Journal of Abnormal Child Psychology

, Volume 41, Issue 2, pp 223-237

First online:

Evidence for a Multi-Dimensional Latent Structural Model of Externalizing Disorders

  • Katie WitkiewitzAffiliated withDepartment of Psychology, Washington State University Email author 
  • , Kevin KingAffiliated withDepartment of Psychology, University of Washington
  • , Robert J. McMahonAffiliated withDepartment of Psychology, Simon Fraser University and the Child & Family Research Institute
  • , Johnny WuAffiliated withDepartment of Psychology, University of Washington
  • , Jeremy LukAffiliated withDepartment of Psychology, University of Washington
  • , Karen L. BiermanAffiliated withDepartment of Psychology, Pennsylvania State University
  • , John D. CoieAffiliated withDepartment of Psychology, Duke University
  • , Kenneth A. DodgeAffiliated withSanford School of Public Policy, Duke University
  • , Mark T. GreenbergAffiliated withPennsylvania State University
    • , John E. LochmanAffiliated withDepartment of Psychology, University of Alabama
    • , Ellen E. PinderhughesAffiliated withEliot Pearson Department of Child Development, Tufts University
    • , the Conduct Problems Prevention Research Group

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Strong associations between conduct disorder (CD), antisocial personality disorder (ASPD) and substance use disorders (SUD) seem to reflect a general vulnerability to externalizing behaviors. Recent studies have characterized this vulnerability on a continuous scale, rather than as distinct categories, suggesting that the revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) take into account the underlying continuum of externalizing behaviors. However, most of this research has not included measures of disorders that appear in childhood [e.g., attention-deficit/hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD)], nor has it considered the full range of possibilities for the latent structure of externalizing behaviors, particularly factor mixture models, which allow for a latent factor to have both continuous and categorical dimensions. Finally, the majority of prior studies have not tested multidimensional models. Using lifetime diagnoses of externalizing disorders from participants in the Fast Track Project (n = 715), we analyzed a series of latent variable models ranging from fully continuous factor models to fully categorical mixture models. Continuous models provided the best fit to the observed data and also suggested that a two-factor model of externalizing behavior, defined as (1) ODD+ADHD+CD and (2) SUD with adult antisocial behavior sharing common variance with both factors, was necessary to explain the covariation in externalizing disorders. The two-factor model of externalizing behavior was then replicated using a nationally representative sample drawn from the National Comorbidity Survey-Replication data (n = 5,692). These results have important implications for the conceptualization of externalizing disorders in DSM-5.


Externalizing Classification Mixture modeling Substance abuse Substance dependence