Longitudinal
Stability of Preschool Oppositional Defiant Problems
To
test stability and change in preschoolers' oppositional defiant
problems, John Lavigne and his co-workers (2001) had parents
complete CBCLs for 510 preschoolers in 68 Chicago-area pediatric
practices. The children were subsequently reassessed with the
CBCL and other instruments in four waves, culminating when the
children averaged 8 years old. Diagnoses of Oppositional Defiant
Disorder (ODD) and other disorders were made on the basis of
consensus between clinicians who reviewed the data available
for each child at each assessment. Initial ODD diagnoses were
significantly associated with diagnoses of a variety of other
disorders at the subsequent waves. In addition to the presence
versus absence of diagnoses, Lavigne et al. analyzed "threshold,"
"subthreshold," and low CBCL Externalizing scores
at each wave. Threshold scores were defined as >90th percentile
for the sample; subthreshold scores were defined as ranging
from above the median through the 90th percentile; and the remaining
scores were defined as low. The research team found that most
children who were initially classified in the threshold category
(>90th percentile for CBCL Externalizing scores) remained
in the threshold category at subsequent assessments. Furthermore,
of the children whose scores dropped from the threshold to the
subthreshold category, 21% subsequently returned to the threshold
category. Levigne et al. concluded (pp. 1397-98) that "wave
1 externalizing scores were strongly predictive of later externalizing
scores" and that "intraclass correlations indicated
a high degree of stability for the 'threshold' category of children
with high CBCL scores (r = .81, p <.0001), while it was less
predictive for the 'subthreshold' category (r = .38, p <.0001)."
In addition, "Markov chain analyses indicated that the
prior CBCL category was strongly predictive of the status of
the individual in the subsequent wave across the five waves
of data (X2 = 433.99, p <.0001)."
Reference:
Lavigne, J.V., Cicchetti, C., Gibbons, R.D., Binns, H.J., Larsen,
L., & DeVito, C. (2001). Oppositional defiant disorder with
onset in preschool years: Longitudinal stability and pathways
to other disorders. Journal of the American Academy of Child
and Adolescent Psychiatry, 40, 1393-1400.
