Predicting Depression and Anxiety from Oppositional Defiant Disorder Symptoms in Elementary School-Age Girls and Boys with Conduct Problems

Abstract

This study investigated the relationship between the three DSM-5 categories of oppositional defiant disorder (ODD) symptoms (irritable mood, defiant behavior, vindictive behavior) and anxiety/depression in girls and boys with conduct problems (CP) while controlling for comorbid child psychopathology at baseline. Data were drawn from an ongoing longitudinal study of 6- to 9-year-old French-Canadian children (N = 276; 40.8 % girls) receiving special educational services for CP at school and followed for 2 years. Using linear regression analysis, the results showed that irritable mood symptoms predicted a higher level of depression and anxiety in girls and boys 2 years later, whereas the behavioral symptoms of ODD (e.g., defiant, vindictive symptoms) were linked to lower depression scores. The contribution of ODD symptoms to these predictions, while statistically significant, remained modest. The usefulness of ODD irritable symptoms as a marker for identifying girls and boys with CP who are more vulnerable to developing internalizing problems is discussed.

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

“…Part of the motivation for developing a diagnosis of DMDD was to stem the over-diagnosis of BD in children, and DMDD remains contentious because of its high overlap with Oppositional Defiant Disorder (Mayes et al, 2016) and because of difficulties in accurately applying its criteria in practice (Malhi and Bell, 2019b). As a risk marker for the subsequent onset of MDD, the diagnosis of DMDD is redundant, as its features are already captured by the irritability dimension (as opposed to the vindictive/defiant dimension) of Oppositional Defiant Disorder (Déry et al, 2017). Indeed, the World Health Organization’s International Classification of Diseases, 11th Revision (ICD-11) panel of experts recommend that DMDD symptoms are classified as an ODD specifier rather than a separate diagnosis.…”

Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review

“…Oppositional Defiant Disorder, Conduct Disorder, and Disruptive Mood Dysregulation Disorder Oppositional Defiant Disorder Oppositional Defiant Disorder (ODD) is a disruptive behavior disorder (DBD) of childhood and adolescence that can be described as recurrent, persistent, developmentally inappropriate patterns of anger, irritability, negativity, defiance, disobedience and deliberate hostility toward others, resulting in functional and social impairment (31). Children with ODD commonly experience dysregulated emotions such as temper tantrums, intense fears, inconsolable despair, problems to feel and express emotions, and a low tolerance to frustration (264), co-occurring with externalizing behavior problems (265,266).…”

Dimensions of irritability in adolescents: longitudinal associations with psychopathology in adulthood

“…Most commonly, irritability symptom items are extracted from diagnostic interviews geared to assessing DSM criteria for specific disorders. Most studies use an aggregate of the touchy or easily annoyed, angry or resentful and temper tantrum items from the ODD section of interviews (Stringaris and Goodman, 2009; Rowe et al ., 2010; Burke, 2012; Stringaris et al ., 2012 b ; Whelan et al ., 2013; Althoff et al ., 2014; Lavigne et al ., 2014; Leadbeater and Homel, 2015; Déry et al ., 2017; Rice et al ., 2017). In addition, some studies have combined these items with the irritability symptom items from the depression, dysthymia, and/or mania sections of the interview (Dougherty et al ., 2013; Copeland et al ., 2014; Dougherty et al ., 2015; Pagliaccio et al ., 2018).…”

“…While some reviewers have argued that irritability is primarily related to later internalizing disorders (Vidal-Ribas et al ., 2016; Stringaris et al ., 2018), these conclusions may be premature given limitations in the assessment of externalizing psychopathology. That is, a substantial portion of studies exploring the longitudinal relationship between irritability and psychopathology have not explored links to externalizing disorders at follow-up (Burke, 2012; Lavigne et al ., 2014; Kouros et al ., 2016; Déry et al ., 2017; Rice et al ., 2017). Among studies that do, the focus is largely on ODD, ADHD, and conduct disorder (CD) in adolescents, with relatively less attention to externalizing outcomes in adults, such as substance use disorders (SUD) and antisocial personality disorder (ASPD).…”