Evidence for developmentally based diagnoses of oppositional defiant disorder and conduct disorder

This paper compares the validity of DSM-III-R diagnoses of oppositional defiant disorder (ODD) and conduct disorder (CD) and an alternative option which is subdivided into three levels according to developmental sequence and severity: modified oppositional disorder (MODD), intermediate CD (ICD), and advanced CD (ACD). Using a sample of 177 boys followed over 3 years, both the DSM-III-R and the alternative diagnostic constructs are evaluated on three criteria: symptom discriminative validity, and diagnostic external and predictive validity. Most DSM-III-R ODD and CD symptoms discriminated between ODD and CD, but exceptions are noted. Additional analyses demonstrated considerable overlap among DSM-III-R oppositional symptoms. The majority of the symptoms proposed for the alternative option could be assigned to a specific level based on acceptable symptom discrimination. External validity lent support to the distinctions between DSM-III-R ODD and CD, and between MODD, ICD, and ACD. MODD was a better predictor than ODD of which boys received a later diagnosis of CD. Suggestions are made for the inclusion and exclusion of symptoms for developmentally based diagnoses of oppositional and conduct disorders.This research was supported by a grant from the John D. and Catherine R. MacArthur Foundation to the American Psychiatric Association, and grant 1-RO1-MH42529-04 from the National Institute of Mental Health. The authors are indebted to Paul Frick for his advice with some of the statistical analyses, and particularly to Ms. Judith Navratil for her expert help in data collection.     

Differences and similarities between children,mothers, and teachers as informants on disruptive child behavior

Prevalence rates of disruptive child behaviors, based on structured psychiatric interviews, are presented for samples of clinic-referred prepubertal boys at two sites to investigate differences and similarities among reports of the behaviors from children, parents, and teachers. Children reported significantly less hyperactive/inattentive and oppositional behaviors than either parents or teachers. In contrast, children did not differ from parents or teachers in their report on the prevalence of more serious conduct problems. These results were well replicated across two sites, despite the fact that there were significant differences between the sites in the level of hyperactive/inattentive child behaviors and conduct problems. The ranking of parents' and teachers' reported prevalence of specific child behavior problems in each of the three domains of disruptive behavior was strikingly similar. With one exception, the concordance between the prevalence ranking based on the children's reports was lower than that based on adults' reports, Children's reports on their own behavior did not predict various child handicaps 1 year later as well as did adults' reports. The results are discussed in relation to the usefulness of certain child behaviors in symptom lists for diagnostic purposes; the reliability of children's reports on their own behavior; and the possible reasons why prevalence rankings, as perceived by adults, are so similar.     

Sexual and Physical Abuse Among Adolescent Girls with Disruptive Behavior Problems

We examined the prevalence and age of onset of physical and sexual abuse in a clinic-referred sample of adolescent girls, as well as differences in diagnoses and symptoms among abused and non-abused girls. Forty-nine girls (aged 13–17 years) with disruptive behavior were interviewed along with their primary caretaker. Data were gathered through both a structured interview with the girl and her parent, as well as self and parent-report questionnaires. Findings indicated that the prevalence of Conduct Disorder (CD) and Major Depression were higher for abused girls. Somatoform Pain Disorder was significantly less likely for physically abused girls, compared to girls who were both physically and sexually abused. Of CD symptoms, truancy was twice as high for the physically and sexually abused group, compared to the prevalence for non-abused girls. Internalizing symptoms were also highest for the dual abuse group. Onset graphs show that the onset of sexual abuse usually occurred at an earlier age than the onset of physical abuse. Abused girls showed an earlier age of onset of CD symptoms. Results indicated that the experience of combined types of abuse is associated with a poorer psychiatric prognosis.     

Boys' Experimentation and Persistence in Developmental Pathways Toward Serious Delinquency

We expand on earlier work documenting developmental pathways in disruptive child behavior towards serious forms of delinquency in boys. Three pathways we hypothesized in our previous work: (a) An Authority Conflict Pathway prior to the age of 12, that starts with stubborn behavior, and has defiance as a second stage, and authority avoidance as a third stage; (b) A Covert Pathway that starts with minor convert acts, has property damage as a second stage, and moderate to serious delinquency as a third stage; and (c) An Overt Pathway that starts with minor aggression, has physical fighting as a second stage, and violence as a third stage. We now refine this work by distinguishing between boys who experiment and those who persist in disruptive behavior. Data are presented showing that the fit for the three pathways is better for persisters than for experimenters. Also, the proportion of persisters that enter each pathway at the first stage (rather than at later stages) is higher than that for experimenters. Penetration in each pathway was more common among boys who received a diagnosis of Attention-Deficit Hyperactive Disorder. Boys' rate of offending increased with penetration into pathways and with persistence on more than one pathway. Boys' persistence and advancement in the Overt or the Covert Pathway was almost invariably accompanied by their advancement in the Authority Conflict Pathway. The classification of boys according to persistence and pathways accounted for the majority of high rate offenders, according to both self-report and court adjudicated offenses.     

