DSM-IV DIAGNOSIS OF CONDUCT DISORDER AND OPPOSITIONAL DEFIANT DISORDER - IMPLICATIONS AND GUIDELINES FOR SCHOOL MENTAL-HEALTH TEAMS

The DSM-IV criteria for conduct disorder (CD) and oppositional defiant disorder (ODD) are reviewed. These diagnoses are compared with their counterparts in DSM-III-R, and the rationale and empirical support for changes in criteria are described. Generally, DSM-IV criteria appear better operationalized and more closely conform to empirical studies t han do prior criteria. However, results from DSM-IV field trials indic ate that interrater and test-retest reliability were only marginally i mproved compared to prior criteria and remained moderately low by psyc hometric standards. Studies confirming the importance of subtyping CD on age of onset are reviewed, and empirical evidence for the relations hip between ODD and early-onset CD is described. These criteria highli ght the importance of alerting clinicians to early intervention, espec ially for symptoms of ODD that are typically easier to modify than one s of CD. Although overlooked in DSM-IV criteria, community factors, ge nder differences, and academic functioning are important consideration s in school-based assessments and interventions.