Child Oppositional Defiant Disorder Symptoms Research Articles

Negative Parenting Mediates the Longitudinal Association between Parental Internalizing Symptoms and Child Oppositional Symptoms.

Research has pointed to both cross-sectional and longitudinal associations between parental internalizing symptoms and child externalizing symptoms. This study analyzed whether the association is mediated by negative parenting behavior in view of previous reports that both parental internalizing symptoms and child externalizing symptoms are related to parenting behaviors. Longitudinal data for the current analyses were derived from a randomized controlled trial on the efficacy of a web-assisted self-help intervention for parents of children with elevated levels of externalizing symptoms. Two different mediation models were analyzed, one using attention-deficit/hyperactivity disorder (ADHD) symptoms as the dependent variable and the other using oppositional defiant disorder (ODD) symptoms. Both models included parental internalizing symptoms as the independent variable, negative parenting behavior as a mediator, and study condition as a confounder. The longitudinal analyses support the mediating role of negative parenting behavior in the association between early parental internalizing symptoms and later child ODD symptoms.

Association of Affiliate Stigma with Parenting Stress and Its Moderators among Caregivers of Children with Attention-Deficit/Hyperactivity Disorder

Caring for children with attention-deficit/hyperactivity disorder (CADHD) is stressful for caregivers. Identifying factors related to parenting stress in caregivers of CADHD can facilitate the development of intervention programs. This study aimed to examine the associations between affiliate stigma and various domains of parenting stress among caregivers of CADHD. This study also analyzed the moderating effects of demographic characteristics and the symptoms of childhood ADHD and oppositional defiant disorder (ODD) on the associations between affiliate stigma and parenting stress. In total, 213 caregivers of CADHD participated in this study. Parenting stress was assessed using the Parenting Stress Index, Fourth Edition Short Form (PSI-4-SF). Affiliate stigma was assessed using the Affiliate Stigma Scale. ADHD and ODD symptoms were assessed using the Parent Form of the Swanson, Nolan, and Pelham Scale, Version IV. The results indicated that higher affiliate stigma was significantly associated with greater parenting stress in all three domains of the PSI-4-SF. ODD symptoms increased the magnitude of parenting stress in two domains of parenting stress among caregivers with affiliate stigma. Intervention programs for relieving parenting stress among caregivers of CADHD should take affiliate stigma and child ODD symptoms into consideration.

Assessment of oppositional defiant disorder and oppositional behavior in children and adolescents with Down syndrome.

Children and adolescents with intellectual disability (ID) exhibit higher rates of oppositional defiant disorder (ODD) than typically developing (TD) peers. However, studies focusing on the investigation of ODD prevalence in youth with Down syndrome (DS) are still limited. The current study aimed to investigate the prevalence of ODD clinical and subclinical symptoms in a group of 101 youth with DS (63 boys, 38 girls) ranging in age from 6 to 18 years. Moreover, the prevalence of ODD symptoms, as detected by means of three parent-report questionnaires, was compared with that detected by a semi-structured psychopathological interview, namely, the Schedule for Affective Disorders and Schizophrenia for School Aged Children Present and Lifetime (K-SADS) Version Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). We found that 17% of participants met diagnostic criteria for ODD on the K-SADS, whereas 24% exhibited subclinical symptoms. Results also suggest good specificity of Swanson, Nolan, and Pelham-IV Rating Scale (SNAP-IV), Conners' Parent Rating Scales Long Version (CPRS) and Child Behavior Checklist (CBCL) in detecting ODD symptoms. The investigation of the agreement in the prevalence rates of clinical and subclinical symptoms of ODD between K-SADS and the parent-report questionnaires indicated CPRS as the parent-report questionnaire with the best agreement with K-SADS. This study provides support for the use of parent-report questionnaires to assess ODD symptoms in children and adolescents with DS by evaluating their levels of agreement with a semi-structured psychopathological interview. In particular, our results suggest that CPRS could be considered a suitable screening tool for ODD clinical and subclinical symptoms in youth with DS.

A Systematic Review of Multiple Family Factors Associated with Oppositional Defiant Disorder.

