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DSM-IV defined conduct disorder and oppositional defiant disorder: an investigation of shared liability in female twins

  • V. S. Knopik (a1), L. C. Bidwell (a1) (a2), C. Flessner (a1), N. Nugent (a1), L. Swenson (a3), K. K. Bucholz (a4), P. A. F. Madden (a4) and A. C. Heath (a4)...



DSM-IV specifies a hierarchal diagnostic structure such that an oppositional defiant disorder (ODD) diagnosis is applied only if criteria are not met for conduct disorder (CD). Genetic studies of ODD and CD support a combination of shared genetic and environmental influences but largely ignore the imposed diagnostic structure.


We examined whether ODD and CD share an underlying etiology while accounting for DSM-IV diagnostic specifications. Data from 1446 female twin pairs, aged 11–19 years, were fitted to two-stage models adhering to the DSM-IV diagnostic hierarchy.


The models suggested that DSM-IV ODD–CD covariation is attributed largely to shared genetic influences.


This is the first study, to our knowledge, to examine genetic and environmental overlap among these disorders while maintaining a DSM-IV hierarchical structure. The findings reflect primarily shared genetic influences and specific (i.e. uncorrelated) shared/familial environmental effects on these DSM-IV-defined behaviors. These results have implications for how best to define CD and ODD for future genetically informed analyses.


Corresponding author

* Address for correspondence: V. S. Knopik, Ph.D., Division of Behavioral Genetics, Coro West Suite 204, 1 Hoppin St, Providence, RI 029 03 USA. (Email:


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DSM-IV defined conduct disorder and oppositional defiant disorder: an investigation of shared liability in female twins

  • V. S. Knopik (a1), L. C. Bidwell (a1) (a2), C. Flessner (a1), N. Nugent (a1), L. Swenson (a3), K. K. Bucholz (a4), P. A. F. Madden (a4) and A. C. Heath (a4)...


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