Co-Occurring Conduct Problems and Anxiety: Implications for the Functioning and Treatment of Youth with Oppositional Defiant Disorder

Thorhildur Halldorsdottir (), Maria G Fraire, Deborah A. G. Drabick and Thomas H. Ollendick
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Thorhildur Halldorsdottir: Department of Psychology, School of Social Sciences, Reykjavik University, 102 Reykjavik, Iceland
Maria G Fraire: Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA 02115, USA
Deborah A. G. Drabick: Department of Psychology and Neuroscience, Temple University, Philadelphia, PA 19122, USA
Thomas H. Ollendick: Child Study Center, Department of Psychology, Virginia Tech, Blacksburg, VA 24060, USA

IJERPH, 2023, vol. 20, issue 4, 1-12

Abstract: Conduct problems and anxiety symptoms commonly co-occur among youths with oppositional defiant disorder (ODD); however, how these symptoms influence functioning and treatment outcomes remains unclear. This study examined subtypes based on these co-occurring symptoms in a clinical sample of 134 youths (M age = 9.67, 36.6% female, 83.6% white) with ODD and the predictive power of these subgroups for youth functioning and psychosocial treatment outcomes. The latent profile analysis (LPA) was used to identify subgroups based on parent- and self-reported conduct problems and anxiety symptoms. Differences among the subgroups in clinician-, parent-, and/or self-reported accounts of symptom severity, school performance, underlying processing known to be impaired across ODD, conduct and anxiety disorders, self-concept, and psychosocial treatment outcomes were examined. Four distinct profiles were identified: (1) Low Anxiety/Moderate Conduct Problems ( n = 42); (2) High Anxiety/Moderate Conduct Problems ( n = 33); (3) Moderate Anxiety/Moderate Conduct Problems ( n = 40); and (4) Moderate Anxiety/High Conduct Problems ( n = 19). The Moderate Anxiety/High Conduct Problems group exhibited more severe behavioral problems, greater difficulties with negative emotionality, emotional self-control, and executive functioning; they also demonstrated worse long-term treatment outcomes than the other subgroups. These findings suggest more homogeneous subgroups within and across diagnostic categories may result in a deeper understanding of ODD and could inform nosological systems and intervention efforts.

Keywords: oppositional defiant disorder; conduct problems; anxiety; subtypes; latent profile analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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