Separation Anxiety and Oppositional Defiant Behavior: Perceived Comorbidity Resulting from Ambiguous Behavioral Items

Abstract

We examined whether ambiguous behavioral items contribute to the perceived co-occurrence between separation anxiety (SA) and oppositional defiant (OD) problems. In Study 1, 72 mothers of 7–10 year old children (56% male) read descriptions of children displaying either SA or OD behaviors and then rated the children on items categorized by judges as ambiguous or unambiguous representations of SA and OD problems. For both SA and OD scenarios, mothers endorsed ambiguous behavioral items describing the non-presented problem more often than unambiguous behavioral items of the non-presented problem. In study 2, parents (N = 201) and 12–17 year old clinic-referred youth (67% male) (N = 177) completed the Child Behavior Checklist (CBCL) and Youth Self Report (YSR), respectively. Scales were created using only the items from these measures judged as unambiguous indicators of SA or OD problems. For parents, the unambiguous SA and OD item scales were significantly less correlated with each other than were the syndromes or DSM-oriented scales of the CBCL. Item ambiguity had less effect on youth self-ratings. Results indicate that some comorbidity between SA and OD behaviors may be explained by ambiguous behavioral items. Implications for assessing and understanding the co-occurrence of SA and OD problems in children are discussed.