Developmental continuity of oppositional defiant disorder subdimensions at ages 8, 10, and 13 years and their distinct psychiatric outcomes at age 16 years

Abstract

Objective: To test the developmental continuity, interrelationships, and predictive associations of the oppositional defiant disorder (ODD) subdimensions of irritable, headstrong, and hurtful.

Method: Data were collected from 6,328 mother-child pairs participating in the Avon Longitudinal Study of Parents and Children (United Kingdom).

Results: Developmental continuity for each subdimension was strong and interrelationships indicated that headstrong was associated mainly with irritable, whereas irritable did not cross associate with other ODD subdimensions; and hurtful was associated with lower levels of headstrong. With regard to associations at age 16 years, irritable at age 13 years was associated with depression, whereas headstrong at 13 was associated with delinquency and callous attitude; at age 13, hurtful failed to associate with any of the 3 age 16 outcomes.

Conclusions: The results suggest that the ODD headstrong and irritable subdimensions are developmentally distinct, with small cross-over (i.e., headstrong to irritable), and are associated with unique outcomes. Hurtful does not appear to be associated with future maladjustment in children.

Keywords: Avon Longitudinal Study of Parents and Children (ALSPAC); callous traits; conduct problems; depression; oppositional defiant disorder.

FIGURE 1. Multivariate autoregressive cross-lagged model of longitudinal relationships between subdimensions of oppositional defiant disorder (ODD) and adolescent outcomes of depression, conduct problems, and callous attitude.

Note: Circles denote latent variables. Controls: partnership status, low socioeconomic status (SES), teen pregnancy, maternal education, sex, and age 7 Development and Well Being Assessment (DAWBA) depression and conduct disorder. The resulting population effect sizes are interpreted using the Cohen³⁵ guidelines: an effect of 0.10 is a small effect, an effect of 0.24 is a medium effect, and an effect of 0.37 is a large effect. Significant (*) results only are shown. The numbers 8, 10, 13 denote age in years. Callous16 = callous attitude at 16 years; CP16 = conduct problems at 16 years; Dep16 = depression at 16 years; Head = headstrong; Hurt = hurtful; Irrit = irritable.