Formal and informal classroom settings: Effects on hyperactivity

The behavior of hyperactive children was compared to controls in two different classroom settings. One setting (Informal) involved choice and variety of tasks; the other setting (Formal) involved teacher specification of a small number of tasks. As assessed by a composite observational measure of hyperactivity, there were significant differences between the hyperactive and control groups in the Formal but not in the Informal setting. Analyses of five individual categories of hyperactive behavior showed that, with one exception, the hyperactive group tended to display higher frequencies of behavior than did controls in both settings. For two of the categories, the difference between the groups was significantly larger in the Formal than in the Informal setting. Finally, a modified observational code was suggested that differentiated hyperactives from controls equally in the two settings.     

Organizational citizenship behavior and organizational commitment in Nepal

The present study examines the structure of organizational citizenship behavior (OCB) and its relation to organizational commitment in Nepal. Four-hundred and fifty employees of five Nepalese organizations filled out standardized questionnaires. Exploratory and confirmatory factor analyses revealed two factors of OCB, altruism and compliance, replicating Western models of extra-role behavior. Structural equation analysis showed a positive relation between affective and normative commitment on the one hand and both citizenship factors on the other. Continuance commitment was negatively related to compliance and unrelated to altruism. The findings thus confirmed the structure and usefulness of the concepts in an under-researched geographical area. Findings of the research are discussed within the Nepalese sociocultural context.     

The true‐change model with individual method effects: Reliability issues

The true intra‐individual change model is generalized by defining individual method effects. This allows the analysis of non‐congeneric test–retest variables assumed to measure a common, possibly (temporally) transient, attribute. Temporal change in the attribute between different times of measurement is modelled by the true‐change variable. Individual causal method effects, due to heterogeneity of the measurement methods, account for the imperfect correlation of the true‐score variables at each time of measurement. The reliability of the composite scores, at each time of measurement, and the reliability of the difference composite score may be estimated with appropriate coefficients derived from the model. Measurements of daily life tension in adult females serve to illustrate how the model can be used empirically.     

Constant versus variable response signal delays in speed--accuracy trade-offs: effects of advance preparation for processing time

In two experiments, we used response signals (RSs) to control processing time and trace out speed--accuracy trade-off(SAT) functions in a difficult perceptual discrimination task. Each experiment compared performance in blocks of trials with constant and, hence, temporally predictable RS lags against performance in blocks with variable, unpredictable RS lags. In both experiments, essentially equivalent SAT functions were observed with constant and variable RS lags. We conclude that there is little effect of advance preparation for a given processing time, suggesting that the discrimination mechanisms underlying SAT functions are driven solely by bottom-up information processing in perceptual discrimination tasks.     

Patient experiences with treatment in private practice compared with public mental health services

The study compared patient experiences with psychiatric treatment provided by private practitioners and public outpatient clinics. Questionnaires were completed by 642 outpatients in private practice and 6,677 outpatients in public clinics. The questionnaire included a measure of patient experiences comprising six items: treatment outcome, enough time for contact and dialogue with clinician, clinicians' understanding of patient's situation, suitability of therapy and treatment, clinician follow-up of planned actions, and influence on treatment. Patients in private practice had generally better experiences than patients in public outpatient treatment. The difference between private and public patients was largest for patients with poor self-evaluated mental health or those who had just one consultation in the previous three months. Private practitioners appear to have an important role in mental health services delivery, and patients have relatively good experiences with services. Further studies that assess the patient - clinician interaction in different mental health services may give further insights into potential service improvements.     

Trajectories of Delinquency and Parenting Styles

We investigated trajectories of adolescent delinquent development using data from the Pittsburgh Youth Study and examined the extent to which these different trajectories are differentially predicted by childhood parenting styles. Based on self-reported and official delinquency seriousness, covering ages 10-19, we identified five distinct delinquency trajectories differing in both level and change in seriousness over time: a nondelinquent, minor persisting, moderate desisting, serious persisting, and serious desisting trajectory. More serious delinquents tended to more frequently engage in delinquency, and to report a higher proportion of theft. Proportionally, serious persistent delinquents were the most violent of all trajectory groups. Using cluster analysis we identified three parenting styles: authoritative, authoritarian (moderately supportive), and neglectful (punishing). Controlling for demographic characteristics and childhood delinquency, neglectful parenting was more frequent in moderate desisters, serious persisters, and serious desisters, suggesting that parenting styles differentiate non- or minor delinquents from more serious delinquents.