Variability in emotional/behavioral problems in boys with oppositional defiant disorder or conduct disorder: the role of arousal

Abstract

It is often reported that children with oppositional defiant disorder (ODD) or conduct disorder (CD) are under-aroused. However, the evidence is mixed, with some children with ODD/CD displaying high arousal. This has led to the hypothesis that different profiles of arousal dysfunction may exist within children with ODD/CD. This knowledge could explain variability within children with ODD/CD, both in terms of specific types of aggression as well as comorbid symptoms (e.g., other emotional/behavioral problems). We measured heart rate variability (HRV), heart rate (HR) and skin conductance level (SCL) during rest and stress, and obtained parent and teacher reports of aggression, anxiety, attention problems and autism traits in a sample of 66 ODD/CD and 36 non-clinical boys (aged 8–12 years). The ODD/CD group scored significantly higher on aggression, anxiety, attention problems and autism traits than the controls; boys with ODD/CD also had higher resting HRs than controls, but HR stress, HRV and SCL did not differ. Hierarchical regressions showed different physiological profiles in subgroups of boys with ODD/CD based on their type of aggression; a pattern of high baseline HR and SCL, but low stress HRV was related to reactive aggression, whereas the opposite physiological pattern (low HR, low stress SCL, high stress HRV) was related to proactive aggression. Furthermore, high stress SCL was related to anxiety symptoms, whereas low stress SCL was related to attention problems. These findings are important because they indicate heterogeneity within boys with ODD/CD and highlight the importance of using physiology to differentiate boys with different ODD/CD subtypes.

Boys with Oppositional Defiant Disorder/Conduct Disorder Show Impaired Adaptation During Stress: An Executive Functioning Study

“…As a result they may not be able to benefit from increased arousal to the same degree as typically developing children. Although in this article we considered boys with ODD/CD as one group, in a previous study [ 30 ] on variability in arousal levels in boys with ODD/CD, the same stressor led to some being overaroused and some being underaroused with distinct relations to behavioral problems. According to the Yerkes–Dodson law both are unfavorable for optimal performance.…”

“…The stressful condition was in a nonfamiliar laboratory at Leiden University, using an established and ecologically valid psychosocial stressor that involved provocation, frustration and competition to increase emotional arousal. Boys were led to believe that they were competing against a (videotaped) opponent of similar age and sex for the best performance and a favored award (for details, see [ 30 , 31 ]). Three tasks were used to increase emotional arousal.…”

Perspectives on clinical guidelines for severe behavioural problems in children across Europe: a qualitative study with mental health clinicians

“…SBPs are virtually equivalent to the more popular 'disruptive behaviour disorders' (DBDs) as used up to DSM-5. However, SBPs were preferred for several reasons: they draw focus on the severe end of the spectrum and do not exclude commonly encountered comorbidities (e.g., ADHD, ASD, [36][37][38]). In addition, DSM-5 explicitly no longer combines ODD and CD into DBDs].…”

Can Self-Persuasion Reduce Hostile Attribution Bias in Young Children?

“…We computed aggression scores as the average of the seven items (α = 0.79). This measure shows positive associations with other (peer-and teacher-report) aggression measures (Polman et al 2009) and effectively discriminates between children with disruptive behavior disorders and controls (Schoorl et al 2016). We also obtained ratings of reactive and proactive motives, but opted not to report these because the results were similar as for the frequency ratings.…”