Oppositional Defiant Disorder In Children Research Articles

The Mutual Influence Between Marital Quality and Child Oppositional Defiant Disorder Symptoms in Chinese Families: Do Child and Parent’s Gender Matter?

Frequent exposure to poor marital relationship is closely associated with behavioral and emotional problems in children, including oppositional defiant disorder (ODD) symptoms. However, the longitudinal links between parental marital quality and child ODD symptoms, and whether these links vary by child or parent gender remain unclear. In the present study, we aimed to examine the bidirectional associations between parental marital quality and child ODD symptoms and whether the associations differed across parent and child gender. The sample included 253 children with ODD and their parents and teachers from Mainland China. Parental marital quality and child ODD symptoms were measured at two waves (T1, T2), roughly 1 year apart. Results from cross-lagged analyses showed bidirectional associations between parental marital quality and child ODD symptoms in the whole sample. Specifically, more child ODD symptoms predicted poorer parental marital quality, and lower levels of parental marital quality predicted subsequent increase in child ODD symptoms. Multigroup path analysis indicated that these associations differed across child gender. That is, girls but not boys’ ODD symptoms predicted poorer parental marital quality; marital quality predicted subsequent ODD symptoms for boys but not for girls. There was no difference in the association between marital quality and child ODD symptoms for mothers and fathers. Results highlight the importance of considering child gender in understanding the bidirectional relations between parental marital quality and child ODD symptoms.

The Relationship between Cognitive-Behavioral Skills and Mother-Child Interaction with Symptoms of Conduct Disorder and Oppositional Defiant Disorder in Children with ADHD

Introduction: Nowadays, the main focus of modern researches in the field of ADHD has been on the area of comorbid disorders and reducing their symptoms. In this regard, cognitive-behavioral therapies have tried to reduce the symptoms by using methods such as self-control, problem-solving, and social skills. Given the important role of the family, the present study investigated the pre-assumptions of the treatment by addressing the structural relationships between the social skills, problem-solving skills, and self-control with the symptoms of conduct disorder and oppositional defiant disorders in the children with ADHD and the mediating role of the mother-child interaction. Methods: This study was performed on 104 male students, fourth to sixth grade students of the elementary schools in Yazd City, Iran. In this study, the Child Symptom Inventory (CSI), Child-Parent Relationship Scale (CPRS), Problem-Solving Inventory (PSI), Self-Control Rating Scale (SCRS), and Matson Evaluation of Social Skills with Youngsters (MESSY) were used. The results were analyzed with path analysis by SPSS software version 23. Results: Findings showed that problem-solving skills, self-control skills, social skills, and mother-child interaction can explain 75% of the variance of CD and 71% of the variance of ODD in the model. In another section of the analysis, the findings showed that the effect of problem-solving and self-control skills on the mother-child interaction was significant, but the social skills had no significant effect on the mother-child interaction. Also, the problem-solving variable can affect the CD through the mediating variable in the mother-child interaction, and also has a direct relationship with the current disorder but does not have a significant effect on ODD. The self-control variable in addition to its direct relationship to disorder can affect CD and ODD through the mother-child interaction. Conclusion: Self-control, problem-solving, and social skills are associated with the symptoms of behavioral disorders in the children with ADHD, and can be used in designing cognitive-behavioral therapy packages, and also the way the mother and child interact, is effective in this type of treatments. Keywords: Attention Deficit and Hyperactivity Disorder, Conduct Disorder, Oppositional Defiant Disorder, Cognitive Behavioral Therapy, Mother-Child Interaction

Longitudinal linkages between parenting stress and oppositional defiant disorder (ODD) symptoms among Chinese children with ODD.

