Oppositional Defiant Disorder Dimensions Research Articles

Development of symptoms of oppositional defiant disorder from preschool to adolescence: the role of bullying victimization and emotion regulation.

Childhood oppositional defiant disorder (ODD) is associated with adverse outcomes which can continue to impair life well into adulthood. Identifying modifiable etiological factors of ODD is therefore essential. Although bullying victimization and poor emotion regulation are assumed to be risk factors for the development of ODD symptoms, little research has been conducted to test this possibility. A sample (n = 1,042) from two birth cohorts of children in the city of Trondheim, Norway, was assessed biennially from age 4 to 14 years. Parents and children (from age 8) were assessed with clinical interviews to determine symptoms of ODD, children reported on their victimization from bullying, and teachers reported on children's emotion regulation. Oppositional defiant disorder symptoms increased from age 4 to 6, from age 8 to 10, and then started to wane as children entered adolescence. A Random Intercept Cross-Lagged Panel Model revealed that increased emotion regulation predicted a reduced number of ODD symptoms across development (β = -.15 to -.13, p < .001). This prediction was equally strong for the angry/irritable and argumentative/defiant dimensions of ODD. No longitudinal links were observed between bullying victimization and ODD symptoms. Improving emotion regulation skills may protect against ODD symptoms throughout childhood and adolescence.

Identifying Symptoms of ADHD and Disruptive Behavior Disorders Most Strongly Associated with Functional Impairment in Children: A Symptom-Level Approach

To enhance the understanding of how symptoms of attention-deficit/hyperactivity disorder (ADHD) and disruptive behavior disorders such as oppositional defiant disorder (ODD), conduct disorder (CD), including callous-unemotional (CU) traits, differentially relate to functional impairment (FI). Participants were 474 German school-age children (age: M = 8.90, SD = 1.49, 81% male) registered for participation in the ESCAschool trial (ESCAschool: Evidence-based, Stepped Care of ADHD in school-aged children). Clinicians assessed the severity of individual symptoms and five FI domains specifically associated with ADHD symptoms or ODD/CD/CU symptoms using a semi-structured clinical interview. We conducted two multiple linear regression analyses, combined with relative importance analyses, to determine the impact of individual symptoms on global FI associated with ADHD and ODD/CD/CU symptoms. Next, we estimated two networks and identified the strongest associations of ADHD symptoms or ODD/CD/CU symptoms with the five FI domains. Symptoms varied substantially in their associations with global FI. The ADHD symptom Easily Distracted (15%) and ODD symptom Argues with Adults (10%) contributed most strongly to the total explained variance. FI related to academic performance, home life and family members, and psychological strain were most strongly associated with ADHD inattention symptoms, whereas FI related to relationships with adults and relationships with children and recreational activities were most strongly associated with hyperactivity-impulsivity symptoms. By comparison, the ODD/CD/CU symptoms most closely linked to FI domains originated from the ODD and CD dimensions. Our findings contribute to a growing body of literature on the importance of analyzing individual symptoms and highlight that symptom-based approaches can be clinically useful.

Inter-relationships between ADHD, ODD and impulsivity dimensions in emerging adults revealed by network analysis: extending the ‘trait impulsivity hypothesis’

BackgroundThe trait-impulsivity hypothesis posits impulsivity as the underlying substrate of Attention-deficit/hyperactivity disorder (ADHD) and Oppositional defiant disorder (ODD) symptom expressions. The current study applied network analysis to evaluate the inter-relationships of dimensions within ADHD (inattention and hyperactivity/impulsivity) and ODD (anger/irritable, vindictiveness, and argumentative/defiant behavior) with components of impulsivity as captured by the UPPS-P model (negative urgency, lack of premeditation, lack of perseverance, sensation seeking, and positive urgency). MethodA total of 324 emerging adults (women = 246) from the general community completed questionnaires covering these dimensions. ResultsOur findings showed that the ADHD and ODD dimensions were associated differentially with different types of impulsivity, in their unique patterns of network connectivities, a possibility that has had little attention in the trait-impulsivity hypothesis literature. ConclusionsThis study is the first to tease out the unique associations of the ADHD and ODD dimensions with different types of impulsivity, and in that way provide new contributions to our understanding of the existing trait impulsivity theory. Our findings would be especially relevant to those interested in understanding how different dimensions of trait impulsivity underly the ADHD and ODD dimensions.

