Disruptive Behavior Disorder Rating Scale (DBDRS)

Abstract

The Disruptive Behaviour Disorder Rating Scale (DBDRS) is a crucial screening instrument utilized by parents and teachers to assist in the diagnostic process of various child psychopathologies, specifically focusing on externalizing disorders. Developed as an evolution of the earlier Swanston, Nolan and Pelham (SNAP) rating scale, the DBDRS was designed to align with the revised criteria introduced in the DSM-III-R for Attention-Deficit/Hyperactivity Disorder (ADHD). The scale comprehensively includes diagnostic criteria for all three major disruptive behaviour disorder categories: Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), and ADHD.

Keywords

Disruptive Behaviour Disorder Rating Scale, DBDRS, ADHD, Conduct Disorder, Oppositional Defiant Disorder, Child Psychopathology, Teacher Rating Scale, Externalizing Disorders, DSM-III-R, Screening Tool.

Authors

William E. Pelham, Elizabeth M. Gnagy, Karen E. Greenslade, Richard Milich.

Purpose

The primary purpose of the DBDRS is to serve as an effective screening and assessment tool for children exhibiting symptoms related to disruptive behaviour disorders. It facilitates the collection of structured observational data from primary informants, such as parents and teachers, which is critical for making informed clinical judgments regarding diagnostic classification.

Specifically, the scale enables clinicians and researchers to determine if a child meets the requisite number of symptoms, based on DSM-III-R criteria, for Attention-Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, or Conduct Disorder. The utility of the scale is enhanced by its ability to compare an individual child’s factor scores against established normative data, allowing for a standardized assessment of symptom severity and frequency.

Construct

The DBDRS operationalizes the constructs of disruptive behaviour disorders as defined by the DSM-III-R. It measures the frequency and severity of observable behaviours associated with three distinct but often comorbid externalizing disorders: Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), and Attention-Deficit/Hyperactivity Disorder (ADHD), which is further split into Inattention and Hyperactivity/Impulsivity subdomains.

The scale’s 42 items are designed to directly map onto the 36 diagnostic criteria specified in the DSM-III-R for these conditions, ensuring a high degree of content validity relevant to clinical diagnosis. By quantifying symptoms across these categories, the DBDRS allows for a nuanced assessment of a child’s profile, moving beyond simple presence or absence of a disorder to measure symptom burden.

Validity

A significant validation study involving 931 boys aged 5 to 14 years attending regular classrooms provided evidence supporting the psychometric soundness of the DBDRS. This research confirmed that the scale possesses satisfactory criterion validity and construct validity, indicating that it measures the intended theoretical constructs accurately and correlates appropriately with external criteria of disruptive behaviour.

Further analysis, utilizing conditional probability, highlighted the predictive utility of specific symptom combinations. While some prominent individual ADHD symptoms demonstrated poor predictive power on their own, combinations of symptoms derived from the two ADHD factors (Inattention and Hyperactivity/Impulsivity) showed good predictive capability. Notably, combinations of ODD symptoms exhibited very high predictive power. However, teacher-reported “don’t know” responses led to lower predictive power for Conduct Disorder symptoms, leading the authors to anticipate that the parent rating scale version might offer higher predictive power for CD.

Reliability

The DBDRS demonstrates good internal consistency across its primary diagnostic categories derived from the DSM-III-R. The internal reliability was quantified using coefficient alpha values, which were found to be robust for all measured constructs.

The reported coefficient alphas were: .81 for Conduct Disorder, .95 for Oppositional Defiant Disorder, and .95 for Attention Deficit Hyperactivity Disorder. These high values suggest that the items within each subscale are highly correlated and reliably measure the underlying specific disruptive behaviour construct.

Factor Analysis

The validation study employed factor analysis to explore the underlying structure of the 42 items. This analysis successfully identified a three-factor structure, which largely aligns with the distinct diagnostic categories the scale was intended to measure.

The three identified factors were:

• One factor reflecting symptoms of ODD combined with a number of CD symptoms.
• A second factor comprising symptoms related to ADHD Hyperactivity/Impulsivity.
• A third factor on which ADHD symptoms of Inattention loaded highly.

The study also observed a high degree of covariation between oppositional symptoms and certain CD symptoms, particularly within the elementary school age range, as reported by teachers.

Instrument

Test Type: Screening and Diagnostic Aid Rating Scale (Parent/Teacher Report)

Format: 42 items rated on a four-point Likert-type scale, ranging from not at all (0) to very much (3). Includes a “don’t know” option for teachers.

Language Available: English, Pakistani (adapted), Georgian (translated using back-translation).

Population Group: Children and adolescents in regular classroom settings.

Age Group: Typically 5 to 15 years (Validation sample used 5-14 years; Nigerian norms used 6-15 years).

Population Details: Originally validated on a sample of 931 boys. Adapted and used to generate normative data for specific populations, including Pakistani children and Nigerian children.

Test Methodology: Symptom counting (to meet DSM criteria) or comparison of factor scores to established norms.

Keywords

Psychometrics, Internal Consistency, Criterion Validity, Construct Validity, Factor Analysis, Teacher Ratings, Child Behavior Assessment, Externalizing Disorders, Disruptive Behaviour Disorder Rating Scale.

Authors

Author ORCID Identifier: Not provided in source.

Affiliation Email addresses: Not provided in source.

Correspondence Address: Not provided in source.

Permissions & Fee and Test Year

The Disruptive Behaviour Disorder Rating Scale (DBDRS) is available as a free download. Access is unrestricted, and permission is not required for its use in clinical or research settings. The original scale development and validation study were published in 1992.

The original PDF containing information about accessing this and other free assessment measures can be downloaded here: http://csmh.umaryland.edu/media/SOM/Microsites/CSMH/docs/Resources/ClinicianTools/Summary-of-Free-Assessment-Measures—And-Google-Doc-Link-to-Measures-Saved.pdf

Reference’s

• Bzhalava, V., & Inasaridze, K. (2017). Disruptive Behavior Disorder (DBD) Rating Scale for Georgian Population. arXiv preprint arXiv:1702.03409.
• Loona, M. I., & Kamal, A. (2011). Translation and adaptation of disruptive behaviour disorder rating scale. Pakistan Journal of Psychological Research, 26(2), 149.
• Ofovwe, G. E., & Ofovwe, C. E. (2010). Disruptive Behaviour Disorder (DBD) Rating Scale for Attention Deficit/Hyperactivity Disorder: Normative Values and Percentile Charts for Nigerian Children Aged 6 to 15 Years. Nigerian Hospital Practice, 6(1-2).
• Pelham, W. E., Gnagy, E. M., Greenslade, K. E., & Milich, R. (1992). Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 31(2), 210-218.

Items of the Disruptive Behaviour Disorder Rating Scale (DBDRS)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The Disruptive Behaviour Disorder Rating Scale (DBDRS) is composed of 42 items in total. These items are designed to cover the 36 diagnostic criteria specified in the DSM-III-R for the three disruptive behaviour disorders, and they are intentionally randomized across diagnostic categories.

The item distribution is as follows:

• Symptoms of Conduct Disorder (CD): 16 items.
• Symptoms of Oppositional Defiance Disorder (ODD): 8 items.
• Symptoms of ADHD-Inattention: 9 items.
• Symptoms of ADHD-Hyperactivity/Impulsivity: 9 items.

Each item is assessed using a four-point severity scale: not at all (0), just a little (1), quite a bit (2), and very much (3).