Diagnostic specificity and nonspecificity in the dimensions of preschool psychopathology.
BACKGROUND
The appropriateness of the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) nosology for classifying preschool mental health disturbances continues to be debated. To inform this debate, we investigate whether preschool psychopathology shows differentiation along diagnostically specific lines when DSM-IV symptoms are aggregated statistically.


METHODS
One thousand seventy-three parents of preschoolers aged 2-5 years attending a large pediatric clinic completed the Child Behavior Checklist 1.5-5. A stratified probability sample of 193 parents of high scorers and 114 parents of low scorers were interviewed with the Preschool Age Psychiatric Assessment (PAPA). Confirmatory factor analysis was performed on symptoms from seven DSM disorders.


RESULTS
Comparison of competing models supported the differentiation of emotional syndromes into three factors: social phobia (SOC), separation anxiety (SAD), and depression/generalized anxiety (MDD/GAD), and the differentiation of disruptive syndromes into three factors: oppositional defiant/conduct syndrome (ODD/CD), hyperactivity/impulsivity, and inattention. Latent syndrome correlations were moderately high after accounting for symptom overlap and measurement error.


CONCLUSIONS
Psychopathology appears to be differentiated among preschoolers much as it is among older children, and adolescents. We conclude that it is as reasonable to apply the DSM-IV nosology to preschoolers as it is to apply it to older individuals.
Sterba
Sonya
S
Thurstone Psychometric Laboratory, Department of Psychology, University of North Carolina at Chapel Hill, NC 27599-3270, USA. ssterba@email.unc.edu
Egger
Helen L
HL
Angold
Adrian
A
D000342:Affective Symptoms / Q000175:diagnosis* / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D001010:Anxiety, Separation / Q000175:diagnosis / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000523:psychology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000523:psychology; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000523:psychology; D002675:Child, Preschool; D015897:Comorbidity; D019955:Conduct Disorder / Q000175:diagnosis / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D010552:Personality Assessment; D010698:Phobic Disorders / Q000175:diagnosis / Q000523:psychology; D011594:Psychometrics; D015203:Reproducibility of Results; D012959:Socioeconomic Factors