Deconstructing the PDD clinical phenotype: internal validity of the DSM-IV
Open accessAbstract
Background: Empirical studies of the structure of autism symptoms have challenged the three‐domain model of impairment currently characterizing pervasive developmental disorders (PDD). The objective of this study was to assess the internal validity of the DSM as a conceptual model for describing PDD, while paying particular attention to certain subject characteristics. Methods: Parents and teachers completed a DSM‐IV‐referenced rating scale for 3‐ to 12‐year‐old clinic referrals with a PDD (n = 730). Ratings were submitted to confirmatory factor analysis and different models were assessed for fit. Results: Measures of fit indicated that the three‐factor solution based on the DSM was superior to other models. Most indices of fit were acceptable, but showed room for improvement. Fit indices varied according to the rater (parent or teacher), child’s age (preschool versus school aged), PDD subtype (autism, Asperger’s, pervasive developmental disorder not otherwise specified (PDDNOS)), and IQ. Conclusions: More research needs to be done before discarding current classification systems. Subject characteristics, modality of assessment, and procedural variations in statistical analyses impact conclusions about the structure of PDD symptoms.
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The triadic model proposed in DSM-IV-TR lacks validity, as all but one CFA study found it inferior to alternative models.
“They are strongly suggestive that the triadic model proposed in DSM-IV-TR lacks validity, [7][8][9][10][11] as all but one study 12 found it to be inferior to alternative models.”
From Testing the construct validity of proposed criteria for DSM-5 autism spectrum disorder (2012) · cites this paper as [12]
The CFA findings and Discussion report the opposite result for this study: the DSM-based three-factor model fit better than the one- and two-factor alternatives. The Abstract also says more research is needed before discarding the current classification system. The paper discusses mixed findings from other studies, but does not establish the claimed all-but-one pattern. (LLM, conf=0.91)
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Experimental — accuracy not yet measuredModels of autistic symptoms can vary according to participant characteristics.
“Previous CFA findings have shown that models of autistic symptoms can vary according to participant characteristics.12”
From Testing the construct validity of proposed criteria for DSM-5 autism spectrum disorder (2012) · cites this paper as [12]
The factor structure of the autistic phenotype can vary with IQ such that better model fit is found in more intellectually able groups.
“There is some evidence that the factor structure of the autistic phenotype can vary with IQ such that better model fit is found in more intellectually able groups.12”
From Testing the construct validity of proposed criteria for DSM-5 autism spectrum disorder (2012) · cites this paper as [12]
Autism is not well conceptualized as a single dimension.
“We also confirmed previous findings that autism is not well conceptualized as a single dimension.9,11,12”
From Testing the construct validity of proposed criteria for DSM-5 autism spectrum disorder (2012) · cites this paper as [12]
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References 38 · Cited by 49
Research works printed but not linked: 3
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, 4th edition. Wash- ington, DC: American Psychiatric Association.
- Browne, M.W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K.A. Bollen, & J. Scott Lang (Eds.), Testing structural models (pp.136-162).
- Internal validity of the DSM-IV 1253 Ó 2009 The Authors Journal compilation Ó 2009 Association for Child and Adolescent Mental Health. 14697610, 2009, 10, Downloaded from https://acamh.onlinelibrary.wiley.com/doi/10.1111/j.1469-7610.2009.02104.x by Mount Vernon Nazarene University, Wiley Online Library on [22/06/2026]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License · DOI
- Authors
- Lecavalier, L., Gadow, K. D., DeVincent, C. J., Houts, C., & Edwards, M. C.
- Affiliations
- The Ohio State University (US)
- State University of New York (US)
- Corresponding author
- Lecavalier, Luc
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2009-09-17
- Volume
- 50
- Issue
- 10
- Pages
- 1246-1254
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W1970329190
- Cited by
- 49
- References
- 38
- Citations by year
- 2024: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 1 · 2015: 3 · 2014: 6 · 2013: 10 · 2012: 7
- FWCI
- 3.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ohio State University
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- pervasive developmental disorders, autism spectrum disorder, Asperger syndrome, pervasive developmental disorder not otherwise specified, DSM-IV, internal validity, symptom structure, factor structure, parent and teacher ratings, child age, IQ, classification systems
- MeSH terms
- Child, Child Development Disorders, Pervasive, Child, Preschool, Factor Analysis, Statistical, Female, Humans, Male, Models, Psychological, Neuropsychological Tests, New York City, Psychometrics, Reproducibility of Results, Diagnostic and Statistical Manual of Mental Disorders
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