The Psychosocial Outcome of Conduct and Oppositional Defiant Disorder in Children With Attention Deficit Hyperactivity Disorder

Abstract

Attention deficit hyperactivity disorder (ADHD) is one of the most common mental disorders diagnosed in children below the age of 12 years. It is characterized by hyperactivity, inattention, and impulsive behavior. ADHD affects the social, academic, and psychological aspects of children and adolescents. Children with ADHD struggle with school tasks and performance. They have lower grades than their peers and have difficulties interacting with their friends. Oppositional defiant disorder (ODD) is a mental disorder characterized by disruptive behavior, a pattern of angry and irritable mood, argumentative, and vindictive behavior. Children with ODD struggle with forming friendships and have problems at school. Conduct disorder (CD) is divided into the childhood onset and the adolescent onset types. The childhood onset is associated with poor outcomes in adulthood, an increase in criminal behavior, violence, and progression to antisocial behavior. Children with CD are at increased risk for substance use disorders (SUD) and antisocial personality disorder. The current literature review is aiming to provide an overview of the psychosocial impact of comorbid ODD and CD in children with ADHD. The results of this study review showed the comorbidity of ODD and CD is very strong. ODD is a strong predictor of CD in boys. The presence of comorbid ODD and ADHD in children is a significant predictor of adolescent onset CD. The comorbidity of ADHD with ODD and CD worsens symptom severity and is associated with high psychosocial dysfunction. Children with ADHD and comorbid ODD and CD have difficulties with school, friends, and trouble with the police.

The potential shared brain functional alterations between adults with ADHD and children with ADHD co-occurred with disruptive behaviors

“…Children with ADHD ODD+ may form an intermediate subgroup between ADHD only and ADHD CD+ [ 38 , 39 ]. Some scholars even suggested that ODD is a common feature that is exaggerated in normal adolescents, and it should be considered a temperament dimension rather than a separate categorical disorder [ 3 ]. Therefore, it is not surprising that although the association between ODD and FCs indicated the same association trend as CD, this correlation was not significant.…”

“…DBD is a common and highly impairing psychiatric disorder characterized by conduct problems, irritability, and oppositional defiant behaviour [ 2 ]. Children with ADHD and DBD (ADHD DBD+ ) have additional impairments and worse prognosis than children with ADHD alone or DBD alone [ 3 , 4 ]. In particular, many empirical studies have shown that comorbid DBD predicts ADHD persistence through adulthood.…”

Conduct Disorder: An Update

“…Some individuals experiencing resolution of the disorder in adulthood, while others continue to exhibit symptoms and meet the criteria for antisocial personality disorder (Berluti et al 2023). Childhood-onset conduct disorder has been associated with a poor prognosis, as it increases the risk of developing antisocial personality and substance use disorders in adulthood (Eskander 2020). Furthermore, the prognosis is particularly poor when conduct disorder co-occurs with attention deficit hyperactivity disorder, as this combination is associated with a higher likelihood of antisocial and violent behaviors (Thabrew et al 2017).…”

Peer functioning difficulties may exacerbate symptoms of attention‐deficit/hyperactivity disorder and irritability over time: a temporal network analysis

“…Although ADHD and irritability are highly cooccurring and consistently associated with peer functioning impairments, the interplay between these clinical dimensions and peer functioning has rarely been examined. These interactions are particularly relevant given evidence that children who meet the criteria for both ADHD and ODD displayed worse peer relationships (including peer rejection and bullying) than children who meet the criteria for either ADHD or ODD alone (Eskander, 2020;Tseng et al, 2011). Evans et al (2020) examined the longitudinal effects of ADHD and ODD dimensions on peer functioning and found that irritability was concurrently associated with peer rejection and victimization, whereas inattention and hyperactivity-impulsivity robustly predicted subsequent peer rejection and victimization.…”

“…Although ADHD and irritability are highly co‐occurring and consistently associated with peer functioning impairments, the interplay between these clinical dimensions and peer functioning has rarely been examined. These interactions are particularly relevant given evidence that children who meet the criteria for both ADHD and ODD displayed worse peer relationships (including peer rejection and bullying) than children who meet the criteria for either ADHD or ODD alone (Eskander, 2020; Tseng et al., 2011). Evans et al.…”