Longitudinal Stability of Preschool Oppositional Defiant Problems

To test stability and change in preschoolers’ oppositional defiant problems, John Lavigne and his co-workers (2001) had parents complete CBCLs for 510 preschoolers in 68 Chicago-area pediatric practices. The children were subsequently reassessed with the CBCL and other instruments in four waves, culminating when the children averaged 8 years old. Diagnoses of Oppositional Defiant Disorder (ODD) and other disorders were made on the basis of consensus between clinicians who reviewed the data available for each child at each assessment.

Initial ODD diagnoses were significantly associated with diagnoses of a variety of other disorders at the subsequent waves. In addition to the presence versus absence of diagnoses, Lavigne et al. analyzed “threshold,” “subthreshold,” and low CBCL Externalizing scores at each wave. Threshold scores were defined as >90th percentile for the sample; subthreshold scores were defined as ranging from above the median through the 90th percentile; and the remaining scores were defined as low. The research team found that most children who were initially classified in the threshold category (>90th percentile for CBCL Externalizing scores) remained in the threshold category at subsequent assessments.

Furthermore, of the children whose scores dropped from the threshold to the subthreshold category, 21% subsequently returned to the threshold category. Levigne et al. concluded (pp. 1397-98) that “wave 1 externalizing scores were strongly predictive of later externalizing scores” and that “intraclass correlations indicated a high degree of stability for the ‘threshold’ category of children with high CBCL scores (r = .81, p <.0001), while it was less predictive for the ‘subthreshold’ category (r = .38, p <.0001).” In addition, “Markov chain analyses indicated that the prior CBCL category was strongly predictive of the status of the individual in the subsequent wave across the five waves of data (X2 = 433.99, p <.0001).”

Reference: Lavigne, J.V., Cicchetti, C., Gibbons, R.D., Binns, H.J., Larsen, L., & DeVito, C. (2001). Oppositional defiant disorder with onset in preschool years: Longitudinal stability and pathways to other disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1393-1400.