Links between Oppositional Defiant Disorder Dimensions, Psychophysiology, and Interpersonal versus Non-interpersonal Trauma.

The etiology of oppositional defiant disorder (ODD) is not well understood but appears to have both biologically-based roots and can develop following adverse experiences. The current study is the first to examine the interaction between biologically-based factors and type of trauma experience (i.e., interpersonal and non-interpersonal) and associations with ODD. The psychophysiological factors included baseline resting heart rate, respiratory sinus arrhythmia (RSA), and cortisol. ODD was measured as two dimensions of irritable and defiant/vindictive. The sample included 330 children, 3-7 years-old, oversampled for a history of trauma. Results showed the interactions between baseline physiological arousal variables and trauma type in predicting ODD dimensions were not supported. However, the baseline RSA by trauma interaction was a significant predictor of defiance/vindictiveness among boys, but not girls, when interpersonal trauma was compared to controls. Several other gender differences emerged. Among boys, both interpersonal and non-interpersonal trauma were predictive of ODD dimensions; however, among girls, non-interpersonal trauma was not. Among girls, there was a significant negative bivariate relationship between baseline cortisol and irritability. Also, when the sample was restricted to those with interpersonal trauma only and controls, baseline RSA was negatively associated with irritability in girls only (controlling for trauma). Finally, retrospective reports revealed that children who met criteria for ODD diagnosis and experienced interpersonal trauma were more likely to exhibit ODD symptoms prior to their trauma compared to those who experienced non-interpersonal trauma. Results are discussed in the context of previous mixed findings, and avenues for future research are highlighted.

The Irritable and Oppositional Dimensions of Oppositional Defiant Disorder: Integral Factors in the Explanation of Affective and Behavioral Psychopathology.

Oppositional defiant disorder includes distinct but inseparable dimensions of chronic irritability and oppositional behavior. The dimensions have been identified in early childhood to adulthood, and show discriminant associations with internalizing and externalizing psychopathology. The introduction of disruptive mood dysregulation disorders and the requirements that it take precedence over oppositional defiant disorder diagnostically are not supported by evidence and introduce confusion about the structure and linkages of irritability and oppositional behavior, and obscure the importance of the behavioral dimension in explaining and predicting poor outcomes. A dimensional framework with irritability, oppositionality, callous-unemotional traits, and aggression may more fully describe antisocial outcomes.

Longitudinal Associations between Parental Warmth, Harsh Discipline, Child Emotion Regulation, and ODD Dimensions

Research has yet to investigate the mediating role of emotion regulation in the relation between parental warmth and harsh discipline with oppositional defiant disorder (ODD). Further, few studies have investigated ODD as both a unitary construct and as three distinct dimensions (anger, defiance, spitefulness). Thus, the present study aimed to investigate child emotion regulation (grade 2) as a mediator of the relation between parental warmth and harsh discipline (kindergarten, grade 1, grade 2) and ODD and its dimensions (grade 3). Participants included the high-risk and normative samples from the Fast Track project (N = 753, male = 58 %, Black = 46 %). Constructs were assessed using observation and parent and teacher reports. Although results demonstrated an absence of indirect effects, emotion regulation was negatively associated with overall ODD and anger and defiance, but not spitefulness. Findings illustrate how increased attention toward the study of ODD as distinct dimensions contributes to our ability to parse out heterogeneity among children with the disorder.

