The Longitudinal Association Between Oppositional and Depressive Symptoms Across Childhood

229

163

Background To evaluate associations between ADHD and comorbid psychiatric disorders using research-identified incident cases of ADHD and population-based controls. Methods Subjects included a birth cohort of all children born 1976–1982 remaining in Rochester, MN after age five (n = 5718). Among them we identified 379 ADHD incident cases and 758 age-sex matched non-ADHD controls, passively followed to age 19 years. All psychiatric diagnoses were identified and abstracted, but only those confirmed by qualified medical professionals were included in the analysis. For each psychiatric disorder, cumulative incidence rates for subjects with and without ADHD were estimated using the Kaplan-Meier method. Corresponding hazard ratios (HR) were estimated using Cox models adjusted for gender and mother’s age and education at the subject’s birth. The association between ADHD and the likelihood of having an internalizing or externalizing disorder was summarized by estimating odds ratios (OR). Results ADHD was associated with a significantly increased risk of adjustment disorders (HR=3.88), conduct/oppositional defiant disorder (HR=9.54), mood disorders (HR=3.67), anxiety disorders (HR=2.94), tic disorders (HR=6.53), eating disorders (HR=5.68), personality disorders (HR=5.80), and substance-related disorders (HR=4.03). When psychiatric comorbidities were classified on the internalization-externalization dimension, ADHD was strongly associated with coexisting internalizing/externalizing (OR=10.6), or externalizing-only (OR=10.0) disorders. Conclusion This population-based study confirms that children with ADHD are at significantly increased risk for a wide range of psychiatric disorders. Besides treating the ADHD, clinicians should identify and provide appropriate treatment for psychiatric comorbidities.

Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 60%

Childhood ADHD is strongly associated with a broad range of psychiatric disorders during adolescence: a population‐based birth cohort study

Yoshimasu

Barbaresi²,

Colligan

et al. 2012

229

163

“…Fourth, we used global measures of externalising and internalising problems in our study, rather than narrowband dimensions such as delinquency or aggressive behaviour. We would not expect different results when using subtypes, because dimensions within one problem group are highly correlated (Achenbach, Edelbrock, & Howell, ; Wadsworth, Hudziak, Heath, & Achenbach, ) and the association between externalising and internalising problems does not seem to be restricted to any particular dimensions of these problems (Boylan et al., ; Reef et al., ). Fifth, given that we used continuous measures, our analyses did not allow us to test whether there is a group of children with externalising problems who are at particularly high risk of developing internalising problems.…”

Section: Discussionmentioning

confidence: 99%

“…Although most children displaying such behaviour grow up to become well‐adjusted adolescents and adults, some will engage in recidivistic, violent criminal activities throughout their life (Moffitt, Caspi, Harrington, & Milne, ). Apart from experiencing such persisting antisocial symptoms, children with externalising behaviour are also at risk of developing internalising problems, such as anxiety and depression, both concurrently and as they grow older (Boylan, Georgiades, & Szatmari, ; Reef, van Meurs, Verhulst, & van der Ende, ). The processes underlying the association between earlier externalising and later new internalising problems are unknown.…”

Section: Introductionmentioning

confidence: 99%

Why some children with externalising problems develop internalising symptoms: testing two pathways in a genetically sensitive cohort study

Wertz

Zavos

Matthews

et al. 2014

Background: Children with externalising problems are at risk of developing internalising problems as they grow older. The pathways underlying this developmental association remain to be elucidated. We tested two processes that could explain why some children with externalising problems develop internalising symptoms in preadolescence: a mediation model whereby the association between early externalising and later new internalising symptoms is explained by negative experiences; and a genetic model, whereby genes influence both problems. Methods: We used data from the Environmental Risk (E-Risk) Study, a 1994–1995 birth cohort of 2,232 twins born in England and Wales. We assessed externalising and internalising problems using combined mothers’ and teachers’ ratings at age 5 and 12. We measured bullying victimisation, maternal dissatisfaction and academic difficulties between age 7 and 10 and used linear regression analyses to test the effects of these negative experiences on the association between early externalising and later internalising problems. We employed a Cholesky decomposition to examine the genetic influences on the association. Results: Children with externalising problems at age 5 showed increased rates of new internalising problems at age 12 (r = .24, p < .001). Negative experiences accounted for some of the association between early externalising and later internalising problems. Behavioural genetic analyses indicated that genes influencing early externalising problems also affected later internalising problems. Conclusions: Our findings highlight the role of genetic influences in explaining why some children with externalising problems develop internalising symptoms in preadolescence. Negative experiences also contribute to the association, possibly through gene-environment interplay. Mental health professionals should monitor the development of internalising symptoms in young children with externalising problems.

