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Teacher-Reported Irritable and Defiant Dimensions of Oppositional Defiant Disorder: Social, Behavioral, and Academic Correlates

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Abstract

Previous research suggests that the symptoms of oppositional defiant disorder (ODD) reflect both a general diagnostic construct and two distinct symptom dimensions, irritability and defiant behavior. Recent studies have found that these two symptom dimensions exhibit different patterns of correlates and outcomes (e.g., irritability linked to depressive symptoms, defiant behavior linked to conduct problems). The present study investigated common and unique correlates of the irritable and defiant dimensions of ODD symptoms in a sample of 706 school-age children (49 % female, ages 5–12) in grades K-5. Classroom teachers rated their students’ ODD symptoms, proactive and reactive aggression, relational and physical aggression and victimization, withdrawn/depressed symptoms, peer rejection, and academic performance. Multilevel regression models—controlling for grade level, gender, and shared variance between symptom dimensions and variable subtypes—showed that teacher-reported irritability and defiant behavior exhibit common correlates of physical and relational aggression, relational victimization, and peer rejection. With respect to differential correlates, irritability was uniquely associated with physical victimization and withdrawn/depressed symptoms, whereas defiant behavior was uniquely associated with proactive aggression and hyperactive–impulsive symptoms. Further, reactive aggression was more strongly linked to irritability than to defiant behavior. These findings provide further support for a multidimensional conceptualization of ODD symptoms within the school context and suggest that irritability and defiant behavior have important implications across several domains of children’s social–emotional development.

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Notes

  1. Researchers have used a variety of different names to represent dimensions of ODD symptoms (e.g., “irritable” vs. “negative affect”; “defiant” vs. “headstrong”). In most cases, these differences are in name only; the dimensions themselves are very similar in item content. For clarity, we use the terms “irritable” and “defiant” throughout this paper to represent the two dimensions, each comprised of particular ODD symptoms (defined below).

  2. The 15-item Conduct Disorder Scale from the DBD was not administered. These items represent delinquent behaviors (e.g., destruction of property, deceitfulness/theft, serious rule violations), which many elementary teachers would be unlikely to observe—for example, because the behaviors are committed at home, in the community, covertly, or infrequently. Thus, teachers would not be ideal reporters of these variables in this sample. For this reason, and due to the practical constraints on teachers’ time, we decided that these items were not justified for the present study. However, in light of past research, the link between ODD dimensions and conduct problems remains an important topic for future school mental health research.

  3. Two other models were evaluated: (a) the one-factor model, with all eight ODD symptoms loading onto a general factor, χ2 (df = 20) = 107.366, p < .001, RMSEA = .079 (95 % CI .064–.094), CFI = .919, TLI = .887, SRMR = .039; and (b) Stringaris and Goodman’s three-factor model, χ2 (df = 18) = 75.051, p < .001, RMSEA = .067 (95 % CI .052–.083), CFI = .947, TLI = .918, SRMR = .037. Notably, the two-factor model showed a significant improvement in model fit over the one-factor model, χ2 (Δdf = 1) = 7.928, p < .01 (using a robust estimation χ2 difference test; Muthén & Muthén, 2012). However, for empirical and theoretical reasons (Kline, 2011), the three-factor model is not directly comparable to the other two models. The third “factor”—the spiteful/vindictive dimension—is in fact a manifest item (not a latent factor) comprised of only a single four-point ordinal item (not a continuous variable). Therefore, results of the three-factor model should be interpreted cautiously because such a model effectively treats this single item as a continuous, latent dimension, as if it were directly comparable to the defiant and irritable dimensions (both of which are continuous, latent factors). Because this third dimension was measured so differently from the other two—likely with more measurement bias and less precision/reliability (Kline, 2011)—it was considered statistically inappropriate to interpret the results for all three dimensions in a similar way. For these same reasons, the three-factor model could not be directly compared to the other two models. Therefore, the two-factor model was considered the most parsimonious model, providing good fit to the data and better fit than the one-factor model.

  4. Importantly, caution is advised in interpreting the zero-order correlations among study variables. Estimates may be somewhat inflated due to the nestedness of students within teacher raters. The multilevel models below support this possibility and statistically control for these effects. Further, note that the zero-order correlations of irritability with other variables do not partial out the effects of defiant behavior, and vice versa.

  5. For reference, compare to three-month point estimate (2.7 %) and lifetime prevalence estimate (10.2 %) of ODD in national epidemiological samples of children and adolescents (Costelllo et al., 2003; Nock et al., 2007), and a meta-analytic prevalence estimate of ADHD (11.4 %) based on teacher-reported symptom criteria only (Wilcutt, 2012).

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Acknowledgments

We thank the elementary school teachers who participated in the present study. We are also grateful to the school’s administrators and staff for their continued partnership and cooperation. Portions of this research were completed with support from the University of Kansas (New Faculty General Research Fund, PJF; Lillan Jacobey Baur Early Childhood Fellowship, SCE), as well as the American Psychological Foundation (Elizabeth Munsterberg Koppitz Child Psychology Graduate Student Fellowship, SCE).

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  1. Clinical Child Psychology Program, Dole Human Development Center, University of Kansas, 1000 Sunnyside Avenue, Lawrence, KS, 66045, USA

    Spencer C. Evans, Casey A. Pederson, Paula J. Fite, Jennifer B. Blossom & John L. Cooley

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Evans, S.C., Pederson, C.A., Fite, P.J. et al. Teacher-Reported Irritable and Defiant Dimensions of Oppositional Defiant Disorder: Social, Behavioral, and Academic Correlates. School Mental Health 8, 292–304 (2016). https://doi.org/10.1007/s12310-015-9163-y

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