Diagnostic Changes for Conduct Disorder Across DSM and ICD Versions
Critical Limitation of Available Evidence
The provided evidence does not contain specific information about the diagnostic criteria changes for Conduct Disorder across DSM-III, DSM-III-TR, DSM-IV, DSM-5, DSM-5-TR, ICD-10, or ICD-11. The available guidelines and research papers discuss Oppositional Defiant Disorder (ODD) rather than Conduct Disorder (CD), or mention CD only tangentially without detailing the evolution of diagnostic criteria across classification system versions.
What the Evidence Does Reveal About Conduct Disorder
DSM-IV Conduct Disorder Criteria
- DSM-IV included 15 specific symptoms for Conduct Disorder that clinicians used to assess the diagnosis, including behaviors such as truancy and association with deviant peers 1.
- The diagnosis required symptoms to be present for at least 6 months, with at least one symptom present in the past 6 months 2.
- At least 3 symptoms needed to be present in the past 12 months for diagnosis 2.
DSM-5 Changes
- The diagnostic criteria for Conduct Disorder remained unchanged from DSM-IV to DSM-5, maintaining the same symptom requirements 3.
- DSM-5 introduced a new specifier: "with callous-unemotional (CU) presentation", which was the only substantive modification to the CD diagnosis 3.
- This callous-unemotional specifier allows clinicians to identify a subgroup of youth with CD who display limited prosocial emotions and reduced empathy 3.
DSM-5-TR
- No specific information about DSM-5-TR changes to Conduct Disorder criteria is provided in the available evidence.
ICD-10 and ICD-11
- ICD-10 does not list Intermittent Explosive Disorder as a separate category, though this relates to impulsive aggression rather than Conduct Disorder specifically 4.
- ICD-11 expanded from 11 to 21 disorder groupings but specific changes to Conduct Disorder classification are not detailed in the provided evidence 4.
- The ICD-11 revision emphasized global applicability, scientific validity, and clinical utility, with dimensional severity specifications (mild, moderate, severe) introduced for several disorders 4.
Research Gaps Identified
Proposed But Unimplemented Changes
Research from 2008 identified several potential additions to CD diagnosis that were being considered for DSM-5 but lacked sufficient evidence 5:
- Childhood-limited subtype
- Family psychiatric history criteria
- Female-specific criteria
- Preschool-specific criteria
- Early substance use markers
- Biomarkers from genetics, neuroimaging, and physiology 5
None of these proposed changes were ultimately incorporated into DSM-5, as the diagnostic criteria remained unchanged except for the CU specifier 3.
Core Diagnostic Features That Remained Stable
- Aggression toward people or animals, destruction of property, deceitfulness or theft, and serious violations of rules constitute the primary diagnostic features across all DSM versions discussed 2.
- The 6-month minimum duration requirement has remained consistent 6, 2.
Clinical Assessment Considerations
Multi-Informant Approach
- Assessment should be systematic and comprehensive, based on a multi-informant approach, gathering information from multiple sources using developmentally sensitive techniques 3, 7.
- Informant discrepancies should be expected and evaluated systematically, as they do not invalidate the diagnosis 7.
Contextual Factors
- Clinicians tend to apply contextual information (such as association with deviant peers) when making likelihood judgments about CD symptoms, though individual clinicians vary in which specific symptoms they weight more heavily based on context 1.