Conduct problems are of great concern to mental health
workers, educators, parents, and society as a whole. Major investments
have been made in efforts to understand, prevent, and treat conduct
problems. The DSM-IV lists 15 criterial symptoms for Conduct Disorder
(CD). Any 3 of the 15 symptoms can qualify a youth for the diagnosis.
Consequently, some youths may be diagnosed as having CD on the basis
of 3 kinds of overtly aggressive behavior (e.g., forced sex; use of
a dangerous weapon; physical cruelty to animals or people). Others may
be diagnosed on the basis of 3 kinds of nonaggressive behaviors (e.g.,
lying, stealing, staying out late, running away from home, truancy).
Still others may be diagnosed on the basis of a mixture of both kinds
of behaviors. Multivariate analyses of the CBCL, TRF, YSR, and other
rating forms have yielded separate, though correlated, syndromes of
aggressive versus nonaggressive conduct problems. To determine whether
the DSM-IV CD symptoms form such patterns, a team of American and Australian
researchers factor analyzed DSM-IV CD symptoms reported by parents of
a national sample of 1,669 Australian boys aged 6 to 17 (Tackett, Krueger,
Sawyer, & Graetz, 2003). The parents' reports were obtained by home
interviewers who administered the Diagnostic Interview Schedule for
Children Version IV (DISC-IV). After being interviewed with the DISC-IV,
the parents completed the CBCL. (Girls were not included in the analyses
because parents reported 11 of the 15 DSM-IV CD symptoms for <1%
of girls.) Factor analysis of the CD symptoms yielded one factor with
highest loadings for overtly aggressive symptoms and a second factor
with highest loadings for nonaggressive symptoms. These two factors
thus reflected groupings of symptoms like the syndromes of conduct problems
found in multivariate analyses of rating forms. To test associations
between the two groups of DSM-IV symptoms and empirically based syndromes,
the researchers performed separate multiple regressions of each group
of DSM-IV symptoms on the boys' scores for the CBCL Aggressive Behavior
and Delinquent (now called Rule-Breaking) Behavior syndromes. The results
revealed that the overtly aggressive CD symptoms were predicted primarily
by the CBCL Aggressive Behavior syndrome. Conversely, the nonaggressive
CD symptoms were predicted primarily by the CBCL Delinquent Behavior
syndrome. The researchers concluded that "the distinction between
aggressive and delinquent antisocial behavior in this age group, as
captured by the CBCL, appears to provide a more accurate account of
childhood antisocial behaviors than the unitary conduct disorder defined
in the DSM-IV" (p. 652).
Reference:
Tackett, J.L., Krueger, R.F., Sawyer, M.G., & Graetz, B.W. (2003).
Subfactors of DSM-IV Conduct Disorder: Evidence and connections with
syndromes from the Child Behavior Checklist. Journal of Abnormal
Child Psychology, 31, 647-654.