1. Stability of the Latent Class Structure of Conners’ Parent Rating Scales: Oppositional Subscale in a Sample of Dutch Children Vermont Center for Children, Youth and Families at University of Vermont VU University, Amsterdam, The Netherlands Objective Analyses Sample and Measures Introduction Results and Conclusions References Oppositional defiant disorder (ODD) and oppositional defiant behavior (ODB) are associated with a higher risk of the later development of conduct disorder (CD) and antisocial personality disorder (Burke et al., 2002 & Loeber et al., 2000). Although ODD is usually considered the mildest of the disruptive behavior disorders, research has demonstrated that it is a key disorder in predicting young adult anxiety and depression and is distinguishable from normal childhood behavior. In an effort to understand possible subsets of ODB which may differentially predict outcome, we used Latent Class Analysis (LCA) of mother’s report on the Conners’ Parent Rating Scales Revised Short Forms (CPRS-R:S). LCA is a form of person-centered categorical data analysis that assumes that it is possible to account for the relations among symptoms by a set of discrete classes of item endorsement probabilities. LCA presupposes the existence of discrete latent categories which distinguish it from factor analysis which assumes continuous latent variables are present. The analysis results in two metrics: (1) the probability of class membership for each individual and (2) symptom endorsement probabilities for each class The advantage to this approach is that it is free of preconceived notions about which items should go together and thus allows for a manner of classifying individuals empirically using a bottom-up approach. The examination of distinct differences between classes may allow for a more accurate and complete understanding of presenting oppositional defiant behaviors. Multilevel LCA with robust standard error estimates was performed using Latent Gold to control for twin-twin dependence in the data. To calculate the best fitting model, we first ensured goodness of fit with a bootstrapping algorithm—a step that is essential when dealing with sparse data matrices such as these—and then compared the change in the Bayesian Information Criterion (BIC) when moving from one class solution to the next. In addition, logistic regression was used to predict stability of class membership by examining the likelihood that being in a particular class at one age predicted the categorical outcome of being in all other classes at the next age. Boomsma DI, Vink JM, van Beijsterveldt TC, de Geus EJ, Beem AL, Mulder EJ, Derks EM, Riese H, Willemsen GA, Bartels M, van den Berg M, Kupper NH, Polderman TJ, Posthuma D, Rietveld MJ, Stubbe JH, Knol LI, Stroet T, van Baal GC (2002). Netherlands Twin Register: a focus on longitudinal research. Twin Res 5:401 406. Burke JD, Loeber R, Birmaher B (2002). Oppositional defiant disorder and conduct disorder: a review of the past 10 years, part II. J Am Acad Child Adolesc Psychiatry 41:1275-1293. Conners CK (2001). Conners Rating Scales-Revised. New York/Toronto: Multi-Health Systems. Loeber R, Burke JD, Lahey BB, Winters A, Zera M (2000). Oppositional defiant and conduct disorder: a review of the past 10 years, part I. J Am Acad Child Adolesc Psychiatry 39:1468–1484. Vermunt JK, Magidson J. Latent Gold 4.0 user’s guide. Belmont, MA: Statistical Innovations Inc, 2005. The data of the present study are derived from a large ongoing longitudinal study from the Netherlands Twin Registry that examines genetic and environmental influences on the development of problem behavior in families with twin’s ages 3 to 12-years-old. Mothers completed the CPRS-R:S, which consists of 27 items rated on a four-point Likert scale for symptom severity (i.e., 0 = not true at all, 1 = just a little true, 2 = pretty much true, 3 = very much true). Data were obtained from mother’s report for: 7 year-old [n = 7,374] 10 year-old [n = 6,320] 12 year-old [n = 5,558] Samples partially overlapped from ages 7 to 10 and from 10 to 12, but did not overlap from ages 7 to 12. ODB was measured using the 6-item Oppositional subscale of the CPRS-R:S. For the LCA, items were recoded such that 0 or 1 = 0 and 2 or 3 = 1. Table 1: Latent Class Analysis Optimal Solution of 4-classes Odds Ratios Figure 1: 4-Class solution for CPRS:RS LCA Ana V. Kuny, B.A., Robert R. Althoff, M.D., Ph.D., William Copeland, Ph.D., Meike Bartels, Ph.D., Toos C.E.M. Van Beijsterveldt, Ph.D., Dorret Boomsma Ph.D., Julie Baer, B.A., and James J. Hudziak, M.D. The LCA identified an optimal solution of 4-classes across age groups co-varying for sex (Figure 1). 1. Class 1 was associated with no or low symptom endorsement 2. Class 2 was characterized by non-reactive defiance, 3. Class 3 was characterized by non-defiant emotional reactivity 4. Class 4 was associated with elevated scores on all The distinguishing feature between the two intermediate classes (classes 2 and 3) is the level of emotional reactivity The results of the logistic regression (Table 1) demonstrate that, on the whole, odds ratios were significantly higher between age groups for comparisons within a particular latent than across latent classes. Additionally, being in Class 2 at age 7 did predict being in either Class 2 or Class 4 at age 10 and being in Class 3 at age 10 did predict being in either Class 3 or Class 4 at age 12. However, there was no significant crossover in switching between Class 2 and 3. It is possible that there are subsets of ODB in the population that may have differential presentation, longitudinal course, association with other disorders, and genetics. An understanding of distinct differences between these subsets is necessary if clinicians and researchers wish to tease apart the specific contributions of environmental and genetic factors to ODD. Age 10 Class1Age 10 Class2Age 10 Class3Age 10 Class4 Age 7 Class15.178 [95% C.I. 4.18-6.42].510 [95% C.I..376-.690].269 [95% C.I..199-.363].123 [95% C.I..083-.183] Age 7 Class2.567 [95% C.I..415-.776]2.067 [95% C.I. 1.37-3.11].739 [95% C.I..42-1.301]2.257 [95% C.I. 1.401-3.637] Age 7 Class3.282 [95% C.I..208-.383]1.23 [95% C.I..761-1.987]5.592 [95% C.I. 3.916-7.986]1.58 [95% C.I..926-2.693] Age 7 Class4.152 [95% C.I..110-.211]1.75 [95% C.I. 1.122-2.731]2.6 [95% C.I. 1.729-3.908]10.252 [95% C.I. 6.909-15.211] Age 12 Class1Age 12 Class2Age 12 Class3Age 12 Class4 Age 10 Class16.988 [95% C.I. 5.617-8.695].311 [95% C.I..233-.415].137 [95% C.I..096-.197].096 [95% C.I..058-.160] Age 10 Class2.487 [95% C.I..365-.650]2.79 [95% C.I. 1.95-3.992]1.491 [95% C.I..932-2.385].843 [95% C.I..404-1.761] Age 10 Class3.371 [95% C.I..278-.496]1.193 [95% C.I..751-1.897]5.147 [95% C.I. 3.557-7.448]1.352 [95% C.I..710-2.574] Age 10 Class4.117 [95% C.I..088-.154]2.943 [95% C.I. 2.048-4.228]4.155 [95% C.I. 2.845-6.066]17.082 [95% C.I. 11.003-26.519]