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Evidence-based assessment/Conduct disorder (assessment portfolio)

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Subject classification: this is a psychology resource.
Type classification: this is an evidence-based assessment resource.

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What is a "portfolio"?

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  • For background information on what assessment portfolios are, click the link in the heading above.
  • Want more information? There's a extended version of this page here.

Preparation phase

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Diagnostic criteria for Conduct disorder

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ICD-11 Diagnostic Criteria

Conduct-dissocial disorder is characterized by a repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws are violated such as aggression towards people or animals; destruction of property; deceitfulness or theft; and serious violations of rules. The behaviour pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. To be diagnosed, the behaviour pattern must be enduring over a significant period of time (e.g., 12 months or more). Isolated dissocial or criminal acts are thus not in themselves grounds for the diagnosis.

Note: The ICD-11 lists 8 additional subcategories of conduct-dissocial disorder. They can be found here with more information.

Changes in DSM-5

  • The diagnostic criteria for Conduct disorder changed slightly from DSM-IV to DSM-5. Summaries are available here.


Base rates of conduct disorder in different clinical settings and populations

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This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of conduct disorder that they are likely to see in their clinical practice.

  • To see prevalence rates across multiple disorders, click here.
Demography Setting Base Rate Diagnostic Method
All of U.S.A.[1] Nationally representative large-scale study (N=9282) - adult retrospective report 9.5% overall: 12% males, 7% females CIDI: WHO Composite International Diagnostic Interview

(Parent Interview)

Western North Carolina[2] The Great Smoky Mountains Study – longitudinal, population-based study of community sample 9.0% overall: 14% males, 4% females CAPA: Child and Adolescent Psychiatric Interview

(Parent and Youth Interview)

California, Division of Juvenile Justice (DJJ)[3] Incarcerated adolescents 93% males, 92% females SCID-IV: Structured Clinical Interview for DSM-IV

(Youth Interview)

All of USA[4] National Comorbidity Survey Replication Adolescent Supplement –population-based study of adolescents 5.4% Overall CIDI

(Parent Interview)

Various locations across USA[5] Community samples – summary of past findings 6-16% males, 2-9% females Varied
Urban Midwestern USA[6] Clinic-referred sample 12.5% overall; 50% of those with CD met criteria for CU traits based on combined-informant report on APSD KSADS-PL
Small metropolitan area in SE USA[6] Community based sample 16.2% overall; 32% of those with CD met criteria for CU traits based on combined-informant report on APSD CSI-4, based on combined-informant report

Note: Despite a plethora of studies assessing prevalence of comorbidity of conduct disorder with other disorders (e.g., substance abuse, bipolar, ADHD), searches outlined below did not yield a single study providing a prevalence of conduct disorder alone in an outpatient or community clinic setting.

Prediction phase

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Measure Format (Reporter) Age Range Administration/

Completion Time

Where to Access
ASEBA (Achenbach System of Empirically Based Assessment) not free[7] Parent report (CBCL)

Youth self-report (YSR)

6-18 (CBCL)

11-18 (YSR)

10-15 minutes For Purchase
BASC-2 (Behavior Assessment System for Children, 2nd Edition) not free[8] teacher/ parent/ self-report 2:0-21:11 for parent/ teacher; 6:0-college age for self-report 10-20 minutes for parent/ teacher; 30 minutes self-report For Purchase
ECBI/ SESBI-R (Eyberg Child Behavior Inventory/Sutter-Eyberg Child Behavior Inventory-Revised) not free[9] parent/ teacher 2-16 5 minutes For Purchase

Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings.

Prescription phase

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Gold standard diagnostic interviews

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  • For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), click here.

Semi-structured and Structured Diagnostic Interviews

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Measure Format (Reporter) Age Range Administration/

Completion Time

Where to Access
Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (KSADS-PL)[10][11] Structured interview 6-28 45-75 minutes PDF Version
Diagnostic Interview Schedule for Children IV (DISC-IV) [12][13] Structured Interview (Self report and parent) 4-12 70/ 90-120 Interviewer manual
Diagnostic Interview for Children and Adolescents (DICA)[14][15] Structured interview 6-18

Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings.

Process phase

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The following section contains a brief overview of treatment options for Conduct disorder and list of process and outcome measures for Conduct disorder. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the process phase of assessment. For more information of differences between process and outcome measures, see the page on the process phase of assessment.

Outcome and severity measures

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This table includes clinically significant benchmarks for Conduct disorder specific outcome measures

  • Information on how to interpret this table can be found here.
  • Additionally, these vignettes might be helpful resources for understanding appropriate adaptation of outcome measures in practice.
  • For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks, see here.

