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European Child & Adolescent Psychiatry

, Volume 28, Issue 10, pp 1385–1393 | Cite as

Prevalence, comorbidity, functioning and long-term effects of subthreshold oppositional defiant disorder in a community sample of preschoolers

  • Nuria de la OsaEmail author
  • Eva Penelo
  • Jose Blas Navarro
  • Esther Trepat
  • Lourdes Ezpeleta
Original Contribution
  • 354 Downloads

Abstract

To study the prevalence of subthreshold oppositional defiant disorder (ST ODD)—less than 4 symptoms, but nonetheless an impairing form of oppositional defiant disorder (ODD)—its coexistence with other homotypic externalizing and heterotypical internalizing problems in children and associated impairment, as well as the long-term effect of this condition. A population-based sample of 622 preschoolers (5.0% boys) was followed up from preschool to preadolescence. Parents were interviewed when the children were 3, 6 and 9 years old with the Diagnostic Interview for Preschoolers/Children and Adolescents versions following DSM-5 and the children’s functioning was assessed by trained clinicians. ST ODD diagnosis is highly prevalent (19.4–25.5%), highly comorbid [homo- (1.9–18.4%) and heterotypical (5.8–23.7%)], resulting in functional impairment across child development in a similar way for both genders. ST is also a risk factor condition that predicts the presence of psychological problems and impairment in childhood and preadolescence from preschool age. A broader clinical assessment and intervention similar to that provided full syndrome cases is needed for children presenting subthreshold forms of ODD.

Keywords

Dimensional ODD Preschoolers Subthreshold 

Notes

Acknowledgements

Funding was provided by the Spanish Ministry of Economy and Competitiveness grants PSI2012-32695 and PSI2015-63965-R (MINECO/FEDER). Thank you to the Secretaria d’Universitats i Recerca, Departament d’Economia i Coneixement de la Generalitat de Catalunya (2014 SGR 312). We would also like to acknowledge all the schools, families and children involved in this research.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