Irritability and Behavioral Symptom Dimensions of Oppositional Defiant Disorder in Young Adults: Associations with DSM-5 Pathological Personality Traits

Irritability and behavioral symptom dimensions of oppositional defiant disorder (ODD) in youth exhibit differential associations with adult psychopathology. Recently, researchers have begun to examine ODD in adults, with evidence that symptoms persist into adulthood and continue to cause impairment above and beyond other types of psychopathology. Based on this emerging literature, there is a need to understand how ODD symptoms in adulthood relate to novel frameworks for characterizing adult psychopathology. Three-hundred and four young adult college students completed measures of ODD symptoms, DSM-5 pathological personality traits, ADHD, depression, and anxiety. Poisson regression was used to predict ODD severity score from the five DSM-5 personality traits, while controlling for sex, race, and comorbid psychopathology. Structural equation modeling was used to test competing models of ODD structure, and then to examine ODD dimensions and their specific associations with other psychopathology and the DSM-5 traits. Results show that ODD severity was positively associated with negative affectivity, antagonism, and disinhibition, and negatively associated with psychoticism. The two-factor model, with correlated irritability and behavioral dimensions, fit better than the unidimensional model. Irritability was uniquely associated with anxiety, depression, negative affectivity, and detachment, while the behavioral dimension was uniquely associated with ADHD, antagonism, and disinhibition. These analyses provide evidence that symptoms of ODD in young adults are associated with DSM-5 pathological personality traits above and beyond other psychopathology. These findings provide a framework for future studies and clinical consideration of ODD among adults.

Examining ODD/ADHD Symptom Dimensions as Predictors of Social, Emotional, and Academic Trajectories in Middle Childhood

The goal of this article is to investigate the symptom dimensions of oppositional defiant disorder (ODD; irritability, defiance) and attention deficit/hyperactivity disorder (ADHD; inattention, hyperactivity-impulsivity) as predictors of academic performance, depressive symptoms, and peer functioning in middle childhood. Children (N = 346; 51% female) were assessed via teacher-report on measures of ODD/ADHD symptoms at baseline (Grades K–2) and academic performance, depressive symptoms, peer rejection, and victimization on 7 occasions over 4 school years (K–2 through 3–5). Self-report and grade point average data collected in Grades 3–5 served as converging outcome measures. Latent growth curve and multiple regression models were estimated using a hierarchical/sensitivity approach to assess robustness and specificity of effects. Irritability predicted higher baseline depressive symptoms, peer rejection, and victimization, whereas defiance predicted higher baseline peer rejection; however, none of these ODD-related effects persisted 3 years later to Grades 3–5. In contrast, inattention predicted persistently poorer academic performance, persistently higher depressive symptoms, and higher baseline victimization; hyperactivity-impulsivity predicted subsequent peer rejection and victimization in Grades 3–5. In converging models, only inattention emerged as a robust predictor of 3-year outcomes (viz., grade point average, depressive symptoms, peer rejection, and relational victimization). Broadly, ODD dimensions—particularly irritability—may be linked to acute disturbances in social-emotional functioning in school-age children, whereas ADHD dimensions may predict more persistent patterns of peer, affective, and academic problems. By examining all 4 ODD/ADHD symptom dimensions simultaneously, the present analyses offer clarity and specificity regarding which dimensions affect what outcomes, and when. Findings underscore the importance of multidimensional approaches to research, assessment, and intervention.

Oppositional Defiant Disorder Dimensions: Associations with Traits of the Multidimensional Personality Model among Adults.

The occurrence of Oppositional Defiant Disorder (ODD) behaviours among adults has been supported by a proportion of scholars. The current work examines potential ODD dimensions and their associations with the primary personality traits of Tellegen's [57] multi-dimensional conceptualization during adulthood. Two independent, general community, adult groups [Group 1: N = 214; mean age (SD) = 35.74 (16.60); Group 2: N = 205; mean age (SD) = 29.00 (12.42)] completed the Current Symptom Scale involving the eight ODD criteria. Group 2 additionally addressed the Multidimensional Personality Questionnaire -Brief Form (MPQ-BF). A series of Confirmatory Factor Analyses (CFA) were implemented. The three-dimensional ODD conceptualization of Burke and colleagues [14] referring to "Negative Affect", "Oppositional Behavior", and "Antagonistic Behavior" was confirmed. Considering personality traits, valuable associations were revealed between Oppositional Behavior and Aggression, Antagonistic Behavior and Social Potency as well as Harm Avoidance, and finally, Negative Affect and Stress Reaction, as well as Aggression. The dimensionality of ODD behaviours in adulthood and its correspondence with particular personality traits is approached in the context of psychological practice.

