DSM-IV field trials for the disruptive behavior disorders: symptom utility estimates.
OBJECTIVE
We tested the predictive utility of symptoms for proposed DSM-IV definitions of the disruptive behavior disorders using indices corrected for symptom and diagnosis base rates.


METHODS
The field trials sample consisted of 440 clinic-referred youths who were consecutive referrals to a heterogeneous group of mental health clinics. Multiple informants were interviewed to determine the presence of symptoms and diagnoses.


RESULTS
Some symptoms which were either not in DSM-III or DSM-III-R, or were modifications of DSM-III-R symptoms, had greater diagnostic efficiency than did several existing symptoms. Symptom utility estimates were generally similar for different ages and genders, although some interesting age and sex trends emerged for a few symptoms.


CONCLUSIONS
The results supported the inclusion of more restricted definitions of "lying" and "truancy" to increase their association with a conduct disorder diagnosis and they supported the elimination of "swearing" in the oppositional defiant disorder criteria. In addition to their relevance for developing optimal criteria for DSM-IV, these results can aid DSM-IV users by providing a useful guide to the relative efficiency of individual symptoms based on data from a large heterogeneous clinic population.
Frick
P J
PJ
Department of Psychology, University of Alabama, Tuscaloosa 35487.
Lahey
B B
BB
Applegate
B
B
Kerdyck
L
L
Ollendick
T
T
Hynd
G W
GW
Garfinkel
B
B
Greenhill
L
L
Biederman
J
J
Barkley
R A
RA
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000145:classification / Q000175:diagnosis / Q000523:psychology; D007604:Juvenile Delinquency / Q000145:classification / Q000523:psychology*; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics; D015203:Reproducibility of Results