Parents of children with oppositional defiant disorder (ODD) experience considerable stress and challenges in parenting. Based on a 2-year, 3-wave longitudinal study of children with ODD (N = 243, mean age = 9.47 years, SD = 1.53; 72.8% boys) and their parents in Mainland China, our study examined the relation between 3 dimensions of parenting stress (i.e., Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child) and their children's ODD symptoms. Using cross-lagged panel models, we tested the bidirectional relation between parenting stress and children's ODD symptoms. We found evidence for both parent-driven and child-driven effects. Specifically, Parent-Child Dysfunctional Interaction (PCDI) at T2 positively predicted children's ODD symptoms at T3. Moreover, children's ODD symptoms at T1 positively predicted parental perceptions of Difficult Child and PCDI at T2. Further, children's ODD symptoms at T2 positively predicted all 3 dimensions of parenting stress at T3. Further, multiple-group path analysis by child's gender suggested that PCDI had a significant negative relation with girls' (but not boys') ODD symptoms from T1 to T2 and had a significant positive relation with boys' (but not girls) ODD symptoms from T2 to T3. These findings provided support for the dynamic relations among parenting stress, parent-child interaction, and children's ODD symptoms and highlighted the different effects of child gender in the parent-child interaction process. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Informant-specific reports of peer and teacher relationships buffer the effects of harsh parenting on children's oppositional defiant disorder during kindergarten.

Harsh and restrictive parenting are well-established contributors to the development of oppositional defiant disorder (ODD) among children. However, few studies have explored whether interpersonal relationships that develop outside the family environment attenuate the risk for ODD that is associated with harsh parenting. The current study tested multireporter measures of teacher-child closeness and peer acceptance as moderators of the association between harsh parenting and children's ODD as children's social worlds widen during the kindergarten year (N = 338 children, 48% girls, M age = 5.32 years). Harsh parenting interacted with peer nominations of peer acceptance and children's report of teacher-child closeness to predict children's ODD symptoms in the spring, adjusting for fall symptoms. Children exposed to harsh parenting exhibited greater symptom increases when they were less liked/accepted playmates and in the context of lower teacher-child closeness. However, harsh parenting was not associated with symptom change among children with higher levels of peer-nominated acceptance and those who reported closer relationships with teachers. There were no significant interactions using teacher's report of peer acceptance or teacher's report of teacher-child closeness. Findings highlight positive peer and teacher relationships as promising targets of intervention among children exposed to harsh parenting and support the importance of assessing multiple perspectives of children's social functioning.

Child-based treatment of oppositional defiant disorder: mediating effects on parental depression, anxiety and stress.

Previous research has shown that child-oppositional defiant disorder (ODD) and conduct disorders (CD) are associated with parental symptoms of depression, anxiety and/or stress, probably in a bidirectional relationship with mutual influences. It is, therefore, reasonable to assume that in child-centered treatment, a decrease in child-oppositional behavior problems constitutes (at least in part) a mechanism of change for a subsequent reduction in parental psychopathology. The aim of the present study (Clinical trials.gov Identifier: NCT01406067) was to examine whether the reduction in ODD symptoms due to child-based cognitive behavioral treatment (CBT) led to a reduction in parental depression, anxiety and stress. Eighty-one boys (age 6-12years) with a diagnosis of ODD/CD were randomized either to a cognitive behavioral intervention group or an educational play group (acting as control group). Mediation analyses were conducted using path analysis. The stronger reduction in child ODD symptoms in the CBT group compared to the control group led to a decrease in parental depression and stress, as indicated by significant indirect effects (ab = 0.07 and ab = 0.08, p < 0.05). The proposed model for mechanisms of change was, therefore, confirmed for two of the three outcome parameters. Parental psychopathology and stress can be modified by child-centered CBT. The preceding reduction in ODD symptoms acts as a mediator for at least some of the changes in parental depression and stress. However, due to some limitations of the study, other possible explanations for the results found cannot be completely ruled out and are, therefore, discussed.

Parents’ Executive Functions, Parenting Styles, and Oppositional Defiant Disorder Symptoms: A Relational Model

The present study examined the role of mother’s and father’s executive functions (EF), warmth and harsh parenting, and child oppositional defiant disorder symptoms (ODD). A total of 100 families with preschool children participated. The parents answered three questionnaires: the EMBU, the ECI-4 and each parent answered the BRIEF for evaluating their own EF. The analysis was done by testing two structural equation models (SEM). The results showed that both models had an excellent fit and presented a significant path between mother’s EF toward harsh parenting; the second model presented a significant path from harsh parenting to ODD symptoms. Our findings are concluded in light of the importance of addressing parenting interventions to prevent further conduct/disruptive disorders.