Oppositional Defiant Disorder (ODD) is characterized by a recurrent pattern of angry/irritable emotional lability, argumentative/defiant behavior, and vindictiveness. Previous studies indicated that ODD typically might originate within a maladaptive family environment, or was at least maintained within such an environment. As such, the present review summarized pertinent research from the last 20 years that focused on the pathways connecting family risk factors to the development of child ODD symptoms. A systematic search of electronic databases was completed in August 2020, resulting in the inclusion of 62 studies in the review. The review established a multi-level framework to describe the mechanisms underlying the pathway from familial factors to ODD psychopathological symptoms: (a) the system level that is affected by the family’s socioeconomic status and family dysfunction; (b) the dyadic level that is affected by conflict within the marital dyad and parent–child interactions; and (c) the individual level that is affected by parent and child factors. Additionally, from the perspective of family systems theory, we pay special attention to the interactions among and between the various levels of the pathway (moderation and mediation) that might be associated with the occurrence and severity of ODD symptoms. Considering future prevention and intervention efforts, this three-level model emphasizes the necessity of focusing on familial risk factors at multiple levels and the mechanisms underlying the proposed pathways.

Family Risk Factors Associated With Oppositional Defiant Disorder Symptoms, Depressive Symptoms, and Aggressive Behaviors Among Chinese Children With Oppositional Defiant Disorder.

Family factors including parental emotion dysregulation and harsh parenting practices place children at high risk for malfunctioning in emotion regulation, depressive symptoms, and aggressive behaviors. This study investigated the associations among parental emotion dysregulation, harsh parenting practices (i.e., emotional abuse and corporal punishment), and child emotion regulation and child oppositional defiant disorder (ODD) symptoms and co-occurring depressive symptoms and aggressive behaviors. Participants included 239 parent–child dyads from 14 primary schools in Mainland China. All children were diagnosed with ODD. Parental emotion dysregulation, harsh parenting practices, and child emotion regulation were reported by parents; child ODD symptoms were reported by parents and teachers; child depressive symptoms were reported by children; and child aggressive behaviors were reported by teachers. Data indicated that parental emotion dysregulation was related to child ODD symptoms in the home and depressive symptoms indirectly through harsh parenting practices and child emotion regulation. Harsh parenting practices were related to child ODD symptoms in the home directly and indirectly through child emotion regulation. Moreover, emotional abuse was associated with child depressive symptoms directly and indirectly through child emotion regulation. Our findings highlighted the need for prevention and intervention targeting parent emotion dysregulation and harsh parenting practices among children with ODD.

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.

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.

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.

Longitudinal Associations between Oppositional Defiant Symptoms and Interpersonal Relationships among Chinese Children.

Children with oppositional defiant disorder (ODD) are at increased risk for developing poor relationships with people around them, but the longitudinal links between ODD symptoms and subsequent interpersonal functioning remain unclear. In the current study, we examined the bidirectional associations between ODD symptoms and children's relationships with parents, peers, and teachers. We included separate analyses for parent vs. teacher reports of ODD symptoms, with regard to subsequent interpersonal relationships. Participants included 256 children with ODD, recruited in China, along with their parents and teachers, assessed at three time points roughly two years apart. Parents and teachers reported child ODD symptoms at each time point, and children reported their perceptions of father- and mother-child attachment, peer relationships, and teacher-student relationships across the three time points. ODD symptoms reported either by parents or teachers predicted impairments in interpersonal functioning. Meanwhile, child interpersonal impairments with peers and teachers predicted subsequent increase in teacher-reported ODD symptoms. These findings highlight the importance of transactional models of influence-and of considering early intervention for ODD in protecting children from developing further deficits and impairments. Additionally, we discuss the perspectives of multiple informants on ODD symptoms, including their different patterns of association with subsequent interpersonal relationships.

Factor Structure of Teacher Ratings of the ODD Symptoms in Children.

This study used confirmatory factor analysis (CFA) to determine the best model for Oppositional Defiant Disorder (ODD) symptoms in children aged 3 to 15years, as presented in the Disruptive Behavior Rating Scale. Teachers' ratings of the ODD symptoms of 213 children from general community schools in Australia were obtained. The findings provided most support for a bifactor model based on Stringaris and Goodman's [1] three-factor model (primary factors for irritable, hurtful, and headstrong). The general factor, but not the group factors in the model, showed high omega hierarchical and explained common variance. Thus, only the general factor in this model can be meaningfully interpreted. Also, the general factor was supported with regard to external validity. Specifically, this factor, but not the group factors, correlated strongly with ADHD inattention and hyperactivity/impulsivity symptom groups, and other measures of behavioural and emotional problems. The taxonomic, diagnostic, practical, and research implications of the findings are discussed.

