External validation of a bifactor model of oppositional defiant disorder

Abstract

Dimensions of irritability and defiant behavior, though correlated within the structure of ODD, convey separable developmental risks through adolescence and adulthood. Irritability predicts depression and anxiety, whereas defiant behavior is a precursor to antisocial outcomes. Previously we demonstrated that a bifactor model comprising irritability and defiant behavior dimensions, in addition to a general factor, provided the best fitting structure of ODD symptoms in five large datasets.1 Herein we extend our previous work by externally validating the bifactor model of ODD using multiple regression and multivariate behavior genetic analyses. We used parent ratings of DSM IV ODD symptoms, and symptom dimensions for ADHD (i.e., inattention and hyperactivity-impulsivity), Conduct Disorder (CD), Depression / Dysthymia, and Generalized Anxiety Disorder (GAD) from 846 6–18 year old twin pairs. We found that the ODD irritability factor was associated only with Depression / Dysthymia and GAD and the ODD defiant behavior factor was associated only with inattention, hyperactivity-impulsivity, and CD, whereas the ODD General factor was associated with all 5 symptom dimensions. Multivariate behavior genetic analyses found all 5 symptom dimensions shared genetic influences in common with the ODD General, irritability, and defiant behavior factors. In contrast, the defiant behavior factor shared genetic influences uniquely with inattention and hyperactivity-impulsivity, whereas the irritability factor shared genetic influences uniquely with Depression / Dysthymia and GAD, but not vice versa. This suggests that genes that influence irritability in early childhood also predispose to depression and anxiety in adolescence and adulthood. These multivariate genetic findings also support the external validity of the 3 ODD dimensions at the etiological level. Our study provides additional support for subtyping ODD based on these symptom dimensions, as in the revisions in the ICD-11, and suggests potential mechanisms underlying the development from ODD to behavioral or affective disorders.

Riskier Tests of the Validity of the Bifactor Model of Psychopathology

“…Hypothesis 1 : We hypothesize that the general factor within a bifactor model will not be influenced equally by all psychopathology dimensions and instead will be defined primarily by distress (Oltmanns et al, 2018) and antagonism-imbued forms of externalizing (i.e., conduct disorder, oppositional defiant disorder). We predicted that antagonism-imbued forms of externalizing would load highly onto the general factor given that our demonstration relies on youth data and antagonism and neuroticism tend to be more highly correlated and thus more difficult to disentangle in youth compared with adults (Tackett, Kushner, De Fruit, & Mervielde, 2013; Waldman et al, 2018).…”

Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): II. Externalizing superspectrum

“…Specifically, in youth samples, twin studies have shown high heritabilities (h 2 ) and moderate levels of nonshared environ mental influences, but nonsignificant shared environmental influences, for ADHD (h 2 =~6080%) 94 and ODD (h 2 =~3070%) 93 , as well as for psychopathic traits (such as callousunemotion ality and narcissism) 95 . These studies have also found moder ate heritability (h 2 =~50%), shared environmental influences, and nonshared environmental influences for CD 96 , and moderate heritability for various forms of youth antisocial behavior, includ ing rule breaking and aggression 97 , with its various forms such as reactive, proactive and relational aggression 96,98,99 .…”

Is an irritable ADHD profile traceable using personality dimensions? Replicability, stability, and predictive value over time of data-driven profiles

“…Although irritability is not a defining diagnostic feature, impairments in irritability are highly prevalent in childhood ADHD and affect at least half of patients in clinical samples [28][29][30]. Irritability is also strongly associated to defiant behaviours [31], and as such defined as a dimension of ODD in the DSM-5 [16].…”