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Putting theory to the test: Modeling a multidimensional, developmentally-based approach to preschool disruptive behavior
Lauren S. Wakschlag; David B. Henry; Patrick H. Tolan; Alice S. Carter; James L. Burns; Margaret J. Briggs-Gowan (Profiled Author: Lauren S Wakschlag)
Journal of the American Academy of Child and Adolescent Psychiatry. 2012;51(6):593-604.e1.Abstract
Objective: There is increasing emphasis on dimensional conceptualizations of psychopathology, but empirical evidence of their utility is just emerging. In particular, although a range of multidimensional models have been proposed, the relative fit of competing models has rarely been tested. Furthermore, developmental considerations have received scant attention. In this study, we tested a developmentally based, four-dimensional model of disruptive behavior theorized to represent the defining features of disruptive behavior at preschool age: Temper Loss, Noncompliance, Aggression, and Low Concern for Others. Method: Model testing was conducted in two independent samples of preschoolers: Clinically Enriched Sample (n = 336) and Epidemiologic Sample (n = 532). The tau-equivalent confirmatory factor analyses were used to test the fit of the Developmental Model relative to three leading competing models (DSM opositional defiant disorder (ODD)/conduct disorder (CD) Model, "Callous" Model, and an "Irritable/Headstrong/Hurtful" Model). Reliability of the four dimensions was also tested. Validity of the dimensions was tested by predicting multi-informant, multi-method ratings of disruptive behavior and impairment, and incremental utility relative to DSM symptoms. Results: In both samples, the Developmental Model demonstrated a superior fit compared with the competing models within the full sample, and across key demographic subgroups. Validity was also demonstrated, including incremental utility relative to DSM-IV disruptive behavior symptoms. Conclusions: Critical next steps for achieving scientific consensus about the optimal dimensional model of disruptive behavior and its clinical application are discussed. © 2012 American Academy of Child and Adolescent Psychiatry.
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