Article

Longitudinal Outcome of Youth Oppositionality: Irritable, Headstrong, and Hurtful Behaviors Have Distinctive Predictions

Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD 20892-2670USA.
Journal of the American Academy of Child and Adolescent Psychiatry (Impact Factor: 6.35). 05/2009; 48(4):404-12. DOI: 10.1097/CHI.0b013e3181984f30
Source: PubMed

ABSTRACT Oppositional behavior in youths is one of the strongest predictors of a wide range of psychiatric disorders. We test the hypothesis that oppositionality encompasses an Irritable, a Headstrong, and a Hurtful dimension, each with distinct predictions.
Longitudinal design combining data from two British national surveys and their respective 3-year follow-ups (N = 7,912). The Developmental and Well-Being Assessment was used to generate DSM-IV diagnoses.
The Irritable dimension was the sole predictor of emotional disorders at follow-up and was particularly associated with distress disorders (depression and anxiety) rather than fear disorders (phobias, separation anxiety, and panic disorder), both before and after adjustment for baseline psychopathology. The Headstrong dimension was the only predictor of attention-deficit/hyperactivity disorder at follow-up. Both Headstrong and Hurtful predicted conduct disorder, although only the Headstrong dimension did so after adjustment for baseline psychopathology. The Hurtful dimension was the strongest predictor of aggressive conduct disorder symptoms.
Our data suggest a developmental model of mental disorder whereby oppositionality is an interim shared manifestation of different dimensions of psychopathology with distinct outcomes.

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    • "Partly due to the fact that Oppositional Defiant Disorder (ODD) predicts to such a wide range of adjustment difficulties in children, the DSM 5 (American Psychiatric Association, 2013) has suggested a distinction among irritable, headstrong, and hurtful ODD dimensions, as these dimensions appear to associate with distinct outcomes. Importantly , studies suggest that the ODD subdimension of irritability (i.e. has temper outbursts; touchy or easily annoyed; angry or resentful) predicts adolescent and young adult depressive symptoms (Leibenluft , Cohen, Gorrindo, Brook, & Pine, 2006; Leibenluft & Stoddard, 2013; Stringaris & Goodman, 2009a; Whelan, Stringaris, Maughan, & Barker, 2013). In addition, previous studies show predictive associations between adolescent depressive symptoms and other child characteristics such as anxiety/depressive symptoms (e.g. has many worries or often seems worried; often unhappy, depressed or tearful) and conduct problems (e.g. "
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    • "irritability and internalizing problems (Krieger et al., 2013; Mandy et al., 2014; Stringaris & Goodman, 2009a, 2009b). Recently, Simonoff et al. (2012) demonstrated that parent-reported mood dysregulation symptoms identified adolescents with ASD who had higher rates of comorbidity. "
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