References

  1. 1.
    Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A (2003) Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 60(8):837–844CrossRefGoogle Scholar
  2. 2.
    Kim J, Carlson GA, Meyer SE, Bufferd SJ, Dougherty LR, Dyson MW et al (2012) Correlates of the CBCL-dysregulation profile in preschool-aged children. J Child Psychol Psychiatry 53(9):918–926.  https://doi.org/10.1111/j.1469-7610.2012.02546.x PubMedPubMedCentralCrossRefGoogle Scholar
  3. 3.
    Burke J, Loeber R (2010) Oppositional defiant disorder and the explanation of the comorbidity between behavioral disorders and depression. Clin Psychol Sci Pract 17(4):319–326.  https://doi.org/10.1111/j.1468-2850.2010.01223.x CrossRefGoogle Scholar
  4. 4.
    Breslau J, Miller E, Chung WJ, Schweitzer JB (2012) Childhood and adolescent onset psychiatric disorders, substance use, and failure to graduate high school on time. J Psychiatr Res 45(3):295–301CrossRefGoogle Scholar
  5. 5.
    American Psychological Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychological Association, Washington, DCCrossRefGoogle Scholar
  6. 6.
    Lavigne JV, Bryant FB, Hopkins J, Gouze KR (2015) Dimensions of oppositional defiant disorder in young children: model comparisons, gender and longitudinal invariance. J Abnorm Child Psychol 43(3):423–439.  https://doi.org/10.1007/s10802-014-9919-0 PubMedCrossRefGoogle Scholar
  7. 7.
    Burke JD (2012) An affective dimension within oppositional defiant disorder symptoms among boys: personality and psychopathology outcomes into early adulthood. J Child Psychol Psychiatry Allied Discip 53(11):1176–1183CrossRefGoogle Scholar
  8. 8.
    Ezpeleta L, Granero R, de la Osa N, Penelo E, Domenech JM (2012) Dimensions of oppositional defiant disorder in 3-year-old preschoolers. J Child Psychol Psychiatry 53(11):1128–1138PubMedCrossRefGoogle Scholar
  9. 9.
    Lavigne JV, Bryant FB, Hopkins J, Gouze KR (2014) Dimensions of oppositional defiant disorder in young children: model comparisons, gender and longitudinal invariance. J Abnorm Child Psychol 43(3):423–439.  https://doi.org/10.1007/s10802-014-9919-0 CrossRefGoogle Scholar
  10. 10.
    Achenbach TM (2015) Transdiagnostic heterogeneity, hierarchical dimensional models, and societal, cultural, and individual differences in the developmental understanding of psychopathology. Eur Child Adolesc Psychiatry 24(12):1419–1422.  https://doi.org/10.1007/s00787-015-0795-0 PubMedCrossRefGoogle Scholar
  11. 11.
    Caspi A, Houts RM, Belsky DW, Goldman-mellor SJ (2015) The p factor: one general psychopathology factor in the structure of psychiatric disorders? Clin Psychol Sci 2(2):119–137CrossRefGoogle Scholar
  12. 12.
    Forbes MK, Tackett JL, Markon KE, Krueger RF (2016) Beyond comorbidity: toward a dimensional and hierarchical approach to understanding psychopathology across the life span. Dev Psychopathol 28:971–986PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Lindhiem O, Bennett CB, Hipwell AE, Pardini DA (2015) Beyond symptom counts for diagnosing oppositional defiant disorder and conduct disorder? J Abnorm Child Psychol 3(7):1379–1387CrossRefGoogle Scholar
  14. 14.
    Van Os J (2013) The dynamics of subthreshold psychopathology: implications for diagnosis and treatment. Am J PsychiatryGoogle Scholar
  15. 15.
    Kraemer HC (2015) Research Domain Criteria (RDoC) and the DSM—two methodological approaches to mental health diagnosis. JAMA Psychiatry 72(12):1163. https://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/jamapsychiatry.2015.2134, Accessed 13 Dec 2016PubMedCrossRefGoogle Scholar
  16. 16.
    Balázs J, Keresztény A (2014) Subthreshold attention deficit hyperactivity in children and adolescents: a systematic review. Eur Child Adolesc Psychiatry 23(6):393–408.  https://doi.org/10.1007/s00787-013-0514-7 PubMedCrossRefGoogle Scholar
  17. 17.
    Hong S-B, Dwyer D, Kim J-W, Park E-J, Shin M-S, Kim B-N et al (2014) Subthreshold attention-deficit/hyperactivity disorder is associated with functional impairments across domains: a comprehensive analysis in a large-scale community study. Eur Child Adolesc Psychiatry 23(8):627–636PubMedCrossRefGoogle Scholar
  18. 18.
    Malmberg K, Edbom T, Wargelius HL, Larsson JO (2011) Psychiatric problems associated with subthreshold ADHD and disruptive behaviour diagnoses in teenagers. Acta Paediatr Int J Paediatr 100(11):1468–1475CrossRefGoogle Scholar
  19. 19.
    Haller H, Cramer H, Lauche R, Gass F, Dobos GJ (2014) The prevalence and burden of subthreshold generalized anxiety disorder: a systematic review. BMC Psychiatry 14:1–13CrossRefGoogle Scholar
  20. 20.
    Lewinsohn PM, Shankman SA, Gau JM, Klein DN (2004) The prevalence and co-morbidity of subthreshold psychiatric conditions. Psychol Med 34(4):613–22. https://www.journals.cambridge.org/abstract_S0033291703001466.. Accessed 14 Dec 2016PubMedCrossRefGoogle Scholar
  21. 21.
