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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. B...
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... followed by neuroticism and low agreeableness (0.85 and −0.64, respectively) in a meta-analysis of 40 data sets using the FFM (Gomez & Corr 2014). With regard to disruptive, impulse control, and conduct disorders, for instance, the behavioral component of oppositional defiant disorder in adults is strongly related to antagonism and disinhibition (β = 0.957 and 0.600, respectively), whereas irritability is closer to negative affectivity (β = 0.859) ( Johnston et al. 2020). Moreover, normal personality traits are at the core, and determine the severity, of antisocial PD (Zuckerman 1999). ...
The Alternative Model of Personality Disorders (AMPD) is a dimensional, empirically based diagnostic system developed to overcome the serious limitations of traditional categories. We review the mounting evidence on its convergent and discriminant validity, with an incursion into the less-studied ICD-11 system. In the literature, the AMPD's Pathological Trait Model (Criterion B) shows excellent convergence with normal personality traits, and it could be useful as an organizing framework for mental disorders. In contrast, Personality Functioning (Criterion A) cannot be distinguished from personality traits, lacks both discriminant and incremental validity, and has a shaky theoretical background. We offer some suggestions with a view to the future. These include removing Criterion A, using the real-life consequences of traits as indicators of severity, delving into the dynamic mechanisms underlying traits, and furthering the integration of currently disengaged psychological paradigms that can shape a sounder clinical science.
Expected final online publication date for the Annual Review of Clinical Psychology, Volume 20 is May 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
... Characterizing the magnitude of the stigmatization is necessary to estimate the cost-benefit ratio, as there are demonstrable benefits to receiving a diagnosis, such as selecting evidence-based treatments, making prognoses, and facilitating formal academic support plans. Receiving a diagnosis of ODD or CD can bring relief to parents (e.g., Johnston et al., 2020), and parents retain privilege in regard to the disclosure of protected health records, including diagnoses. While responses to vignettes provide some information, research on stigma should estimate the real-world costs and benefits of assigning any diagnostic labels, including DBDs. ...
... Confirmatory factor analyses (CFAs) robustly support the distinction between the irritable and defiant symptom dimensions of ODD (e.g., Burke et al., 2014;Evans et al., 2017;Herzhoff & Tackett, 2016;Rowe et al., 2010;Waldman et al., 2021). Notably, this evidence stretches from preschool age (e.g., Ezpeleta et al., 2012) to adulthood (Gomez & Stavropoulos, 2019;Johnston et al., 2020). However, latent classification and trajectory models have shown mixed findings. ...
The assessment of oppositional defiant disorder, conduct disorder, antisocial personality disorder, and intermittent explosive disorder-the Disruptive, Impulse Control and Conduct Disorders-can be affected by biases in clinical judgment, including overestimating concerns about distinguishing symptoms from normative behavior and stigma associated with diagnosing antisocial behavior. Recent nosological changes call for special attention during assessment to symptom dimensions of limited prosocial emotions and chronic irritability. The present review summarizes best practices for evidence-based assessment of these disorders and discusses tools to identify their symptoms. Despite the focus on disruptive behavior disorders, their high degree of overlap with disruptive mood dysregulation disorder can complicate assessment. Thus, the latter disorder is also included for discussion here. Good practice in the assessment of disruptive behavior disorders involves using several means of information gathering (e.g., clinical interview, standardized rating scales or checklists), ideally via multiple informants (e.g., parent-, teacher-, and self-report). A commitment to providing a full and accurate diagnostic assessment, with careful and attentive reference to diagnostic guidelines, will mitigate concerns regarding biases.
... For many youths, ODD symptoms resolve by early adulthood. When ODD symptoms persist into adulthood, these symptoms coincide with endorsements of antagonistic personality traits, endorsements of internalizing problems, risky behavior use (i.e., substance use) and increased risks of criminal activity (Leadbeater et al., 2015;Johnston et al., 2020;Nock et al., 2007;Rowe et al., 2010). ...
This chapter reviews oppositional defiant disorder (ODD), which is one of the most commonly diagnosed behavioral disorders for children and one of the most common reasons children are referred for mental health services. ODD involves eight symptoms of disruptive, authority-defying, and aggressive behaviors that coincide with poorer personal and social adjustment for children. ODD is often comorbid with other externalizing and internalizing problems for children and adolescents. Further, if not addressed, ODD problems can persist and contribute to more severe aggressive and deviant behaviors over time. As such, there is great interest in understanding, assessing, and intervening to reduce ODD symptoms among children and adolescents. This chapter reviews the definitions and concepts regarding ODD, distinguishes ODD from related disruptive behavior and mood disorders relevant to children and adolescents, addresses the etiology and developmental trajectory of ODD, and reviews prevalent assessments and treatments for ODD.KeywordsChildhood behavior problemsDisruptive behaviorsConduct disordersPrevalenceComorbidityEtiologyRisk factorsAssessmentTreatment
... Oppositional defiant disorder is a frequently reported disorder in childhood and adolescence, with a prevalence ranging from 1 to 11 percent and an average of 3.3 percent (Johnston et al., 2020). Individuals with this disorder struggle to regulate their emotions and behaviors, displaying persistent negative, opportunities if left untreated (Déry et al., 2017). ...