A Longitudinal Study of the Relation Between Family Functioning and Preschool ADHD Symptoms

The present study examined the bidirectional relation between family functioning and attention-deficit/hyperactivity disorder (ADHD) symptoms across the preschool years. Participants included 197 (110 boys) 3-year-old children (M = 44.14 months, SD = 3.43; 60% White) with and without behavior problems and their parents who took part in a 3-year longitudinal study. Parenting, parent psychopathology, life stress, and child symptoms were assessed annually from ages 3 to 6. Cross-lagged models provided evidence for both parent and child effects for mothers. In particular, greater maternal overreactive parenting and life stress were predictive of more child ADHD symptoms, and greater child ADHD symptoms significantly predicted greater maternal life stress and depressive symptoms and lower warmth, controlling for child oppositional defiant disorder and parent ADHD symtoms. Child effects were evident for fathers’ depression and life stress, but these did not remain controlling for paternal ADHD symptoms. Findings suggest that targeting child ADHD symptoms, maternal overreactive parenting, and maternal stress each hold promise for attenuating the negative mutual influence of child ADHD symptoms and family functioning over time.

Parental involvement as an etiological moderator of middle childhood oppositional defiant disorder.

The goal of this study was to investigate parental involvement as an etiologic moderator of oppositional defiant disorder (ODD) during middle childhood. Previous studies examining the influence of genetic and environmental factors on ODD have not considered whether and how these factors might vary by parental involvement. We thus conducted a series of "latent genetic by measured environmental" interaction analyses, in which measured parental involvement was allowed to moderate genetic, shared, and nonshared environmental influences on child ODD. Participants include 1,027 twin pairs (age ranged from 6 to 11 years old) from the Michigan State University Twin Registry. Results did indeed suggest that the etiology of ODD varies with maternal involvement, such that genetic influence on ODD became more prominent as maternal involvement decreased. However, these results were specific to children's perceptions of maternal involvement and did not extend to maternal perceptions of her involvement. There was no evidence that paternal involvement moderated the etiology of ODD, regardless of informant. The different results found in twins' and parents' data are consistent with those in previous research showing that children may have different perceptions from parents' about their family relationships and that this discrepancy needs to be taken into account in future research. (PsycINFO Database Record

Interrelationships and Continuities in Symptoms of Oppositional Defiant and Conduct Disorders from Age 4 to 10 in the Community

Childhood oppositional defiant disorder (ODD) has commonly been thought to increase the risk of conduct disorder (CD) in late childhood and adolescence. However, symptoms of CD may also emerge during preschool and middle childhood. The few studies that have examined whether ODD increases the risk of such early onset CD have produced equivocal results, potentially due to methodological issues. In this study, a community sample of Norwegian 4-year-olds (n = 1042, 49.9 % males) was examined bi-annually over four waves of data collection. Symptoms of ODD, CD, attention-deficit/hyperactivity disorder (ADHD), anxiety and depressive disorders were measured through interviews with parents and children using the Preschool Age Psychiatric Assessment and the Child and Adolescent Psychiatric Assessment. The results showed that at all ages, more symptoms of ODD predicted more symptoms of CD at the next age of examination even after adjusting for previous CD and comorbid conditions. The effect of previous ODD on CD two years later did not differ according to gender, SES, or parental cohabitating status at any point in time. There was modest homotypical continuity in symptoms of CD and moderate homotypical continuity in symptoms of ODD. Symptoms of ODD increased from age 4 to 8 and declined to age 10. In conclusion, symptoms of ODD increase the risk of early onset symptoms of CD. The continuity in symptoms of ODD, and to some extent CD, combined with an increased risk of early symptoms of CD forecasted by symptoms of ODD, underscore the importance of detection, prevention and treatment of behavioral disorders already in early childhood.

Emotional Abilities in Children with Oppositional Defiant Disorder (ODD): Impairments in Perspective-Taking and Understanding Mixed Emotions are Associated with High Callous-Unemotional Traits.

