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Risk factors for comorbid oppositional defiant disorder in attention-deficit/hyperactivity disorder

Siri D S Noordermeer1, Marjolein Luman2, Wouter D Weeda3

  • 1Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands. s.d.s.noordermeer@vu.nl.

European Child & Adolescent Psychiatry
|March 12, 2017
PubMed

Insights

Identifying risk factors for attention-deficit/hyperactivity disorder (ADHD) with oppositional defiant disorder (ODD) is crucial. Adverse life events, parental ADHD, criticism, peer affiliation, and socioeconomic status are key predictors for ADHD + ODD.

Area of Science:

  • Child and Adolescent Psychiatry
  • Developmental Psychology
  • Behavioral Neuroscience

Background:

  • Oppositional defiant disorder (ODD) frequently co-occurs with attention-deficit/hyperactivity disorder (ADHD).
  • The co-occurrence of ADHD and ODD (ADHD + ODD) is associated with a significantly poorer prognosis.
  • Identifying risk factors for ADHD + ODD is vital for developing effective early interventions.

Purpose of the Study:

  • To investigate pre- and perinatal, transgenerational, and postnatal risk factors associated with ADHD + ODD.
  • To differentiate risk factors for ADHD-only versus ADHD + ODD.
  • To inform the development of targeted preventive strategies for comorbid ODD in ADHD.

Main Methods:

  • A case-control study design was employed, matching participants on age, gender, and ADHD subtype.
  • Risk factors assessed included perinatal variables (e.g., birth weight, maternal smoking), transgenerational factors (parental ADHD, warmth, criticism), and postnatal factors (SES, adverse life events, peer affiliation).
  • Three models were analyzed: ADHD-only vs. controls, ADHD + ODD vs. controls, and ADHD + ODD vs. ADHD-only.

Main Results:

  • Adverse life events and parental ADHD were identified as risk factors for both ADHD-only and ADHD + ODD.
  • Higher levels of adverse life events were a stronger predictor for ADHD + ODD compared to ADHD-only.
  • Parental criticism, deviant peer affiliation, and lower parental socioeconomic status (SES) were significant risk factors specifically for ADHD + ODD.
  • Maternal smoking during pregnancy was a minor risk factor for ADHD-only, while higher birth weight was a minor risk factor for ADHD + ODD.

Conclusions:

  • The findings underscore the significant role of adverse life events, parental factors (ADHD, criticism), peer affiliation, and SES in the development of comorbid ODD in individuals with ADHD.
  • These identified risk factors provide a foundation for developing targeted preventive interventions.
  • Parent-focused interventions are recommended to address these critical developmental influences.

Keywords:
ADHDComorbidityODDRisk factors

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