The Developmental Propensity Model Extends to Oppositional Defiant Disorder: a Twin Study.

Previous research has supported the developmental propensity model, which proposes that three socioemotional dispositions (prosociality, negative emotionality, and daring) increase risk for the development of conduct problems through shared genetic and environmental influences. The current study extends this research by examining the model in relation to oppositional defiant disorder (ODD). Based on a confirmatory factor analysis, ODD was examined as three separate dimensions (irritable, headstrong, and hurtful) rather than a unitary construct. Parents of 686 same-sex twins (ages 7-13) provided ratings of their twins' dispositions and ODD symptoms. Results from a path model examining phenotypic relationships showed that all dispositions were significantly related to each ODD dimension, except daring was not predictive of the irritable dimension. Preliminary twin analyses showed nonadditive genetic effects only on daring, which limited the appropriateness of evaluating it with the other dispositions. Results from a series of models used to examine etiological associations showed all ODD dimensions had common additive genetic influences with prosociality and negative emotionality. Only headstrong had common additive genetic influences with daring. Irritable and headstrong had common shared environmental influences with respect for rules (an aspect of prosociality), and common nonshared environmental influences with negative emotionality. Hurtful showed no shared environmental influences, but it had common nonshared environmental influences with prosociality and negative emotionality. These findings support the idea that the socioemotional dispositions in the developmental propensity model have some common etiological influences with ODD dimensions, suggesting this model can provide a novel framework for understanding the development of ODD.

Reciprocity in Undesirable Parent–Child Behavior? Verbal Aggression, Corporal Punishment, and Girls’ Oppositional Defiant Symptoms

Parental verbal aggression and corporal punishment are associated with children’s conduct problems and oppositional defiant disorder (ODD). The strength of bidirectional relationships among specific disruptive behaviors has been inconsistent across gender, and the direction of influence between parental aggression and girls’ ODD symptoms is particularly understudied. This study tested reciprocal effects between aggressive parent behaviors and girls’ ODD dimensions of oppositionality, antagonism, and irritability. Data from the Pittsburgh Girls Study (N = 2,450) were used, including annual child and parent-reported aggressive discipline and girls’ parent-reported ODD symptoms between ages 5 and 16. Separate clustered Poisson regression models examined change in parent or child behavior outcomes using predictors lagged by one time point. After controlling for demographic factors, behavior stability, and other disruptive behaviors, parent-reported corporal punishment predicted girls’ increasing antagonism and irritability, whereas child-reported corporal punishment was unrelated to ODD symptom change. Both parent- and child-reported verbal aggression predicted increases across ODD dimensions. Girls’ oppositionality and antagonism predicted increasing parent-reported verbal aggression over time, but only oppositionality was significantly related to child-reported verbal aggression. Although ODD symptoms were unrelated to change in corporal punishment, attention deficit/hyperactivity disorder (ADHD) predicted increasing parental aggression of both types. Bidirectional associations emerged such that parental verbal aggression escalates reciprocally with girls’ behavioral ODD symptoms. Verbal aggression contributed to increasing irritability, but irritability did not influence parenting behavior. “Child effects” may be most salient for behavioral ODD symptoms in transaction with verbal aggression and for ADHD symptoms in predicting worsening corporal punishment and verbal aggression.

Dimensions and subtypes of oppositionality and their relation to comorbidity and psychosocial characteristics.