Most studies of emotion abilities in disruptive children focus on emotion expression recognition. This study compared 74 children aged 4-8years with ODD to 45 comparison children (33 healthy; 12 with an anxiety disorder) on behaviourally assessed measures of emotion perception, emotion perspective-taking, knowledge of emotions causes and understanding ambivalent emotions and on parent-reported cognitive and affective empathy. Adjusting for child's sex, age and expressive language ODD children showed a paucity in attributing causes to emotions but no other deficits relative to the comparison groups. ODD boys with high levels of callous-unemotional traits (CU) (n=22) showed deficits relative to low CU ODD boys (n=25) in emotion perspective-taking and in understanding ambivalent emotions. Low CU ODD boys did not differ from the healthy typically developing boys (n=12). Impairments in emotion perceptive-taking and understanding mixed emotions in ODD boys are associated with the presence of a high level of CU.

Is Emotional Lability Distinct From “Angry/Irritable Mood,” “Negative Affect,” or Other Subdimensions of Oppositional Defiant Disorder in Children With ADHD?

Objective: Emotional lability (EL) and oppositional defiant disorder (ODD) frequently co-occur with ADHD. This study evaluates whether EL merely represents the negative “mood/affect” component of ODD or forms a distinct dimension. Method: EL and ODD data from 1,317 ADHD participants were analyzed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) for binary data. Results: Within ADHD, 39.4% children had ODD and 42.6% had EL. A sizable proportion expressed only either ODD or EL: 16.6% had ODD-only, 19.7% had EL-only, and 22.9% expressed both. In both EFA and CFA, EL forms a separate dimension from ODD items and the “mood/affect” subdimensions (whether classified by Diagnostic and Statistical Manual of Mental Disorders [5th ed.; DSM-5] or the Burke et al. models or the de novo ODD subdimensions derived from our data). This factorial structure remains invariant across gender. Conclusion: EL is distinct from ODD and its “mood/affect” subdimensions. In line with emerging evidence, our findings provide further evidence of factorial validity for EL as a separate construct from ODD.

Multiple Family Groups to reduce child disruptive behavior difficulties: Moderating effects of child welfare status on child outcomes

Children who remain at home with their permanent caregivers following a child welfare (CW) involvement (e.g., investigation, out-of-home placement) manifest high rates of behavioral difficulties, which is a risk factor for further maltreatment and out-of-home placement if not treated effectively. A recently tested Multiple Family Group (MFG) service delivery model to treat youth Disruptive Behavior Disorders (DBDs) has demonstrated effectiveness in improving child behavior difficulties among hard-to-engage, socioeconomically disadvantaged families by addressing parenting skills, parent–child relationships, family communication and organization, social support, and stress. This exploratory study examines whether child behavioral outcomes for MFG differ for families with self-reported lifetime involvement in CW services compared to other families, as families with CW involvement struggle with additional stressors that can diminish treatment success. Youth (aged 7–11) and their families were assigned to MFG or services as usual (SAU) using a block comparison design. Caregivers reported on child behavior, social skills, and functional impairment. Mixed effects regression modeled multilevel outcomes across 4 assessment points (i.e., baseline, mid-test, post-test, 6-month follow-up). Among CW-involved families, MFG participants reported significantly reduced child oppositional defiant disorder symptoms at 6-month follow-up compared with SAU participants. No other differences were found in the effect of MFG treatment between CW and non-CW involved families. Findings suggest that MFG may be as effective in reducing child behavior difficulties for both CW and non-CW involved families. As a short-term, engaging, and efficient intervention, MFG may be a particularly salient service offering for families involved in the CW system.

Treatment of Childhood Oppositional Defiant Disorder

Oppositional defiant disorder (ODD) is a common behavioral disorder of childhood which can be described as a learned pattern of behavior reinforced by caregivers’ responses. Behavioral modification for ODD, particularly in preschool and school-aged children, should primarily focus on teaching caregivers to reinforce positive behaviors, discourage negative behaviors, and ultimately interrupt the cycle of argumentativeness and deliberate attention-seeking behavior. Unfortunately, children who are referred for behavioral therapy for ODD often do not receive evidence-based treatments that target the root cause of the disorder. There is some role for the use of psychopharmacology in the treatment of ODD, though primarily in the treatment of underlying and comorbid disorders. The core symptoms of ODD are not amenable to pharmacotherapy, and behavioral modification is the mainstay of intervention. Attention-deficit hyperactivity disorder (ADHD) frequently occurs with ODD. Poor impulse control is a core feature of ADHD, and appropriate use of stimulant and/or non-stimulant ADHD medications can help children with ODD make better behavioral choices and be more successful with behavior modification programs. There is some evidence for the effectiveness of atypical antipsychotics in disruptive behavior disorders (DBDs), but the target symptoms of explosive and aggressive behaviors are seen only in children with more severe ODD who progress to conduct disorder (CD). Pediatric providers should understand the evidence-based behavioral interventions and targeted psychiatric medications that will achieve the best outcomes for children with ODD.