Statistically significant change benchmarks with common instruments

Measure Subscale Cut-off scores* Critical Change
(unstandardized scores)
A B C 95% 90% SEdifference
Benchmarks Based on Published Norms
CBCL T-scores
(2001 Norms) 		Externalizing 49 70 58 7 6 3.4
Conduct Disorder Samples Were Not Found in Searches*

Note: “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean

Search terms: (1)“antisocial process screening device,” (2) antisocial process screening device AND benchmarks, searches previously mentioned.

External Resources

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See Effective Child Therapy, a website sponsored by The Society for Child and Adolescent Psychology (APA, Division 53) and the Association for Behavioral and Cognitive Therapies (ABCT), for current summary of evidence-based treatments.

References

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Click here for references
  1. ↑ Nock, M. K.; Kazdin, A. E.; Hiripi, E.; Kessler, R. C.. "Pravalence, subtypes and correlates of DSM-IV conduct disorder in the National Comorbidity Survey Replication". Psychological Medicine 36: 699-910.. 
  2. ↑ Costello, E. J.; Mustillo, S.; Erkanli, A.; Keeler, G.; Angold, A.. "Prevalence and development of psychiatric disorders in adolescence". Arch Gen Psychiatry 60: 837-844.. 
  3. ↑ Karnik, N. S.; Soller, M.; Redlick, A.; Silverman, M.; Kraemer, H.C.; Steiner, H.. "Psychiatric disorders among juvenile delinquents incarcerated for nine months". Psychiatric Services 60: 838-841.. 
  4. ↑ Kessler RC, Avenevoli S, Costello E, et al. Prevalence, Persistence, and Sociodemographic Correlates of DSM-IV Disorders in the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry. 2012;69(4):372-380. doi:10.1001/archgenpsychiatry.2011.160
  5. ↑ Farrington, D.P.. "Conduct disorder, aggression, and delinquency". Handbook of adolescent psychology: 324–345). Hoboken, NJ: Wiley.. 
  6. ↑ 6.0 6.1 Kahn RE, Frick PJ, Youngstrom E, Findling RL, Youngstrom JK. The effects of including a callous-unemotional specifier for the diagnosis of conduct disorder. J Child Psychol Psychiatry. 2012;53(3):271–282
  7. ↑ Paul, Howard A. (2019-09-18). "Treatment of Disorders in Childhood and Adolescence". Child & Family Behavior Therapy 41 (4): 247–255. doi:10.1080/07317107.2019.1659554. ISSN 0731-7107. http://dx.doi.org/10.1080/07317107.2019.1659554. 
  8. ↑ Paul, Howard A. (2019-09-18). "Treatment of Disorders in Childhood and Adolescence". Child & Family Behavior Therapy 41 (4): 247–255. doi:10.1080/07317107.2019.1659554. ISSN 0731-7107. http://dx.doi.org/10.1080/07317107.2019.1659554. 
  9. ↑ Paul, Howard A. (2019-09-18). "Treatment of Disorders in Childhood and Adolescence". Child & Family Behavior Therapy 41 (4): 247–255. doi:10.1080/07317107.2019.1659554. ISSN 0731-7107. http://dx.doi.org/10.1080/07317107.2019.1659554. 
  10. ↑ Kaufman, John; Birmaher, Boris; Brent, David; Rao, Uma; Flynn, Cynthia; Moreci, Paula; Williamson, Douglas; Ryan, Neal (1997). "Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version". PsycTESTS Dataset. Retrieved 2022-08-15.
  11. ↑ Paul, Howard A. (2019-09-18). "Treatment of Disorders in Childhood and Adolescence". Child & Family Behavior Therapy 41 (4): 247–255. doi:10.1080/07317107.2019.1659554. ISSN 0731-7107. http://dx.doi.org/10.1080/07317107.2019.1659554. 
  12. ↑ Shaffer, David; Fisher, Prudence; Lucas, Christopher P.; Dulcan, Mina K.; Schwab-Stone, Mary E. (2000). "National Institute of Mental Health Diagnostic Interview Schedule for Children-IV". PsycTESTS Dataset. Retrieved 2022-08-15.
  13. ↑ Paul, Howard A. (2019-09-18). "Treatment of Disorders in Childhood and Adolescence". Child & Family Behavior Therapy 41 (4): 247–255. doi:10.1080/07317107.2019.1659554. ISSN 0731-7107. http://dx.doi.org/10.1080/07317107.2019.1659554. 
  14. ↑ Reich, Wendy (2000-01). "MORE ON THE DICA". Journal of the American Academy of Child & Adolescent Psychiatry 39 (1): 14–15. doi:10.1097/00004583-200001000-00008. ISSN 0890-8567. http://dx.doi.org/10.1097/00004583-200001000-00008. 
  15. ↑ Paul, Howard A. (2019-09-18). "Treatment of Disorders in Childhood and Adolescence". Child & Family Behavior Therapy 41 (4): 247–255. doi:10.1080/07317107.2019.1659554. ISSN 0731-7107. http://dx.doi.org/10.1080/07317107.2019.1659554. 
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