“…Recent studies have put the current concept of oppositional defiant disorder (ODD) into question and suggested that ODD is not only a precursor of conduct disorder (CD) but, rather, an independent disorder, which may persist into adolescence (Maughan, Rowe, Messer, Goodman, & Meltzer, 2004) and has other outcomes and comorbidities than CD (Copeland, Shanahan, Costello, & Angold, 2009; Greene et al., 2002; Nock, Kazdin, Hiripi, & Kessler, 2007; Rowe, Costello, Angold, Copeland, & Maughan, 2010). Beyond the well‐known association of ODD with attention‐deficit‐hyperactivity‐disorder (ADHD) and CD (Moffitt et al., 2008), a number of studies found a strong link between ODD and internalizing disorders (Boylan, Vaillancourt, Boyle, & Szatmari, 2007; Burke & Loeber, 2010), particularly between concurrent and later childhood, adolescent, and adult depression (Boylan, Georgiades, & Szatmari, 2010; Burke, Loeber, Lahey, & Rathouz, 2005; Copeland et al., 2009; Rowe et al., 2010). Furthermore, ODD was found to contribute to later adult antisocial behaviors independent of CD (Langbehn, Cadoret, Yates, Troughton, & Stewart, 1998) and ODD independent of CD was the strongest predictor of criminal recidivism in incarcerated male juveniles (Plattner et al., 2009).…”

Section: Introductionmentioning

confidence: 99%

Parent‐ and self‐reported dimensions of oppositionality in youth: construct validity, concurrent validity, and the prediction of criminal outcomes in adulthood

Aebi¹,

Plattner²,

Metzke³

et al. 2013

Background: Different dimensions of oppositional defiant disorder (ODD) have been found as valid predictors of further mental health problems and antisocial behaviors in youth. The present study aimed at testing the construct, concurrent, and predictive validity of ODD dimensions derived from parent-and self-report measures. Method: Confirmatory factor analyses were performed to test a threedimensional model (ODD-irritability, ODD-headstrong, and ODD-hurtful) and a two-dimensional model (ODD-irritability, ODD-headstrong/hurtful) based on items of the Child Behavior Checklist (CBCL) and the Youth Self Report (YSR) collected in a Swiss community study of 1,031 adolescents (519 boys, 512 girls) aged between 10.7 and 17.9 (M = 13.85, SD = 1.63) years. Logistic regression analyses were applied to predict scores in the clinical range of concurrent CBCL/YSR-anxiety/depression, CBCL/YSR-attention problems, and CBCL/YSR-delinquent behavior and depression as measured by the Center for Epidemiological Studies Depression Scale (CES-D) as well as to predict the presence of adult criminal convictions. Results: CFA findings were in favor of a three-dimensional model rather than a two-dimensional model of ODD. The CBCL/YSR-ODD-irritability scale was related to concurrent selfreported depression, but also to attention problems and delinquent behavior. CBCL/YSR-ODD-hurtful and less strongly also the combined YSR-headstrong/hurtful scale predicted adult criminal outcomes. Conclusions: As proposed by the DSM-5 workgroup, different ODD-dimensions were confirmed by the present study. ODD-irritability predicts psychiatric comorbidity and ODD-hurtful symptoms should be specifically considered in youth at risk for criminal outcomes. Competing interestsAll authors declare that they have no conflicting interests to report with the design and the findings of the present study.