The Role of Parental Temperament Traits in Disruptive Behavioral Disorders of Children with ADHD

Introduction No study up to now investigated the role of parental temperament traits in disruptive behavioral disorders (DBD) of children with attention-deficit/hyperactivity disorder (ADHD). Objectives To determine the relationships between parent temperament characteristics and child DBD symptoms in children with ADHD. Methods The sample consisted of 542 treatment naive children with ADHD aged 6-17 years. All children had to be living with both biological mothers and fathers. The severity of ADHD and comorbid DBD were assessed via parent and teacher rated Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale. Temperamental dimensions of mothers and fathers were measured by TEMPS-A. The association between parental ADHD and DBD was evaluated with two separate structural equation models. Results Relationships of parent ADHD and DBD symptoms were presented in Figures 1 and 2. Discussion This study showed a significant relationship between maternal depressive and paternal cyclothymic affective temperament and conduct disorder, and between maternal anxious and irritable, and paternal cyclothymic affective temperament and oppositional defiant disorder in children with ADHD. This study highlights that children with more severe behavioural symptoms are more likely to have a parent with certain temperament traits. Download : Download full-size image Download : Download full-size image

Impact of Parental ADHD Dimensions On Disruptive Behavioral Disorders Symptomatology in Children with ADHD

Introduction Little is known about the effect of parental attention-deficit/hyperactivity disorder (ADHD) dimensions on the development of disruptive behavioral disorders (DBD) in children with ADHD. Objectives To study the association of parental ADHD on the DBD symptoms in children with ADHD. Methods The sample consisted of 542 treatment naive children with ADHD aged 6-17 years. All children had to be living with both biological mothers and fathers. The severity of ADHD and comorbid DBD were assessed via parent and teacher rated Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale. Current ADHD severity of mothers and fathers were evaluated by a self-report inventory. The association between parental ADHD and DBD was evaluated with two separate structural equation models. Results Relationships of parent ADHD and DBD symptoms were presented in Figures 1 and 2. Discussion These results suggest maternal hyperactivity may be a vulnerability factor for the development of conduct disorder and oppositional defiant disorder in children with ADHD. Download full-size image Download full-size image

Emotion Socialization in the Context of Risk and Psychopathology: Maternal Emotion Coaching Predicts Better Treatment Outcomes for Emotionally Labile Children with Oppositional Defiant Disorder.

We examined whether maternal emotion coaching at pre-treatment predicted children's treatment response following a 12-week program addressing children's Oppositional Defiant Disorder (ODD) symptoms. Eighty-nine mother-child dyads participated. At pre-treatment, mothers and children engaged in an emotion talk task. Mothers also reported their beliefs about emotions at pre-treatment and their child's disruptive behavior symptoms, emotion regulation, and emotion lability/negativity at pre-, mid-, and post-treatment. Clinicians reported children's symptom severity at pre- and post-treatment. Children's emotion lability/negativity moderated effects of maternal emotion coaching on children's post-treatment ODD symptoms, with stronger benefits of emotion coaching for children high in emotion lability/negativity. Results suggest that emotion coaching may promote treatment response for children with ODD who are especially at risk due to their emotionality.

Parenting practices as mediating variables between parents' psychopathology and oppositional defiant disorder in preschoolers.

