoogle Scholar
  78. Richards, R. J. (1981). Natural selection and other models in the historiography of science. In M. B. Brewer & B. E. Collins (Eds.), Scientific inquiry and the social sciences (pp. 37–76). San Francisco, CA: Jossey-Bass.Google Scholar
  79. Robins, E., & Guze, S. B. (1970). Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. American Journal of Psychiatry, 126, 983–987.PubMedGoogle Scholar
  80. Shaffer, D., Gould, M. S., Brasic, J., Ambrosini, P., Fisher, P., Bird, H., & Aluwhalla, S. (1983). A Children’s Global Assessment Scale (CGAS). Archives of General Psychiatry, 40, 1228–1231.PubMedCrossRefGoogle Scholar
  81. Shaffer, D., Fisher, P., Piacentini, J., Schwab-Stone, M., & Wicks, J. (1992). Diagnostic Interview for Children, Version 2.3. New York: Columbia University.Google Scholar
  82. Skinner, H. A. (1979). Dimensions and clusters: A hybrid approach to classification. Applied Psychological Measurement, 3, 327–341.CrossRefGoogle Scholar
  83. Skinner, H. A. (1981). Toward the integration of classification theory and methods. Journal of Abnormal Psychology, 90, 68–87.PubMedCrossRefGoogle Scholar
  84. Skinner, H. A. (1986). Construct validation approach to psychiatric classification. In T. Millon & G. L. Klerman (Eds.), Contemporary directions in psychopathology (pp. 307–330). New York: Guilford.Google Scholar
  85. Sternberg, R. J. (1992). Psychological Bulletins Top 10 “Hit Parade.” Psychological Bulletin, 112, 387–388.CrossRefGoogle Scholar
  86. Titterington, D. M., Smith, A. F. M., & Makov, U. E. (1985). Statistical analysis of finite mixture distributions. New York: Wiley.Google Scholar
  87. Uebersax, J. S., & Grove, W. M. (1990). Latent class analysis of diagnostic agreement. Statistics in Medicine, 9, 559–572.PubMedCrossRefGoogle Scholar
  88. Vaillant, G. (1984). The disadvantages of DSM-III outweigh its advantages. American Journal of Psychiatry, 141, 542–545.Google Scholar
  89. Wakefield, J. C. (1992). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 47, 373–388.PubMedCrossRefGoogle Scholar
  90. Wakefield, J. C. (1992). Disorder as harmful dysfunction: A conceptual critique of DSM-III-R’s definition of mental disorder. Psychological Review, 99, 232–247.PubMedCrossRefGoogle Scholar
  91. Waldman, I. D., & Lahey, B. B. (1994). Design of the DSM-IV Disruptive Behavior Disorder Field Trials. Child and Adolescent Psychiatric Clinics of North America, 3, 1–14.Google Scholar
  92. Waldman, I. D., Lahey, B. B., Applegate, B., Biederman, J., Hynd, G. W., Barkley, R. A., Ollendick, T., Frick, P. J., Kerdyk, L., Garfinkel, B., Greenhill, L., McBurnett, K., Newcorn, J., & Hart, E. L. (1994). The construct validity of DSM-IV attention-deficit/hyperactivity disorder subtypes: Report from the DSM-IV field trials. Manuscript in preparation.Google Scholar
  93. Waldman, I. D., & Lilienfeld, S. O. (1991). Diagnostic efficiency of symptoms for Oppositional Defiant Disorder and Attention-Deficit Hyperactivity Disorder. Journal of Consulting and Clinical Psychology, 59, 732–738.PubMedCrossRefGoogle Scholar
  94. World Health Organization. (1990). International classification of diseases and related health problems (10th ed.). Geneva: Author.Google Scholar
  95. Young, M. A. (1982/1983). Evaluating diagnostic criteria: A latent class approach. Journal of Psychiatric Research, 17, 285–296.PubMedCrossRefGoogle Scholar
  96. Young, M. A., & Tanner, M. A. (1983). Recent advances in the analysis of qualitative data with application to diagnostic classification. In R. D. Gibbons & M. W. Dysken (Eds.), Statistical and methodological advances in psychiatric research (pp. 149–180). New York: Spectrum.Google Scholar

Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • Irwin D. Waldman
    • 1
  • Scott O. Lilienfeld
    • 2
  • Benjamin B. Lahey
    • 3
  1. 1.Department of PsychologyEmory UniversityAtlantaUSA
  2. 2.Department of PsychologyState University of New York at AlbanyAlbanyUSA
  3. 3.Department of PsychiatryUniversity of Chicago Medical SchoolChicagoUSA

Personalised recommendations