The symptoms of oppositional defiant disorder (ODD), or oppositionality, seem to constitute a three-dimensional structure of angry/irritable, vindictiveness and argumentative behavior dimensions. Also, subjects with oppositionality are characterized by different comorbidity and longitudinal trajectories, suggesting that they could be divided into subtypes. This study is the first to examine the dimensions and subtypes of oppositionality in Nordic children. Study participants included 3435 children aged 7-10years from the Danish National Birth Cohort. Information was collected using the Development and Well-Being Assessment (DAWBA) online version. A three-factor ODD model was identified. The angry/irritable dimension was associated with emotional problems and disorders, fewer social skills and fewer personal positive attributes. The argumentative behavior dimension was associated with hyperactivity/conduct problems, reduced social skills and positive attributes. The vindictiveness dimension was associated with externalizing, internalizing and prosocial problems. Four ODD subtypes were identified. The subtypes with many or mainly angry/irritable symptoms were characterized by comorbid psychopathology, increased functional impairment and psychosocial problems. Children with ODD had fewer positive attributes, more friendship/school problems and higher functional impairment than children with emotional disorders and control group children. Oppositionality consists of three dimensions differently associated with comorbidity and psychosocial characteristics, and the same pattern is seen for the four ODD subtypes identified in this study. Children with ODD experience more adversities and functional impairment than children with emotional disorders. Our results indicate that treatment of children with ODD would improve from extended knowledge on individual ODD dimensions and subtypes and the related child psychosocial characteristics.

Evaluation of a four-item DSM-5 Limited Prosocial Emotions specifier scale within and across settings with Spanish children.

The objective was to evaluate a 4-item measure of the DSM-5 Limited Prosocial Emotions (LPE) specifier (a 4-item measure of prosocial emotions). Mothers, fathers, primary teachers, and ancillary teachers completed measures of prosocial emotions (PE), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD)-inattention (IN), ADHD-hyperactivity/impulsivity (HI), academic and social impairment on 811 Spanish first-grade children (46% girls). Confirmatory factor and structural regression analyses showed PE symptom scores to have (a) good reliability for the 4 sources (80% to 89% true score variance), (b) invariance of like-symptom loadings and intercepts across the 4 sources, (c) strong convergent and discriminant validity within home and school settings, (d) no convergent validity across settings, and (e) associations with academic and social impairment independent of the ODD dimension (the unique effects of PE also remained significant after controlling for ODD, ADHD-IN, and ADHD-HI for mothers and ancillary teachers). A graded response item response theory analysis indicated that PE scores provided an accurate measure of the PE trait across a wide trait range and especially at low PE trait levels (i.e., scores in the clinical range). Findings also supported the DSM-5 diagnostic criteria of 2 or more LPE symptoms in 2 or more settings (e.g., high levels of the LPE trait were associated with the occurrence of 2 or more symptoms with 4% of the sample showing 2 or more symptoms in both settings). Although additional studies are still required, the PE measure appears useful as a brief measure of the LPE specifier. (PsycINFO Database Record

Oppositional behavior and longitudinal predictions of early adulthood mental health problems in chronic tic disorders

Chronic tic disorders (TD) are associated with a number of psychological problems such as attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive behavior (OCB), oppositional-defiant disorder (ODD) as well as anxious and depressive symptoms. ODD is often considered a risk factor for many psychological symptoms and recent work suggests that different ODD dimensions show independent predictions of later psychological problems. This study examined the longitudinal predictions between ODD dimensions of Irritability and Defiance and the most frequent comorbidities in TD from childhood to early adulthood. From an initial sample of 135, parent reports were obtained on 58 participants with TD using standard clinical questionnaires and semi-structured interviews. Defiance symptoms decreased from baseline to follow-up whereas Irritability symptoms were more stable over time. In multiple regressions, Irritability in childhood predicted anxiety and OCB in early adulthood while Defiance in childhood predicted ADHD and conduct disorder symptoms in early adulthood. No developmental link was found for depressive symptoms. Results indicate that ODD dimensions are developmentally linked to both internalizing and externalizing adult mental health symptoms in TD.

