Developmental pathways in oppositional defiant disorder and conduct disorder.

Abstract

DSM-IV specifies a developmental relationship between Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD). Evidence for this link is mixed, however, and recent studies suggest that different symptom dimensions in ODD may have different outcomes. We examined links between ODD, CD and their young adult outcomes in the Great Smoky Mountains Study; a longitudinal dataset with over 8000 observations of 1420 individuals (56% male) covering ages 9 to 21 years. ODD was a significant predictor of later CD in boys but not in girls after control for comorbid CD and sub-threshold CD symptomatology. Transitions between ODD and CD were less common than anticipated, however, particularly during adolescence. We examined characteristics and outcomes of children with pure ODD, pure CD and combined CD/ODD. Alongside many similarities in childhood and adolescent correlates, key differences were also identified: CD largely predicted behavioral outcomes, whereas ODD showed stronger prediction to emotional disorders in early adult life. Factor analysis identified irritable and headstrong dimensions in ODD symptoms that showed differential prediction to later behavioral and emotional disorders. Overall, the results underscore the utility of retaining separate ODD and CD diagnoses in DSM-V.

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

“…These two dimensions – named ‘headstrong’ and ‘irritability’ – probably have distinct etiologies (Stringaris, Zavos, Leibenluft, Maughan, & Eley, 2012) and predict different longitudinal outcomes (Stringaris & Goodman, 2009a; Vidal‐Ribas, Brotman, Valdivieso‐Lopez, Leibenluft, & Stringaris, 2016), with irritability associated with depression and headstrong with conduct problems and attention‐deficit hyperactivity disorder (ADHD) (Burke, Hipwell, & Loeber, 2010; Stringaris & Goodman, 2009a). Sex differences in predictions from ODD have also been described; ODD in girls is associated with later depression and anxiety, whereas in boys, it is associated with conduct disorders (Rowe, Costello, Angold, Copeland, & Maughan, 2010). …”

Deterioro funcional asociado a los síntomas del trastorno negativista desafiante en niños y niñas de 3 a 7 años de la población general

“…Furthermore, it has been documented that greater parental attention to negative emotions is found for boys compared to girls (Chaplin, Cole, & Zahn-Waxler, 2005), and this might lead to more attention being paid to their consequences, resulting in higher impairment scores in boys. Finally, oppositionality might be measuring different things in boys and girls, as suggested by evidence from the Great Smoky Mountains Study, where ODD was more likely to progress to CD in boys but to internalizing disorder in girls (Rowe, Costello, Angold, Copeland, & Maughan, 2010;Rowe, et al, 2002). This is one of the few studies that reports on the impact of DSM-IV ODD diagnoses and symptoms for this age range (3 to 7) in a European sample of the general popula-anales de psicología, 2014, vol.…”

Mood regulation in youth

“…Outside the US, children with severe irritability are more often diagnosed with oppositional defiant disorder (ODD), a label that implies a behavioural disturbance rather than a mood problem. However, recent research [10][11][12][13] suggests that irritability may be a separable dimension with different long-term outcomes compared to other oppositional symptoms (termed headstrong and hurtful). Irritability seems to be a stronger predictor of depressive disorders 14 and the overlap may be due to genetic factors 15 .…”