Dimensions and subtypes of oppositionality and their relation to comorbidity and psychosocial characteristics
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The symptoms of oppositional defiant disorder (ODD), or oppositionality, seem to constitute a three-dimensional structure of angry/irritable, vindictiveness and argumentative behavior dimensions. Also, subjects with oppositionality are characterized by different comorbidity and longitudinal trajectories, suggesting that they could be divided into subtypes. This study is the first to examine the dimensions and subtypes of oppositionality in Nordic children. Study participants included 3435 children aged 7–10 years from the Danish National Birth Cohort. Information was collected using the Development and Well-Being Assessment (DAWBA) online version. A three-factor ODD model was identified. The angry/irritable dimension was associated with emotional problems and disorders, fewer social skills and fewer personal positive attributes. The argumentative behavior dimension was associated with hyperactivity/conduct problems, reduced social skills and positive attributes. The vindictiveness dimension was associated with externalizing, internalizing and prosocial problems. Four ODD subtypes were identified. The subtypes with many or mainly angry/irritable symptoms were characterized by comorbid psychopathology, increased functional impairment and psychosocial problems. Children with ODD had fewer positive attributes, more friendship/school problems and higher functional impairment than children with emotional disorders and control group children. Oppositionality consists of three dimensions differently associated with comorbidity and psychosocial characteristics, and the same pattern is seen for the four ODD subtypes identified in this study. Children with ODD experience more adversities and functional impairment than children with emotional disorders. Our results indicate that treatment of children with ODD would improve from extended knowledge on individual ODD dimensions and subtypes and the related child psychosocial characteristics.
KeywordsOppositionality Dimensions Social skills Personal strengths Functional impairment
The Danish National Research Foundation has established the Danish Epidemiology Science Centre that initiated and created the Danish National Birth Cohort. The cohort is furthermore a result of a major grant from this Foundation. Additional support for the Danish National Birth Cohort is obtained from the Pharmacy Foundation, the Egmont Foundation, the March of Dimes Birth Defects Foundation, the Augustinus Foundation, and the Health Foundation. The DNBC 7-year follow-up is supported by the Lundbeck Foundation (195/04) and the Danish Medical Research Council (SSVF 0646). This study was funded by grants from the Psychiatric Research Fund of the Region of Southern Denmark, the Lundbeck Foundation and the University of Southern Denmark. The funders had no involvement in any aspect of the study and the authors report no conflicts of interest.
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Conflict of interest
The authors declare that they have no conflict of interest.
- 2.Aebi M, Muller UC, Asherson P, Banaschewski T, Buitelaar J, Ebstein R, Eisenberg J, Gill M, Manor I, Miranda A, Oades RD, Roeyers H, Rothenberger A, Sergeant J, Sonuga-Barke E, Thompson M, Taylor E, Faraone SV, Steinhausen HC (2010) Predictability of oppositional defiant disorder and symptom dimensions in children and adolescents with ADHD combined type. Psychol Med 40:2089–2100CrossRefPubMedGoogle Scholar
- 8.Athanasiadis G, Cheng JY, Vilhjalmsson BJ, Jorgensen FG, Als TD, Le Hellard S, Espeseth T, Sullivan PF, Hultman CM, Kjaergaard PC, Schierup MH, Mailund T (2016) Nationwide genomic study in Denmark reveals remarkable population homogeneity. Genetics 204:711–722CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Crnic K, Low C, Bornstein M (2002) In: Bornstein MH (ed), Handbook of Parenting, Volume 5, Practical Issues in Parenting, Second Edition. Chapter 10, Everyday Stresses and Parenting, Keith Crnic and Christine Low. National Institute of Child Health and Human Development, Lawrence Erlbaum Associates, Inc., Publishers, Mahwah, New Jersey, pp 243–268Google Scholar