... In therapy, these adolescents learn to confront and regulate their emotions, replacing immature defense mechanisms with healthy coping mechanisms. This leads to increased psychological, behavioral, and academic performance, with less anxiety and negative emotions reported (Johnston et al., 2020). ...
... More recent work has shown that this dimensional structure also holds among adults. 33,34 Of particular relevance for this review, tests of the structure of ODD have consistently failed to find support for a complete dissolution of ODD into separate categories of chronic irritability independent from oppositional behavior 6,7 and instead have supported a structure with correlated subfactors of chronic irritability and oppositional behavior. 35 ...
... Irritability was uniquely associated with anxiety, depression, and the DSM-5 pathological personality traits of negative affectivity and detachment. 34 The behavioral dimension was associated with ADHD, and with personality factors of disinhibition and antagonism. Although the associations with internalizing psychopathology and negative affectivity are similar to the findings of Gomez and Stavropoulos 33 with the trait of stress reaction, it is notable that there was not an association with traits that reflected aggression, but rather an association suggesting a withdrawal from or avoidance of others (ie, detachment). ...
... It is possible that these differences are influenced by the presence or absence of spitefulness as an index for irritability. For example, the aggression personality trait that was associated with Gomez and Stavropoulos 33 negative affect dimension (touchy, angry, spiteful) is conceptually similar to the DSM-5 pathology personality trait of antagonism, which was uniquely associated with Johnston & colleagues 34 behavioral dimension of ODD, which includes spitefulness. Regardless of the "true" structure of irritability in adulthood, these findings underscore the importance of considering the behavioral symptoms of ODD in examining the structure and associated characteristics of irritability in adult populations. ...
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.
... Although research models differ slightly in the number of factors, they are generally divided into two dimensions: Irritability, which is characterized by a relatively stable state of anger, and stubborn and destructive and resentful behavior (as a behavioral dimension), characterized by arguing, blaming, and harassing others (11,12). The first dimension of irritability is a strong predictor of anxiety disorder and depression (13). The behavioral dimension of oppositional defiant disorder is the predictor of substance abuse, borderline personality disorder, violence, and criminal behavior. ...
... One-and two-factor models of ODD symptoms adopted from article of Johnston, Grossi, and Burke(13) Harada et al.(14) determined a cutoff score of 20 for distinguishing between children and adolescents with oppositional defiant disorder and other people who did not have this disorder. Concerning concurrent validity, both scores of oppositional defiant (test-retest) were correlated with the criteria of Diagnostic and Statistical Manual of Mental Disorders (0.65 and 0.659, P < 0.001) and disruptive behavior disorders rating (0.654 and 0.725, P < 0.00). ...
Background: Diagnostic questionnaires play a great role in accelerating the diagnosis of mental disorders. Objectives: This study aimed to provide a cross-cultural adaption form of Self-report oppositional defiant behavior inventory (SR-ODBI) in Persian and assess the validity and reliability of this Persian form. Methods: The present study was done on two research samples, including a sample of 294 students who were selected in the school year of 2019 - 2020 (girls and boys) from high schools of Dezful city by multi-stage random sampling method and a sample of 320 parents. The validity of the oppositional defiant behavior inventory was assessed by two methods of confirmatory factor analysis and convergent validity, and the reliability of the inventory was assessed using Cronbach's alpha and split-half methods. Results: Cronbach's alpha was obtained at 0.73 (0.87) for the whole self-report scale (parent version), 0.72 (0.74) for the subscale of irritability, and 0.81 (0.80) for the subscale of stubborn and resentful behavior. The correlation between SR-ODBI and Achenbach Youth Mental Health Test was 0.56 (P < 0.01). The results of confirmatory factor analysis (RMSEA = 0.06 and 0.08) also indicated a relatively good fit of structures of the oppositional defiant behavior inventory. Conclusions: The results of the research indicated that the Persian version of the Oppositional Defiant Behavior Inventory in Iran has good reliability and validity.
