Defining oppositional defiant disorder

Duke University, Durham, North Carolina, United States
Journal of Child Psychology and Psychiatry (Impact Factor: 6.46). 01/2006; 46(12):1309-16. DOI: 10.1111/j.1469-7610.2005.01420.x
Source: PubMed


ICD-10 and DSM-IV include similar criterial symptom lists for conduct disorder (CD) and oppositional defiant disorder (ODD), but while DSM-IV treats each list separately, ICD-10 considers them jointly. One consequence is that ICD-10 identifies a group of children with ODD subtype who do not receive a diagnosis under DSM-IV.
We examined the characteristics of this group of children using the Great Smoky Mountains Study of children in the community aged 9-16. This study provided child and parent reports of symptoms and psychosocial impairment assessed with standardised diagnostic interviews.
Children who received an ICD-10 diagnosis but not a DSM-IV diagnosis showed broadly similar levels of psychiatric comorbidity, delinquent activity and psychosocial impairment to those who met DSM-IV criteria in both cross-sectional and longitudinal analyses.
These results indicate that DSM-IV excludes from diagnosis children who receive an ICD-10 diagnosis of CD (ODD sub-type), and who are substantially disturbed. Methods of redressing this situation are considered.

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Available from: Barbara Maughan, Jul 09, 2014
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    • "The aim was again to decrease the false negative ratio. In addition, some investigators suggested that the threshold of 3 symptoms might be enough for ODD diagnosis [10,27]. Like the ADHD screening positive cases, all ODD screening positive cases were invited to participate in the second stage of the study (N = 43). "
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    ABSTRACT: This study was designed to assess the prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) in a representative sample of second grade students from a country in a region where no previous rates are available (Turkey). The second aim is to evaluate the differences in ADHD and ODD prevalence rates among four different waves with one-year gap in reassessments. Sixteen schools were randomly selected and stratified according to socioeconomic classes. The DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S) was delivered to parents and teachers for screening in around 1500 children. Screen positive cases and matched controls were extensively assessed using the K-SADS-PL and a scale to assess impairment criterion. The sample was reassessed in the second, third and fourth waves with the same methodology. The prevalence rates of ADHD in the four waves were respectively 13.38%, 12.53%, 12.22% and 12.91%. The ODD prevalence was found to be 3.77% in the first wave, 0.96% in the second, 5.41% in the third and 5.35% in the fourth wave. Mean ODD prevalence was found to be 3.87%. The prevalence rates of ADHD in the four waves were remarkably higher than the worldwide pooled childhood prevalence. ADHD diagnosis was quite stable in reassessments after one, two and three years. A mean ODD prevalence consistent with the worldwide-pooled prevalence was found; but diagnostic stability was much lower compared to ADHD.
    Full-text · Article · Aug 2013 · Child and Adolescent Psychiatry and Mental Health
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    • "This fact is unsurprising in light of the reported prevalence rates for these disorders, which are as high as 7% for ADHD, 10% for conduct disorder, and 16% for ODD (American Psychiatric Association 2000). The DSM-IV criteria for ODD and CD may even exclude some ''sub-clinical'' externalizing youth who are nevertheless experiencing functional impairment (Rowe et al. 2005), which suggests that prevalence rates of children in need of treatment for disruptive behavior might be higher still. These findings are sobering considering the likelihood for untreated disruptive behavior problems to persist and the association between childhood disruptive behavior and negative outcomes, such as delinquency and criminality (Farrington 1995; Loeber et al. 1995; Vitelli 1997). "
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    ABSTRACT: Parent-Child Interaction Therapy (PCIT) has been identified as an evidence-based practice in the treatment of externalizing behavior among preschool-aged youth. Although considerable research has established its efficacy, little is known about the effectiveness of PCIT when delivered in a community mental health setting with underserved youth. The current pilot study investigated an implementation of PCIT with primarily low-socioeconomic status, urban, ethnic minority youth and families. The families of 14 clinically referred children aged 2-7 years and demonstrating externalizing behavior completed PCIT initial assessment, and 12 began treatment. Using standard PCIT completion criteria, 4 families completed treatment; and these families demonstrated clinically significant change on observational and self-report measures of parent behavior, parenting stress, and child functioning. Although treatment dropouts demonstrated more attenuated changes, observational data and parent-reported problems across sessions indicated some improvements with lower doses of intervention. Attendance and adherence data, referral source, barriers to treatment participation, and treatment satisfaction across completers and dropouts are discussed to highlight differences between the current sample and prior PCIT research. The findings suggest that PCIT can be delivered successfully in an underserved community sample when families remain in treatment, but that premature dropout limits treatment effectiveness. The findings suggest potential directions for research to improve uptake of PCIT in a community service setting.
    Full-text · Article · Oct 2010 · Journal of Child and Family Studies
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    • "First, reliable and valid definitions of ODD, DBDs, antisocial characteristics, externalizing problems, or any other term used to describe the broad spectrum of behavioral problems must be developed and accepted by the research community. In fact, current versions of the DSM and the ICD, though consistent in some respects, classify ODD differently (i.e., the ICD explicitly conceptualizes ODD as part of the same dimension of behavior as CD; Rey & Walter, 1999; Rowe et al., 2005). Second, methodological inconsistencies must be resolved (e.g., McMahon & Frick, 2005). "
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    ABSTRACT: A large amount of research has been done on Disruptive Behavior Disorders in general and on Oppositional Defiant Disorder in particular. Although research has examined many facets of Oppositional Defiant Disorder, many questions remain. Further, inconsistencies in terminology and methodological concerns across research studies have made it difficult to think consistently about Oppositional Defiant Disorder. As a result, before examining research concerning the etiology of Oppositional Defiant Disorder, concerns in identifying cases of this disorder are discussed. Risk factors for and potential courses of Oppositional Defiant Disorder are examined in the context of possible varying etiologies. Finally, theories about the etiology of and future directions for research related to Oppositional Defiant Disorder and other behavioral problems are examined.
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