To determine whether DSM-III and DSM-III-R criteria for conduct disorder identify girls in the general population with early-onset, persistent, and pervasive antisocial behavior.
2,251 girls, representative of all girls entering kindergarten in Qúebec, were assessed using parent and teacher ratings of antisocial behavior; a subsample was then rated for the next 6 years (ages 7 to 12) by parent and teacher. At age 10 years, the girls who been rated as antisocial in kindergarten, along with a random sample of those not rated as antisocial, were assessed for DSM-III and DSM-III-R diagnoses of conduct and oppositional defiant disorder using a structured psychiatric interview (Diagnostic Interview Schedule for Children) administered to the parent, teacher, and/or child (n = 381).
Of the girls with early-onset, persistent, and pervasive antisocial behavior, 3% met DSM-III-R criteria and 22% met DSM-III criteria for conduct disorder. Conduct disorder was not diagnosed at all in girls who had not been initially rated as antisocial in kindergarten. Lowering the threshold for a DSM-III-R conduct disorder diagnosis to two symptoms and adding the criterion of violation of rules increased the rate of diagnosis to 35% in the pervasively antisocial girls but only to 1% in girls who did not have persistent antisocial behavior.
DSM-III-R criteria for conduct disorder do not identify most preadolescent girls with early-onset, pervasive, and persistent antisocial behavior. Modifications to the DSM-III-R criteria resulted in increased sensitivity without a loss of specificity.
Epidemiological studies of illegal drug use in adolescents have examined frequency of drug use; a few have examined diagnoses or symptoms of drug abuse or dependence. This study examined problem use of illegal drugs, about which very little is known.
Adolescents (879 boys and 929 girls), mean age of 15.7 years, representative of the province of Québec, Canada, were asked about problem use of alcohol and illegal drugs.
Almost one third had used illegal drugs more than 5 times. Of this group, more than 70% reported going to school high on drugs, and the majority reported playing sports while high and using drugs in the morning. In these drugs users, 94% of the boys and 85% of the girls reported at least 1 problem and two thirds of the boys and more than half of the girls reported 3 or more problems from illegal drugs. Marijuana was used by almost all subjects at the time of maximal drug use; hallucinogens were the second most commonly used drug. Alcohol was used more frequently than illegal drugs, but problem use was less common.
Problem drug use is the norm among the large minority who use illegal drugs more than a few times, and drug use is commonly incorporated into 2 major routine activities of teenagers--school and sports.