Disentangling Heterogeneity of Childhood Disruptive Behavior Problems Into Dimensions and Subgroups

Irritable and oppositional behaviors are increasingly considered as distinct dimensions of oppositional defiant disorder. However, few studies have explored this multidimensionality across the broader spectrum of disruptive behavior problems (DBPs). This study examined the presence of dimensions and distinct subgroups of childhood DBPs, and the cross-sectional and longitudinal associations between these dimensions. Using factor mixture models (FMMs), the presence of dimensions and subgroups of DBPs was assessed in the Generation R Study at ages 6 (n= 6,209) and 10 (n=4,724) years. Replications were performed in two population-based cohorts (Netherlands Twin Registry, n= 4,402, and Swedish Twin Study of Child and Adolescent Development, n= 1,089) and a clinical sample (n= 1,933). We used cross-lagged modeling in the Generation R Study to assess cross-sectional and longitudinal associations between dimensions. DBPs were assessed using mother-reported responses to the Child Behavior Checklist. Empirically obtained dimensions of DBPs were oppositional behavior (age 6 years), disobedient behavior, rule-breaking behavior (age 10 years), physical aggression, and irritability (both ages). FMMs suggested that one-class solutions had the best model fit for all dimensions in all three population-based cohorts. Similar results were obtained in the clinical sample. All three dimensions, including irritability, predicted subsequent physical aggression (range, 0.08-0.16). This study showed that childhood DBPs should be regarded as a multidimensional phenotype rather than comprising distinct subgroups. Incorporating multidimensionality will improve diagnostic accuracy and refine treatment. Future studies need to address the biological validity of the DBP dimensions observed in this study; herein lies an important opportunity for neuroimaging and genetic measures.

Sex differences in the associations between vagal reactivity and oppositional defiant disorder symptoms.

BackgroundVagal reactivity to stress in children has been associated with future psychiatric outcomes. However, results have been mixed possibly because these effects are in opposite direction in boys and girls. These sex differences are relevant in the context of development of psychopathology, whereby the rates of psychiatric disorders differ by sex. In this study, we aimed to examine the association between vagal reactivity, assessed as a reduction in respiratory sinus arrhythmia (RSA) in response to a challenge, and the development of future oppositional defiant disorder (ODD) symptoms in boys and girls. In addition, we examine the specific associations with ODD symptom dimensions, named irritability and headstrong. We hypothesized that increased vagal reactivity was associated with increased ODD symptoms in girls and a reduction in ODD symptoms in boys.MethodsParticipants were members of the Wirral Child Health and Development Study, a prospective epidemiological longitudinal study of 1,233 first‐time mothers recruited at 20 weeks’ gestation. RSA during four nonstressful and one stressful (still‐face) procedures was assessed when children were aged 29 weeks in a sample stratified by adversity (n = 270). Maternal reports of ODD symptoms were collected when children were 2.5 years old (n = 253), 3.5 years old (n = 826), and 5 years old (n = 770). Structural equation modeling (SEM) was employed to test our hypotheses.ResultsThere was a significant sex difference in the prediction of ODD symptoms due to the opposite directionality in which increasing vagal reactivity was associated with an increase in ODD symptoms in girls and a reduction of ODD symptoms in boys. This Sex by Vagal reactivity interaction was common for both ODD dimensions, with no sex by dimension‐specific associations.ConclusionsPhysiological reactivity to a stressful situation predicts differently ODD symptoms in boys and girls very early in life, with no difference across irritability and headstrong components. Findings are discussed in the context of the several mechanisms involved on the later development of distinct psychiatric disorders in boys and girls.

Testing Multiple Conceptualizations of Oppositional Defiant Disorder in Youth

Recent theories conceptualize oppositional defiant disorder (ODD) as a two-dimensional construct with angry/irritable (i.e., affective) and argumentative/defiant (i.e., behavioral) components. This view has been supported by studies of nonreferred youth but not yet examined in clinic-referred youth. In a reanalysis of data regarding children who received one of two psychosocial ODD treatments, we examined multiple conceptualizations of ODD, whether children showed improvements across these ODD dimensions, and whether main and joint effects of ODD dimension improvement predicted clinical outcome. One hundred thirty-four clinic-referred youth (ages 7–14 years, 38% female, 84% White) who met Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for ODD received 1 of 2 psychosocial treatments. At pretreatment, 1-week follow-up, and 6-month follow-up, mothers reported child aggression and conduct problems, clinicians reported global clinical impairment and clinical improvement, and ODD symptom counts were collected from a semistructured diagnostic interview with mothers. Baseline ODD symptom were used to test previously supported multidimensional models. One- and two-factor conceptualizations were supported; however, the two-factor solution was preferred. With this solution, each dimension significantly and similarly improved across treatment conditions. Improvements across affective and behavioral ODD factors also had significant effects on clinician- and mother-reported clinical outcomes. The current findings provide empirical support for the ongoing study of multidimensional ODD conceptualizations in clinic-referred youth.

