Dimensional and Categorical Approaches to the Diagnosis of Attention Deficit Disorder in Children

The authors compared two approach methods for the diagnosis of attention deficit disorder with hyperactivity (ADDH) in a sample of 114 9-year-old children in the community. One method was the categorical approach using a structured interview of parents about their children (DISC-P) and the other was the dimensional approach using Achenbach's Child Behavior Checklist (CBCL) filled in by the parents. There were 14 children diagnosed as having ADDH by DISC-P. Of these, two were “diagnosed” by CBCL. The children diagnosed as ADDH by DISC-P differed on the Achenbach's Externalizing factors from the children who did not have any DSM-III diagnosis by DISC-P and from those who had other DSM-III diagnoses; and on the Achenbach's Internalizing Factors they only differed from the children with no diagnosis and not from children with other diagnoses. Finally it is concluded that it is unlikely that a single cut-off score on any rating scale will be an adequate substitute for a systemic evaluation using several data sources.