Protocol - Disruptive Behavior

Disruptive Behavior Disorders Rating Scale

Instructions:

Check the column that best describes your/this child. Please write DK next to any items for which you don’t know the answer.

1. Has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period)

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

2. Often argues with adults

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

3. Often lies to obtain goods or favors or to avoid obligations (i.e., "cons" others)

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

4. Has been physically cruel to people

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

5. Has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery)

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

6. Often truant from school, beginning before age 13 years

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

7. Is often spiteful or vindictive

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

8. Often blames others for his or her mistakes or misbehavior

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

9. Has deliberately destroyed others’ property (other than by fire setting)

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

10. Often actively defies or refuses to comply with adults’ requests or rules

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

11. Often initiates physical fights with others who do not live in his or her household (e.g., peers at school or in the neighborhood)

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

12. Is often angry and resentful

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

13. Is often touchy or easily annoyed by others

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

14. Often loses temper

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

15. Has forced someone into sexual activity

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

16. Often bullies, threatens, or intimidates others

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

17. Has been physically cruel to animals

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

18. Often stays out at night despite parental prohibitions, beginning before age 13 years

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

19. Often deliberately annoys people

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

20. Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery)

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

21. Has deliberately engaged in fire setting with the intention of causing serious damage

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

22. Has broken into someone else’s house, building, or car

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

23. Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun)

0[ ]Not at all

1[ ]Just a little

2[ ]Pretty much

3[ ]Very much

Scoring

There are two scoring approaches that can be used. The first relies on counting symptoms for each disorder using the Disruptive Behavior Disorders (DBD) rating scale and the second employs the use of average scale scores. Within each of these approaches, one has the option of using either the continuous/count score that is created, or of creating a diagnostic (0/1) assessment, depending on research needs. A continuous score provides more variance for predictive capacity; a diagnostic may have more clinical significance. Diagnosis using the scale score method involves comparing the target child’s scale scores on the DBD Rating Scale to established norms. The scale score method is preferable for diagnosis of females (e.g., using a 2 standard deviation cutoff), as the symptom counting method often results in underdiagnosis of female children.

Method 1: Counting Symptoms

To determine if a child meets the symptom criteria for DSM-IV [Diagnostic and Statistical Manual of Mental Disorders, 4th Edition] or DSM-5 diagnoses of Oppositional Defiant Disorder [ODD] or Conduct Disorder as measured by the DBD Parent/Teacher Rating Scale, count the number of symptoms that are endorsed "pretty much" or "very much" by either parent or teacher in each of the following categories: Note that impairment and other criteria must be evaluated in addition to symptom counts.

Some impairment from the symptoms must be present in two or more settings (e.g., school, home).

Oppositional Defiant Disorder

_________Oppositional Defiant Disorder (items 2, 7, 8, 10, 12, 13, 14, 19)

A total of 4 or more items must be endorsed as "pretty much" or "very much" on either the parent or the teacher DBD to meet criteria for ODD.

Conduct Disorder

__________Conduct Disorder - aggression to people and animals (items 4, 11, 15, 16, 17, 23)

__________Conduct Disorder - destruction of property (items 9, 21)

__________Conduct Disorder - deceitfulness or theft (items 3, 5, 22)

__________Conduct Disorder - serious violation of rules (items 1, 6, 18)

For a Continuous/Count Measure

Add up the number of symptoms across all disorders to obtain the externalizing symptom count score.

For a Diagnostic Measure

A total of 3 or more items in any category or any combination of categories must be endorsed as "pretty much" or "very much" on either the parent or the teacher DBD to meet diagnostic criteria for Conduct Disorder.

Method 2: Using Scale Scores

Scale scores for the ODD dimensions for teacher ratings on the DBD are reported in Pelham, W. E., Jr., Gnagy, E. M., Greenslade, K. E., & Milich, R. (1992). Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 210-218. The scores for DSM-IV scales are the same as for the DSM-III-R scales reported in that paper.

For a Continuous/Count Measure

To create a continuous measure of externalizing behavior, compute the average rating for the items for the externalizing scale (listed below) using the following scoring: Not at all = 0, Just a little = 1, Pretty Much = 2, Very much = 3.

Scale

_________Oppositional/Defiant (items 2, 7, 8, 10, 12, 13, 14, 19)

For a Diagnostic Measure

To determine a diagnostic measure based on how a child’s scores compare to normative data, compute the average rating for the items for the externalizing scale as above. Then, using the information from the table of norms in Pelham et al. (1992), determine where the child falls in relation to other children. A variety of cutoff scores can be used (e.g., 2 standard deviations above the mean).