Abstract
Strong associations between conduct disorder (CD), antisocial personality disorder (ASPD) and substance use disorders (SUD)
seem to reflect a general vulnerability to externalizing behaviors. Recent studies have characterized this vulnerability on
a continuous scale, rather than as distinct categories, suggesting that the revision of the Diagnostic and Statistical Manual
of Mental Disorders (DSM-5) take into account the underlying continuum of externalizing behaviors. However, most of this research
has not included measures of disorders that appear in childhood [e.g., attention-deficit/hyperactivity disorder (ADHD) or
oppositional defiant disorder (ODD)], nor has it considered the full range of possibilities for the latent structure of externalizing
behaviors, particularly factor mixture models, which allow for a latent factor to have both continuous and categorical dimensions.
Finally, the majority of prior studies have not tested multidimensional models. Using lifetime diagnoses of externalizing
disorders from participants in the Fast Track Project (n = 715), we analyzed a series of latent variable models ranging from fully continuous factor models to fully categorical mixture
models. Continuous models provided the best fit to the observed data and also suggested that a two-factor model of externalizing
behavior, defined as (1) ODD+ADHD+CD and (2) SUD with adult antisocial behavior sharing common variance with both factors,
was necessary to explain the covariation in externalizing disorders. The two-factor model of externalizing behavior was then
replicated using a nationally representative sample drawn from the National Comorbidity Survey-Replication data (n = 5,692). These results have important implications for the conceptualization of externalizing disorders in DSM-5.
seem to reflect a general vulnerability to externalizing behaviors. Recent studies have characterized this vulnerability on
a continuous scale, rather than as distinct categories, suggesting that the revision of the Diagnostic and Statistical Manual
of Mental Disorders (DSM-5) take into account the underlying continuum of externalizing behaviors. However, most of this research
has not included measures of disorders that appear in childhood [e.g., attention-deficit/hyperactivity disorder (ADHD) or
oppositional defiant disorder (ODD)], nor has it considered the full range of possibilities for the latent structure of externalizing
behaviors, particularly factor mixture models, which allow for a latent factor to have both continuous and categorical dimensions.
Finally, the majority of prior studies have not tested multidimensional models. Using lifetime diagnoses of externalizing
disorders from participants in the Fast Track Project (n = 715), we analyzed a series of latent variable models ranging from fully continuous factor models to fully categorical mixture
models. Continuous models provided the best fit to the observed data and also suggested that a two-factor model of externalizing
behavior, defined as (1) ODD+ADHD+CD and (2) SUD with adult antisocial behavior sharing common variance with both factors,
was necessary to explain the covariation in externalizing disorders. The two-factor model of externalizing behavior was then
replicated using a nationally representative sample drawn from the National Comorbidity Survey-Replication data (n = 5,692). These results have important implications for the conceptualization of externalizing disorders in DSM-5.
- Content Type Journal Article
- Pages 1-15
- DOI 10.1007/s10802-012-9674-z
- Authors
- Katie Witkiewitz, Department of Psychology, Washington State University, 14204 NE Salmon Creek Ave, Vancouver, WA 98686, USA
- Kevin King, Department of Psychology, University of Washington, Box 351525, Seattle, WA 98195-1525, USA
- Robert J. McMahon, Department of Psychology, Simon Fraser University and the Child & Family Research Institute, 8888 University Drive, Burnaby, BC V5A 1S6, Canada
- Johnny Wu, Department of Psychology, University of Washington, Box 351525, Seattle, WA 98195-1525, USA
- Jeremy Luk, Department of Psychology, University of Washington, Box 351525, Seattle, WA 98195-1525, USA
- Karen L. Bierman, Department of Psychology, Pennsylvania State University, 503B Keller Bldg, University Park, PA 16802-3106, USA
- John D. Coie, Department of Psychology, Duke University, Durham, NC 27706, USA
- Kenneth A. Dodge, Sanford School of Public Policy, Duke University, Box 90545, Durham, NC 22708-0545, USA
- Mark T. Greenberg, Pennsylvania State University, 112 Henderson South Building, University Park, PA 16802, USA
- John E. Lochman, Department of Psychology, University of Alabama, Box 870348, Tuscaloosa, AL 35487, USA
- Ellen E. Pinderhughes, Eliot Pearson Department of Child Development, Tufts University, 105 College Avenue, Medford, MA 02155, USA
- the Conduct Problems Prevention Research Group
- Journal Journal of Abnormal Child Psychology
- Online ISSN 1573-2835
- Print ISSN 0091-0627