Oppositional defiant disorder (ODD) is very frequent in preschoolers. The severity and the long-term negative outcomes make the understanding of this disorder a priority. The goal in this study was to assess the mediating role of parenting practices in the relationship between parents' psychopathology and ODD in preschoolers. A community sample of 622 children was assessed longitudinally at age 3 and age 5. Parents reported on children's psychopathology through a diagnostic interview, and on their own psychological state and parenting style through questionnaires. At ages 3 and 5, corporal punishment mediated the relationships between mothers' anxiety-depression and ODD (in girls), between mothers' aggressive behavior and ODD (in boys), and between parents' rule-breaking and ODD both in boys and girls. For both sexes, there was a direct association between mothers' aggressive behavior score and ODD. The association between fathers' psychopathology and ODD was not mediated by the fathers' parenting practices. Fathers' anxiety-depression and aggressive behavior scores were directly associated with ODD. Parents' psychopathology must be explored and, in families where such psychopathology is a relevant variable, parenting practices must be addressed with a view to the prevention and treatment of children's ODD in the preschool years.

Callous‐unemotional traits in children and mechanisms of impaired eye contact during expressions of love: a treatment target?

We previously hypothesised that the early development of psychopathy is associated with a failure to attend to the eyes of attachment figures, and we have presented preliminary data from a parent-child 'love' scenario in support of this. Here, we confirm the association in a larger sample and test mechanisms of impaired eye contact during expressions of love in control and behaviourally disturbed children. Oppositional defiant disorder children, assessed for callous-unemotional (CU) traits, and controls, were observed in a brief interaction task where the mother was asked to show love to her child. Eye contact and affection were measured for each dyad. As predicted, there were no group differences in affection and eye contact expressed by mothers; levels of CU traits predicted low levels of eye contact towards their mothers across all groups of children. As expected, low eye contact was correlated with psychopathic fearlessness in their fathers, and maternal reports of negative feelings towards the child. Independent observations showed that child's behaviour largely drives the low eye contact associated with CU traits, and low eye contact was not associated with independent observations of the quality of attachment-related behaviours in mothers. Impaired eye contact is a unique characteristic of children with CU traits; these impairments are largely independent of maternal behaviour, but associated with psychopathic traits in the fathers. These impairments should be tested for functional significance and amenability to change in longitudinal and treatment studies.

The latent structure of oppositional defiant disorder in children and adults

An understanding of the latent structure of oppositional defiant disorder (ODD) is essential for better developing causal models, improving diagnostic and assessment procedures, and enhancing treatments for the disorder. Although much research has focused on ODD—including recent studies informing the diagnostic criteria for DSM-5—research examining the latent structure of ODD is sparse, and no known study has specifically undertaken a taxometric analysis to address the issue of whether ODD is a categorical or dimensional construct. To address this gap, the authors conducted two separate studies using a set of taxometric analyses with data from the NICHD Study of Early Child Care and Youth Development (child study; n = 969) and with data from a large mixed sample of adults, which included participants reporting psychiatric difficulties as well as healthy controls (adult study; n = 600). The results of a variety of non-redundant analyses across both studies revealed a dimensional latent structure for ODD symptoms among both children and adults. These findings are consistent with previous studies that have examined latent structure of related constructs (e.g., aggression, antisocial behavior) as well as studies that have examined the dimensional versus categorical structure of ODD using methods other than taxometric analysis.

Parental warmth and risks of substance use in children with attention-deficit/hyperactivity disorder

Objective: The study examined factors in the risk trajectory for substance use disorder (SUD) over a 10–12-year period in children with attention-deficit/hyperactivity disorder (ADHD). Method: N = 145 children between the ages of 7 and 16 with ADHD and healthy controls (HCs) were assessed every 2 years for 10–12 years as part of a larger, longitudinal investigation. Onset of SUD was examined using Cox proportional hazards modeling, and included child and parent psychopathology, and parental warmth as well as other key factors. Results: Low paternal warmth and maternal SUD were predictors of SUD in n = 59 ADHD participants after adjusting for gender, child oppositional defiant disorder (ODD), paternal SUD, maternal/paternal ADHD, maternal/paternal major depressive disorder, maternal/paternal anxiety and low maternal warmth in the Cox model. Conclusions: Longitudinal study findings suggest that in addition to the established risk of ADHD and maternal SUD in development of child SUD, low paternal warmth is also associated with onset of SUD. This was evident after controlling for pertinent parent and child psychopathology. These findings suggest that paternal warmth warrants further investigation as a key target for novel interventions to prevent SUD in children with ADHD. More focused investigations examining paternal parenting factors in addition to parent and child psychopathology in the risk trajectory from ADHD to SUD are now warranted.