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 con duct disorder identify girls in the general population with early-onse t, persistent, and pervasive antisocial behavior. Method: 2,251 girls, representative of all girls entering kindergarten in Quebec, were ass essed using parent and teacher ratings of antisocial behavior; a subsa mple 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 ki ndergarten, along with a random sample of those not rated as antisocia l, were assessed for DSM-III and DSM-III-R diagnoses of conduct and op positional 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-on set, persistent, and pervasive antisocial behavior, 3% met DSM-III-R c riteria and 22% met DSM-III criteria for conduct disorder. Conduct dis order was not diagnosed at all in girls who had not been initially rat ed 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 p ervasively antisocial girls but only to 1% in girls who did not have p ersistent antisocial behavior. Conclusions: DSM-III-R criteria for con duct disorder do not identify most preadolescent girls with early-onse t, pervasive, and persistent antisocial behavior. Modifications to the DSM-III-R criteria resulted in increased sensitivity without a loss o f specificity.