Objective; The aim of this study was to compare the effectiveness of anger management and parenting training on selective attention in students with oppositional defiant disorder. Method: This research was applied in terms of purpose, and quasi-experimental design of pre-test and post-test design with a control group in terms of the data nature. The statistical population included all fifthand sixth-grade elementary school students in District 9 of Tehran City in the academic year of 2019-2020, of which 45 were selected by available sampling method and randomly divided into two experimental groups and one control group. The anger management experimental group based on cognitive-behavioral approach was trained in eight 1.5hr sessions, the parenting experimental group was trained in nine 90min sessions, and the control group remained on the waiting list. The instruments used in the present study included the Scoring Scale for Oppositional Defiant Disorder in Children (Homersen et al., 2006) and the word “Stroop” color test for selective attention, which were used in two stages: pre-test and post-test. Results: The analysis of data obtained from the questionnaire
was performed through the SPSS-V24 software in two descriptive and inferential sections (analysis of covariance). Conclusion: The results revealed that the groups receiving the anger management and parenting training programs showed greater effectiveness on selective attention in students with oppositional defiant disorder than the control group. Coping had the same effect in the two groups of “anger management” and “parenting”. It seems that therapists, researchers and psychotherapists in the field of children and adolescents can use the educational programs of the present study to increase the selective attention of learners.
Objective:
Irritability symptoms are closely associated with, and may reflect, temperament traits, particularly negative affectivity (NA). However, there are few empirical data on the relationships between child temperament and irritability symptoms.
Method:
We investigated cross-sectional and longitudinal relationships between irritability symptoms and temperament traits from age 3-15 in a community sample of 609 children and their parents. Irritability symptoms were assessed through structured interviews with parents at ages 3/6, and inventories completed by parents and youth at ages 12/15. Temperament traits were assessed using parent reports at ages 3/6, and parent and child reports at ages 12/15. Path analysis and structural equation modeling were used to explore longitudinal associations from ages 3-6 and 12-15, respectively.
Results:
Higher levels of irritability symptoms at ages 3/6 were concurrently associated with higher levels of NA and lower levels of effortful control (EC). In adolescence, higher irritability symptoms were concurrently associated with higher negative temperament and disinhibition. In longitudinal analyses from age 3-6 and 12-15, irritability symptoms showed modest but significant stability after adjusting for the stability of temperament traits. However, there were significant differences in the stability paths at age 3-6, reflecting lower stability of irritability symptoms. Finally, EC at age 3 predicted increased irritability symptoms at age 6, while irritability symptoms at age 3 predicted increased NA at age 6.
Conclusion:
Irritability symptoms are robustly associated with both temperamental NA and difficulty regulating attention and behavior. These findings help situate irritability symptoms within widely accepted temperament/personality taxonomies.
Objectives. While oppositional defiance is often considered a childhood behavioural problem, the negative impact of symptoms on relationships and emotional wellbeing may endure well into young adulthood and can affect overall physical health. However, little is known about the co - occurrence of oppositional defiance symptoms (ODS) and changes in physical health functioning, particularly during the transition to young adulthood. This study examines the coupled change between ODS and physical health symptoms during this critical developmental period to inform the long - term somatic manifestations of ODS.
Methods. Participants (N = 662; 52% female) from the Victoria Healthy Youth Survey (V-HYS) were assessed for ten years across six biennial occasions from ages 12–18 to ages 22–30. A multilevel time -varying covariation model, disaggregating within- and between - person variability, examined whether change in ODS was systematically associated with change in physical health symptoms.
Results. On average, individuals with higher ODS reported more physical health symptoms. Moreover, ODS also shared a significant within - person time - varying association with physical health, suggesting that the two symptom domains fluctuated together within - individuals across time, irrespective of between - person differences.
Conclusion. This study provides a novel within- and between - person demonstration of the link between ODS and physical health symptoms from youth to young adulthood.
Objective: The aim of this study was to compare the effectiveness of anger management and parenting training on response inhibition in students with Oppositional/Confrontational Defiant Disorder (ODD/FDD). Method: This research was a quasi-experimental study of pre-test and post-test design with a control group. The statistical population included all male students with ODD/FDD in Tehran in 2020. Overall 45 people were selected as a sample according to the entry and exit criteria through voluntary and available sampling and assigned into two experimental groups and one control group. The instruments used in the present study included a grading scale for ODD/FDD in children and to inhibit the response of the Stroop word color test. Results: Anger management and parenting training showed more effectiveness on response inhibition in the case comparing to the control group (P <0.5). Also anger management training group parenting training group had the same effect on the response inhibition of students with ODD/FDD (P<0.5). Conclusion: Therefore, education of anger management and parenting training as two interventional programs can be effective in inhibiting the response of students with ODD/FDD.