    Shankman SA, Lewinsohn PM, Klein DN, Small JW, Seeley JR, Altman SE (2009) Subthreshold conditions as precursors for full syndrome disorders: a 15-year longitudinal study of multiple diagnostic classes. J Child Psychol Psychiatry 50(12):1485–94. https://doi.wiley.com/10.1111/j.1469-7610.2009.02117.x. Accessed 14 Dec 2016PubMedPubMedCentralCrossRefGoogle Scholar
  22. 22.
    Martín V, Granero R, Ezpeleta L (2014) Comorbidity of oppositional de fi ant disorder and anxiety disorders in preschoolers. Psicotherma 26(1): 27–32Google Scholar
  23. 23.
    Goodman R (1997) The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiat 38(5):581–586PubMedCrossRefGoogle Scholar
  24. 24.
    Hollingshead AB (1975) Four factor index of social status. Yale University, New HavenGoogle Scholar
  25. 25.
    Reich W, Ezpeleta L (2009) Entrevista Diagnóstica para Niños y Adolescentes—versión para Padres de Preescolares (3–7 años). Universitat Autónoma de Barcelona, Manuscrito no publicado, Departament de Psicologia Clínica y de la SalutGoogle Scholar
  26. 26.
    Ezpeleta L, de la Osa N, Granero R, Domènech JM, Reich W (2011) The diagnostic interview of children and adolescents for parents of preschool and young children: psychometric properties in the general population. Psychiatry Res 190:137–144PubMedCrossRefGoogle Scholar
  27. 27.
    Goodman R (2001) Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 40(11):1337–1345.  https://doi.org/10.1097/00004583-200111000-00015 PubMedCrossRefGoogle Scholar
  28. 28.
    Ezpeleta L, Granero R, de la Osa N (1999) Evaluación del deterioro en niños y adolescentes a través de la Children’s Global Assessment Scale (CGAS). Rev Psiquiatr Infanto-Juvenil. Spain: Siglo Editorial 1:18–26Google Scholar
  29. 29.
    Shaffer D, Gould MS, Brasic J, Ambrosini P, Fisher P, Bird H (1983) A children’s global assessment scale (CGAS). Arch Gen Psychiatry 40:1228–1231PubMedCrossRefGoogle Scholar
  30. 30.
    Hodges K (1995) Child and Adolescent Functional Assessment Scale (CAFAS). Eastern Michigan University, YpsilantiGoogle Scholar
  31. 31.
    Ezpeleta L, Granero R, De La Osa N, Doménech JM, Bonillo A (2006) Assessment of functional impairment in spanish children. Appl Psychol 55(1):130–143CrossRefGoogle Scholar
  32. 32.
    Bowker AH (1948) A test for symmetry in contingency tables. J Am Stat Assoc 43(244):572–574PubMedCrossRefGoogle Scholar
  33. 33.
    Lavigne JV, Cicchetti C, Gibbons RD, Binns HJ, Larsen L, Vito CDE (2000) Oppositional defiant disorder with onset in preschool years: longitudinal stability and pathways to other disorders. J Am Acad Child Adolesc Psychiatry 40(12):1393–1400CrossRefGoogle Scholar
  34. 34.
    Norén Selinus E, Molero Y, Lichtenstein P, Anckarsäter H, Lundström S, Bottai M et al (2016) Subthreshold and threshold attention deficit hyperactivity disorder symptoms in childhood: psychosocial outcomes in adolescence in boys and girls. Acta Psychiatr Scand 134(6):533–545.  https://doi.org/10.1111/acps.12655 PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Burke JD, Hipwell AE, Loeber R (2010) Dimensions of oppositional defiant disorder as predictors of depression and conduct disorder in preadolescent girls. J Am Acad Child Adolesc Psychiatry 49(5):484–92. https://www.sciencedirect.com/science/article/pii/S0890856710001061. Accessed 30 Nov 2014PubMedPubMedCentralGoogle Scholar
  36. 36.
    Stringaris A, Goodman R (2009) Three dimensions of oppositionality in youth. J Child Psychol Psychiatry 50(3):216–23. https://www.ncbi.nlm.nih.gov/pubmed/19166573. Accessed 2 Dec 2014PubMedCrossRefGoogle Scholar
  37. 37.
    Burke JD, Pardini DA, Loeber R (2008) Reciprocal relationships between parenting behavior and disruptive psychopathology from childhood through adolescence. J Abnorm Child Psychol 36(5):679–692. http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2008-07245-005&lang=es&site=ehost-live PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    Cornell AH, Frick P (2007) The moderating effects of parenting styles in the association between behavioral inhibition and parent-reported guilt and empathy in preschool children. J Clin Child Adolesc Psychol 36(3):305–318PubMedCrossRefGoogle Scholar
  39. 39.
    Booker JA, Capriola-Hall NN, Green RW,Ollendick TH (2019) The parent–child relationship and posttreatment child outcomes across two treatments for oppositional defiant disorder. J Clin Child Adolesc Psychol.  https://doi.org/10.1080/15374416.2018.1555761
  40. 40.
    Lavigne JV, Gouze KR, Hopkins J, Bryant FB, Lebailly SA (2012) A multi-domain model of risk factors for ODD symptoms in a community sample of 4-year-olds. J ABnorm Child Psychol 40(5):741–757PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Unitat D’Epidemiologia i de Diagnòstic en Psicopatologia del DesenvolupamentUniversitat Autònoma de BarcelonaBarcelonaSpain
  2. 2.Departament de Psicologia Clínica i de la SalutUniversitat Autònoma de BarcelonaBarcelonaSpain
  3. 3.Departament de Psicobiologia i Metodologia de les Ciències de la SalutUniversitat Autònoma de BarcelonaBarcelonaSpain
  4. 4.Institut de PsicologiaBarcelonaSpain

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