Multi-Level Family Factors and Affective and Behavioral Symptoms of Oppositional Defiant Disorder in Chinese Children.

Given the important role of family environment in children's psychological development, the objective of this study was to examine the linkages between family factors at the whole, dyadic, and individual levels and two dimensions (affective and behavioral) of Oppositional Defiant Disorder (ODD) symptoms in Chinese children. Participants comprised of 80 father-child dyads and 169 mother-child dyads from families with ODD children. The results indicated that multilevel family factors were differently associated with children's affective and behavioral ODD symptoms. All the family factors at the dyadic and individual levels were significantly associated with child affective ODD symptoms. However, only the most proximal factors (parent-child relationship and child emotion regulation, which were directly related to child) were significantly related to child behavioral ODD symptoms. The present study extends the current knowledge regarding the relationships between family factors and two dimensions of child ODD symptoms by testing the comprehensive multilevel family factors model. This study also recommends that future interventions for ODD children should consider the multi-level family factors to enhance intervention efficacy.

Multiple Levels of Family Factors and Oppositional Defiant Disorder Symptoms Among Chinese Children

Family factors are closely associated with child developmental outcomes. This study examined the relationship of oppositional defiant disorder (ODD) symptoms and factors at whole family, dyadic, and individual levels in Chinese children. Participants, who were recruited from 14 primary schools in north, east, and south-west China, included 80 father-child dyads and 169 mother-child dyads. Children in the participating dyads were previously diagnosed with ODD. Results revealed that family cohesion/adaptability was indirectly associated with ODD symptoms via parent-child relationship and child emotion regulation. Parent-child relationship affected ODD symptoms directly and indirectly through child emotion regulation. In addition, the effects of family cohesion/adaptability on parent emotion regulation and child emotion regulation were mediated by the parent-child relationship. The tested model provides a comprehensive framework of how family factors at multiple levels are related to child ODD symptoms and highlights the importance of understanding child emotional and behavioral problems within the family context, more specifically within the multiple levels of family relationships.

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.

Incontinence and parent-reported oppositional defiant disorder symptoms in young children--a population-based study.

Oppositional defiant disorder (ODD) and incontinence are common disorders of childhood. We have examined associations between ODD symptoms and incontinence in a representative sample of young children. A questionnaire with seven questions referring to incontinence, eight DSM-IV items of ODD, 15 items of the Home Situations Questionnaire and six items regarding eating, drinking or toileting refusal was administered to the parents of 718 children at school-entry from a defined geographical area at school-entry. Of the 718 6-year-old children included in the analysis, 8.2% had nocturnal enuresis (NE), 1.5% had daytime urinary incontinence (DUI) and 1.1% had faecal incontinence (FI). Significantly more boys than girls had NE (12 vs. 4.3%). Overall, 6.7% of children had ODD symptoms. Rates of ODD symptoms were significantly higher in incontinent children (19.5%) than in continent children (5.2%), with the highest rate of ODD symptoms in children with DUI (36.4%). Children with incontinence (mean 6.1 episodes) or ODD symptoms (mean 8.4 episodes) showed non-compliant behaviours in more problem situations than continent children (mean 4.5 episodes) or children without ODD symptoms (mean 4.5 episodes). Incontinence and ODD are common comorbid disorders at school-entry age. Boys are more affected by both disorders. Children with DUI have the highest rate of ODD symptoms. As ODD symptoms affect many daily family situations, ODD needs to be diagnosed and treated in children with incontinence, as it can negatively affect compliance.

