Journal of the American Academy of Child & Adolescent Psychiatry
New researchDeconstructing Oppositional Defiant Disorder: Clinic-Based Evidence for an Anger/Irritability Phenotype
Section snippets
Participants
Participants were parents (primarily mothers) and teachers of 1,160 youth who were consecutive referrals to a university hospital child psychiatry outpatient service that serves an ethnically and economically diverse clientele. Given the well-established developmental differences in the emergence of psychiatric symptomatology, we divided the sample into a younger (6-11-year-olds; n = 546; 72.7% males) and older (12-18-year-olds; n = 614; 67.1% males) cohort (full sample mean = 12.1, SD = 3.4
Distribution of Subgroups
When mothers' ratings were the basis of group classification, 212 younger (69.8% male) and 284 older (69.4% male) youth met symptom criteria for ODD, of whom 53% (63.4% male) and 64% (70.2% male), respectively, were classified as having AIS. Using teachers' ratings to construct groups, 204 younger (78.9% male) and 195 older (76.9% male) youth were classified as having ODD, of whom 61% in each age group (younger: 82.4% male, older: 77.3% male) were classified as having AIS.
Background Variables
The two ODD groups
Discussion
Recent evidence suggests that different types of ODD symptoms have distinct correlates and outcomes,6, 7, 8, 9, 10, 11, 12 which in part contributed to a suggestion by the DSM-5 ADHD and Disruptive Behavior Disorders Workgroups to consider AIS and NS separately. Nevertheless, few studies have explicitly examined their divergent diagnostic validity or considered the implications of contextual variation. Our findings for a large, heterogeneous, clinic-based sample provide additional support for
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This research was supported in part by the National Institute of Mental Health 1K01MH073717-01A2 (D.A.G.D.)
Disclosure: Dr. Gadow is a shareholder in Checkmate Plus which publishes the Child and Adolescent Symptom Inventory. Dr. Drabick reports no biomedical financial interests or potential conflicts of interest.