DSM-III-R and DSM-III criteria for conduct disorder in preadolescent girls: specific but insensitive.
OBJECTIVE
To determine whether DSM-III and DSM-III-R criteria for conduct disorder identify girls in the general population with early-onset, persistent, and pervasive antisocial behavior.


METHODS
2,251 girls, representative of all girls entering kindergarten in Qúebec, were assessed using parent and teacher ratings of antisocial behavior; a subsample was then rated for the next 6 years (ages 7 to 12) by parent and teacher. At age 10 years, the girls who been rated as antisocial in kindergarten, along with a random sample of those not rated as antisocial, were assessed for DSM-III and DSM-III-R diagnoses of conduct and oppositional defiant disorder using a structured psychiatric interview (Diagnostic Interview Schedule for Children) administered to the parent, teacher, and/or child (n = 381).


RESULTS
Of the girls with early-onset, persistent, and pervasive antisocial behavior, 3% met DSM-III-R criteria and 22% met DSM-III criteria for conduct disorder. Conduct disorder was not diagnosed at all in girls who had not been initially rated as antisocial in kindergarten. Lowering the threshold for a DSM-III-R conduct disorder diagnosis to two symptoms and adding the criterion of violation of rules increased the rate of diagnosis to 35% in the pervasively antisocial girls but only to 1% in girls who did not have persistent antisocial behavior.


CONCLUSIONS
DSM-III-R criteria for conduct disorder do not identify most preadolescent girls with early-onset, pervasive, and persistent antisocial behavior. Modifications to the DSM-III-R criteria resulted in increased sensitivity without a loss of specificity.
Zoccolillo
M
M
Department of Psychiatry of Montŕeal Children's Hospital, Qúebec, Canada.
Tremblay
R
R
Vitaro
F
F
D017668:Age of Onset; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008370:Manuals as Topic; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics; D011792:Quebec / Q000453:epidemiology; D012680:Sensitivity and Specificity