Oppositional defiant disorder and conduct disorder: A meta-analytic review of factor analyses and cross-validation in a clinic sample

• Published in: Clinical psychology review 1993, Vol.13 (4), p.319-340
• Main Authors: Frick, Paul J., Lahey, Benjamin B., Loeber, Rolf, Tannenbaum, Lynne, Van Horn, Yolanda, Christ, Mary Anne G., Hart, Elizabeth A., Hanson, Kelly
• Format: Article
• Language: English
• ISSN: 0272-7358; 1873-7811
• DOI: 10.1016/0272-7358(93)90016-F

This study is a meta-analytic summary of 60 factor analyses from 44 published studies of 28,401 children and adolescents. The results suggested that, strictly in terms of behavioral covariation, conduct problems in children may best be conceptualized in terms of two orthogonal dimensions of behavior: (1) an overt/covert dimension and (2) a destructive/nondestructive dimension. The four quadrants created by the intersection of these two bipolar dimensions corresponded well to distinctions among norm-violating behaviors made by legal systems and previous diagnostic conceptualizations: oppositional, aggressive, property violations, and status offenses. The results of this meta-analysis were cross-validated in a clinic sample of 177 boys age 7–12. One major finding from the validation sample was a strong correspondence between empirically derived syndromes based on the meta-analysis and the Diagnostic and Statistical Manual of Mental Disorders (3rd ed. rev., American Psychiatric Association, 1987) (DSM-III-R) definitions of conduct disorder and oppositional defiant disorder. A second major finding from the validation study was that age of onset may be a critical variable in explaining the results of the meta-analysis.