Interpretive Understanding, Sympathy, and Moral Emotion Attribution in Oppositional Defiant Disorder Symptomatology

This study examined the relations between interpretive understanding, sympathy, and moral emotion attribution (MEA) in the prediction of oppositional defiant disorder (ODD) symptomatology in an ethnically diverse sample of 128 4- and 8-year-old children (49 % girls). Caregivers rated the children's ODD symptoms. Interpretive understanding was assessed using an advanced theory-of-mind task. Sympathy was measured via caregiver- and child-report. Strength of MEA was assessed utilizing the children's responses to six hypothetical moral transgressions. Results revealed that interpretive understanding, sympathy, and strength of MEA in the exclusion domain predicted ODD symptoms negatively. Caregiver-reported sympathy partially mediated and moderated the relation between interpretive understanding and ODD symptoms. Strength of MEA in the rule violation domain moderated the relation between interpretive understanding and ODD symptoms. The findings shed light on the importance of social-cognitive and affective-moral antecedents of ODD symptoms.

Tactile sensory dysfunction in children with ADHD.

Objectives: While a group of children with ADHD may have normal behavioral responses to sensory stimuli, another group may be hyperreactive. The aim of this survey was studying association of tactile sensory responsivity with co-morbidity of oppositional defiant disorder (ODD) symptoms, subtypes of ADHD, and gender in children with ADHD. Methods: The subjects were 81 children with ADHD from a child psychiatry clinic. The diagnoses were made according to DSM-IV diagnostic criteria. Tactile dysfunction Checklist was used to assess the three types of tactile sensory dysfunction including Hypersensitivity, hyposensitivity, and poor tactile perception and discrimination (PTPD). Results: Their mean age was 8.4 (SD = 1.9) years. None of the gender, number of symptoms of ODD co-morbidity, and ADHD subtypes was as a predictor of scores of Hyposensitivity and PTPD subscales. Tactile defensiveness was not different between genders and different subtypes of ADHD. Conclusions: Number of ODD symptoms in children with ADHD is a predictor in association with hypersensitivity score of tactile sensory function. Girls are no more than the boys impaired in Hypersensitivity aspect. Different subtypes of ADHD are not distinct disorders regarding to tactile sensory function.

Tactile Sensory Dysfunction in Children with ADHD

Objectives:While a group of children with ADHD may have normal behavioral responses to sensory stimuli, another group may be hyperreactive. The aim of this survey was studying association of tactile sensory responsivity with co-morbidity of oppositional defiant disorder (ODD) symptoms, subtypes of ADHD, and gender in children with ADHD.Methods:The subjects were 81 children with ADHD from a child psychiatry clinic. The diagnoses were made according to DSM-IV diagnostic criteria. Tactile dysfunction Checklist was used to assess the three types of tactile sensory dysfunction including Hypersensitivity, hyposensitivity, and poor tactile perception and discrimination (PTPD).Results:Their mean age was 8.4 (SD = 1.9) years. None of the gender, number of symptoms of ODD co-morbidity, and ADHD subtypes was as a predictor of scores of Hyposensitivity and PTPD subscales. Tactile defensiveness was not different between genders and different subtypes of ADHD.Conclusions:Number of ODD symptoms in children with ADHD is a predictor in association with hypersensitivity score of tactile sensory function. Girls are no more than the boys impaired in Hypersensitivity aspect. Different subtypes of ADHD are not distinct disorders regarding to tactile sensory function.

Depression and Anxiety in Parents of Children With ADHDand Varying Levels of Oppositional Defiant Behaviors:Modeling Relationships With Family Functioning

This study investigated the relation between parental anxiety and family functioning. Parental anxiety and depression, child attention deficit hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD) symptoms were all included as predictors of 3 measures of family functioning to examine the independent contributions of each. Using a self-report battery completed by 45 mother-father pairs, 3 family functioning factors were derived: Parental Warmth and Positive Involvement, Intrusiveness and Negative Discipline, and Social Distress. Multilevel modeling simultaneously estimated the unique contributions of parental and child symptoms on family functioning. Results indicated that parental anxiety was negatively associated with Parental Warmth and Positive Involvement, Intrusiveness and Negative Discipline, and Social Distress; parental depression was only negatively associated with Social Distress. Child ODD symptoms had independent associations with all outcomes; no relations were found with ADHD. Sex moderated the effects of parental anxiety on Parental Warmth and Positive Involvement such that only for mothers did greater anxiety lead to less Parental Warmth and Positive Involvement.