These results support the validity of the oppositional defiant disorder diagnosis as a meaningful clinical entity independent of conduct disorder and highlight the extremely detrimental effects of oppositional defiant disorder on multiple domains of functioning in children and adolescents.

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IQ-achievement discrepancy methodology similar to that used in defining learning disabilities has recently been used to identify a subset of boys with attention-deficit/hyperactivity disorder (ADHD) evidencing marked impairment in social functioning. In this study, 2 issues were examined: (a) What is the longitudinal outcome of boys with ADHD identified at baseline as "socially disabled"? (b) Is social disability at baseline a significant predictor of severe long-term outcomes (such as substance use disorders) in boys with ADHD? If so, are its predictive relationships accounted for by conditions that are comorbid with ADHD? Results showed that, at follow-up, boys with ADHD who also had social disability evidenced significantly higher rates of mood, anxiety, disruptive, and substance use disorders, compared with nonsocially disabled boys with ADHD and comparison boys without ADHD. Findings also showed that social disability at baseline in boys with ADHD was a significant predictor of later conduct disorder and most substance use disorders after baseline mood and conduct disorders and behavior checklist ratings of aggressive behavior and attention problems were controlled.

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The inattentive and/or hyperactive-impulsive behaviors that typify attention-deficit/hyperactivity disorder (ADHD) have been associated with increased stress in parents of children who are so diagnosed and are known to adversely affect the quality of parent-child interactions. Far less is known, however, about the effects of ADHD on interactions between students with the disorder and their teachers and on levels of teacher stress. Using the Index of Teaching Stress, an instrument assessing a teacher's subjective level of stress and frustration in response to teaching and interacting with a particular student, we found that general education elementary school teachers rated students with ADHD as significantly more stressful to teach than their classmates without ADHD. However, we found that the stress reported by teachers was highly individualized.Students with ADHD who evidenced oppositional/aggressive behavior or severe social impairment were rated as significantly more stressful to teach than students with ADHD who did not evidence these associated difficulties.

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Objective Examine the efficacy of Collaborative & Proactive Solutions (CPS) in treating oppositional defiant disorder (ODD) in youth by comparing this novel treatment to Parent Management Training (PMT), a well-established treatment, and a waitlist control (WLC) group. Method One hundred and thirty four youth (ages 7 – 14, 61.9% male, 83.6% white) who fulfilled Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for ODD were randomized to either CPS, PMT or WLC groups. ODD was assessed with semi-structured diagnostic interviews, clinical global severity and improvement ratings, and parent report measures. Assessments were completed pre-treatment, post-treatment, and at 6 months following treatment. Responder and remitter analyses were undertaken using intent-to-treat mixed models analyses. Chronological age, gender, and socioeconomic status as well as the presence of comorbid attention deficit/hyperactivity and anxiety disorders were examined as predictors of treatment outcome. Results Both treatment conditions were superior to the WLC condition but did not differ from one another in either our responder or remitter analyses. Approximately 50% of youth in both active treatments were diagnosis free and were judged to be much or very much improved at post-treatment, compared to 0% in the waitlist condition. Younger age and presence of an anxiety disorder predicted better treatment outcomes for both PMT and CPS. Treatment gains were maintained at 6-month follow-up. Conclusions CPS proved to be equivalent to PMT and can be considered an evidence-based, alternative treatment for youth with ODD and their families.