Oppositional Defiant Disorder and Conduct Disorder: A Review of the Past 10 Years, Part II

Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 7.26). 12/2002; 41(11):1275-93. DOI: 10.1097/00004583-200211000-00009
Source: PubMed

ABSTRACT To review empirical findings on oppositional defiant disorder (ODD) and conduct disorder (CD).
Selected summaries of the literature over the past decade are presented.
Research on ODD and CD during the past decade has addressed the complexity involved in identifying the primary risk factors and developmental pathways to disruptive behavior disorders (DBD). In some domains, research is entering an entirely new phase because of the availability of new technologies. In others, larger data sets and more complicated methodological and statistical techniques are testing increasingly complex models. Yet questions remain regarding the most useful subtyping systems, the identification of the most significant risk factors, and the relationships between risk factors from multiple domains.
Convincing evidence of causal linkages remains elusive. Research has questioned the notion that CD is intractable, especially when multiple domains of risk and impairment are the targets of intervention. It is apparent that there is not one single causative factor; thus it is not likely that one single modality will suffice to treat CD. Future steps will involve the restructuring of diagnostic criteria to capture adequate subtypes and indicators, clarification of the neurological underpinnings of the disorder, and refinement in the models available to explain the varied pathways to DBD.

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    • "According to the diathesisstress model (Zuckerman 1999), effects of environmental stressors may primarily occur in vulnerable individuals. An important general vulnerability factor is parental psychiatric history, which is considered a strong predictor of increased genetic and environmentally-driven vulnerability for externalizing and internalizing psychopathology in offspring (Burke et al. 2002; Kim-Cohen et al. 2005). "
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    ABSTRACT: Large individual differences in adolescent mental health following chronic psychosocial stress suggest moderating factors. We examined two established moderators, basal cortisol and parental psychiatric history, simultaneously. We hypothesized that individuals with high basal cortisol, assumed to indicate high context sensitivity, would show relatively high problem levels following chronic stress, especially in the presence of parental psychiatric history. With Linear Mixed Models, we investigated the hypotheses in 1917 Dutch adolescents (53.2 % boys), assessed at ages 11, 13.5, and 16. Low basal cortisol combined with the absence of a parental psychiatric history increased the risk of externalizing but not internalizing problems following chronic stress. Conversely, low basal cortisol combined with a substantial parental psychiatric history increased the risk of internalizing but not externalizing problems following chronic stress. Thus, parental psychiatric history moderated stress- cortisol interactions in predicting psychopathology, but in a different direction than hypothesized. We conclude that the premise that basal cortisol indicates context sensitivity may be too crude. Context sensitivity may not be a general trait but may depend on the nature of the context (e.g., type or duration of stress exposure) and on the outcome of interest (e.g., internalizing vs. externalizing problems). Although consistent across informants, our findings need replication.
    Journal of Abnormal Child Psychology 01/2015; 43(6). DOI:10.1007/s10802-014-9970-x · 3.09 Impact Factor
    • "Empirically, adolescents who possess unconventional beliefs or attitudes have been shown to have high levels of delinquency, because they do not consider social norms to be valid (Longshore et al. 2005; Ngai and Cheung 2005). Furthermore, Loeber et al. (2000) showed that a substantial proportion of children and adolescents who possess ODD developed subsequent conduct problems. Combining the theoretical perspectives and empirical results, we can expect that adolescents' unhealthy sleep practices may exert effects on their deviance through defiant attitude. "
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    ABSTRACT: Although sleep has been linked to activities in various domains of life, one under-studied link is the relationship between unhealthy sleep practices and conduct problems among adolescents. The present study investigates the influence of adolescents' unhealthy sleep practices-short sleep (e.g., less than 6 h a day), inconsistent sleep schedule (e.g., social jetlag), and sleep problems-on conduct problems (e.g., substance use, fighting, and skipping class). In addition, this study examines unhealthy sleep practices in relationship to adolescent emotional well-being, defiant attitudes, and academic performance, as well as these three domains as possible mediators of the longitudinal association between sleep practices and conduct problems. Three waves of the Taiwan Youth Project (n = 2,472) were used in this study. At the first time-point examined in this study, youth (51 % male) were aged 13-17 (M = 13.3). The results indicated that all three measures of unhealthy sleep practices were related to conduct problems, such that short sleep, greater social jetlag, and more serious sleep problems were concurrently associated with greater conduct problems. In addition, short sleep and sleep problems predicted conduct problems one year later. Furthermore, these three unhealthy sleep practices were differently related to poor academic performance, low levels of emotional well-being, and defiant attitudes, and some significant indirect effects on later conduct problems through these three attributes were found. Cultural differences and suggestions for prevention are discussed.
    Journal of Youth and Adolescence 08/2014; 44(2). DOI:10.1007/s10964-014-0169-9 · 2.72 Impact Factor
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    • "Although associations between ODD, CD and problematic social functioning are somewhat established, many gaps in knowledge still exist. First, much previous research has investigated social functioning in children diagnosed with ODD or CD (Burke, Loeber & Birmaher, 2002; Pardini & Fite, 2010). Although informative and important, these studies omit a large number of children with symptoms of disruptive behavior disorders who are diagnostically subthreshold. "
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    ABSTRACT: Children with disruptive behavior disorders experience substantial social challenges; however, the factors that account for (i.e., mediate), or influence (i.e., moderate), peer problems are not well understood. This study tested whether symptoms of Oppositional Defiant Disorder and Conduct Disorder were associated with peer impairment and whether prosocial skills mediated or moderated these associations. Teacher ratings were gathered for 149 children (Mage = 9.09, SD = 1.71, 26% female) referred for behavioral concerns to an urban child psychiatry clinic. Path-analytic linear regressions testing mediation and moderation effects showed that prosocial skills significantly moderated the negative effects of symptoms of Conduct Disorder on peer impairment. Children showed less peer impairment only when they had relatively few conduct symptoms and high prosocial skills. Measurement of prosocial skills, in addition to conduct problems, may best capture factors which contribute to peer problems of children with disruptive behaviors.
    PeerJ 07/2014; 2(1):e487. DOI:10.7717/peerj.487 · 2.11 Impact Factor
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