- 21.Elberling H, Linneberg A, Ulrikka Rask C, Houman T, Goodman R, Mette Skovgaard A (2016) Psychiatric disorders in Danish children aged 5-7 years: A general population study of prevalence and risk factors from the Copenhagen Child Cohort (CCC 2000). Nord J Psychiatry 70:146–155CrossRefPubMedGoogle Scholar
- 25.Frigerio A, Rucci P, Goodman R, Ammaniti M, Carlet O, Cavolina P, De Girolamo G, Lenti C, Lucarelli L, Mani E, Martinuzzi A, Micali N, Milone A, Morosini P, Muratori F, Nardocci F, Pastore V, Polidori G, Tullini A, Vanzin L, Villa L, Walder M, Zuddas A, Molteni M (2009) Prevalence and correlates of mental disorders among adolescents in Italy: the PrISMA study. Eur Child Adolesc Psychiatry 18:217–226CrossRefPubMedGoogle Scholar
- 35.Heiervang E, Stormark KM, Lundervold AJ, Heimann M, Goodman R, Posserud MB, Ullebo AK, Plessen KJ, Bjelland I, Lie SA, Gillberg C (2007) Psychiatric disorders in Norwegian 8- to 10-year-olds: an epidemiological survey of prevalence, risk factors, and service use. J Am Acad Child Adolesc Psychiatry 46:438–447CrossRefPubMedGoogle Scholar
- 37.Hooper D, Coughlan J, Mullen M (2008) Structurel equation modelling: guidelines for determining model fit. Electron J Bus Res Meth 6(1):53–60Google Scholar
- 43.Kovess-Masfety V, Husky MM, Keyes K, Hamilton A, Pez O, Bitfoi A, Carta MG, Goelitz D, Kuijpers R, Otten R, Koc C, Lesinskiene S, Mihova Z (2016) Comparing the prevalence of mental health problems in children 6-11 across Europe. Soc Psychiatry Psychiatr Epidemiol 51:1093–1103CrossRefPubMedPubMedCentralGoogle Scholar
- 44.Krieger FV, Polanczyk VG, Goodman R, Rohde LA, Graeff-Martins AS, Salum G, Gadelha A, Pan P, Stahl D, Stringaris A (2013) Dimensions of oppositionality in a Brazilian community sample: testing the DSM-5 proposal and etiological links. J Am Acad Child Adolesc Psychiatry 52(389–400):e381Google Scholar
- 45.Kuny AV, Althoff RR, Copeland W, Bartels M, Van Beijsterveldt CE, Baer J, Hudziak JJ (2013) Separating the domains of oppositional behavior: comparing latent models of the conners’ oppositional subscale. J Am Acad Child Adolesc Psychiatry 52(172–183):e178Google Scholar
- 46.Lazarsfeld PHNV (1968) Latent structure analysis, vol 3. Houghton Mifflin company, New York, p 35Google Scholar
- 54.Olsen J, Melbye M, Olsen SF, Sorensen TI, Aaby P, Andersen AM, Taxbol D, Hansen KD, Juhl M, Schow TB, Sorensen HT, Andresen J, Mortensen EL, Olesen AW, Sondergaard C (2001) The Danish National Birth Cohort—its background, structure and aim. Scand J Public Health 29:300–307CrossRefPubMedGoogle Scholar
- 55.Rescorla LA, Achenbach TM, Ivanova MY, Harder VS, Otten L, Bilenberg N, Bjarnadottir G, Capron C, De Pauw SS, Dias P, Dobrean A, Dopfner M, Duyme M, Eapen V, Erol N, Esmaeili EM, Ezpeleta L, Frigerio A, Fung DS, Goncalves M, Guethmundsson H, Jeng SF, Jusiene R, Ah Kim Y, Kristensen S, Liu J, Lecannelier F, Leung PW, Machado BC, Montirosso R, Ja OhK, Ooi YP, Pluck J, Pomalima R, Pranvera J, Schmeck K, Shahini M, Silva JR, Simsek Z, Sourander A, Valverde J, van der Ende J, Van Leeuwen KG, Wu YT, Yurdusen S, Zubrick SR, Verhulst FC (2011) International comparisons of behavioral and emotional problems in preschool children: parents’ reports from 24 societies. J Clin Child Adolesc Psychol 40:456–467CrossRefPubMedPubMedCentralGoogle Scholar
- 56.Rothen S, Vandeleur CL, Lustenberger Y, Jeanpretre N, Ayer E, Gamma F, Halfon O, Fornerod D, Ferrero F, Preisig M (2009) Parent-child agreement and prevalence estimates of diagnoses in childhood: direct interview versus family history method. Int J Methods Psychiatr Res 18:96–109CrossRefPubMedGoogle Scholar