Age 4 Predictors of Oppositional Defiant Disorder in Early Grammar School

Our ability to predict which children will exhibit oppositional defiant disorder (ODD) at the time of entry into grammar school at age 6 lags behind our understanding of the risk factors for ODD. This study examined how well a set of multidomain risk factors for ODD assessed in 4-year-old children predicted age 6 ODD diagnostic status. Participants were a diverse sample of 796 4-year-old children (391 boys).The sample was 54% White, non-Hispanic; 16.8% African American, 20.4% Hispanic; 2.4% Asian; and 4.4% Other or mixed race. The classification accuracy of two models of multidomain risk factors, using either a measure of overall ODD symptoms or dimensions of ODD obtained at age 4, were compared to one another, to chance, and to a parsimonious model based solely on parent-reported ODD using Automated Classification Tree Analysis. Effect Strength for Sensitivity (ESS), a measure of classification accuracy, indicated a multidomain model including a general measure of ODD symptoms at age 4 yielded a large effect (56.29%), a 13.7% increase over the ESS for the parsimonious model (ESS = 42.9%). The ESS (51.23%) for a model including two ODD dimensions (behavior and negative affect) was smaller than that for the model including a measure of overall ODD symptoms. The Classification Tree Analysis approach showed a small but distinct advantage that would be useful in screening for which children would most likely meet criteria for age 6 ODD.

Neuropsychological Predictors of ODD Symptom Dimensions in Young Children

Oppositional defiant disorder (ODD) is a commonly diagnosed childhood behavior disorder, yet knowledge of relations between ODD and early neuropsychological functions, particularly independent of attention deficit/hyperactivity disorder (ADHD), is still limited. In addition, studies have not examined neuropsy chological functioning as it relates to the different ODD symptom dimensions. Structural equation modeling was used to investigate how preschool neuropsychological functioning predicted negative affect, oppositional behavior, and antagonistic behavior symptom dimensions of ODD in 224 six-year-old children, oversampled for early behavior problems. Working memory, inhibition, and sustained attention predicted negative affect symptoms of ODD, controlling for ADHD, whereas delay aversion uniquely predicted oppositional behavior, controlling for ADHD. Delay aversion also marginally predicted antagonistic behavior, controlling for ADHD. Results demonstrate that different ODD symptom dimensions may be differentially predicted by different neuropsychological functions. The findings further underscore the importance of future research on ODD to take into account the possible heterogeneity of both symptoms and underlying neuropsychological functioning.

Oppositional defiant disorder dimensions: genetic influences and risk for later psychopathology.

This study was undertaken to determine how well two oppositional defiant disorder (ODD) dimensions (irritable and headstrong/hurtful) assessed in childhood predict late adolescent psychopathology and the degree towhich these outcomes can be attributed to genetic influences shared with ODD dimensions. Psychopathology was assessed via diagnostic interviews of 1,225 twin pairs at ages 11 and 17. Consistent with hypotheses, the irritable dimension uniquely predicted overall internalizing problems, whereas the headstrong/hurtful dimension uniquely predicted substance use disorder symptoms. Both dimensions were predictive of antisocial behavior and overall externalizing problems. The expected relationships between the irritable dimension and specific internalizing disorders were not found. Twin modeling showed that the irritable and headstrong/hurtful dimensions were related to late adolescent psychopathology symptoms through common genetic influences. Symptoms of ODD in childhood pose a significant risk for various mental health outcomes in late adolescence. Further, common genetic influences underlie the covariance between irritable symptoms in childhood and overall internalizing problems in late adolescence, whereas headstrong/hurtful symptoms share genetic influences with substance use disorder symptoms. Antisocial behavior and overall externalizing share common genetic influences with both the irritable and headstrong/hurtful dimensions.