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Zhou H, Han F, Chen R, Huang J, Chen J, Lin X. Estimating the Heterogeneous Causal Effects of Parent-Child Relationships among Chinese Children with Oppositional Defiant Symptoms: A Machine Learning Approach. Behav Sci (Basel) 2024; 14:504. [PMID: 38920836 DOI: 10.3390/bs14060504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
Oppositional defiant symptoms are some of the most common developmental symptoms in children and adolescents with and without oppositional defiant disorder. Research has addressed the close association of the parent-child relationship (PCR) with oppositional defiant symptoms. However, it is necessary to further investigate the underlying mechanism for forming targeted intervention strategies. By using a machine learning-based causal forest (CF) model, we investigated the heterogeneous causal effects of the PCR on oppositional defiant symptoms in children in Chinese elementary schools. Based on the PCR improvement in two consecutive years, 423 children were divided into improved and control groups. The assessment of oppositional defiant symptoms (AODS) in the second year was set as the dependent variable. Additionally, several factors based on the multilevel family model and the baseline AODS in the first year were included as covariates. Consistent with expectations, the CF model showed a significant causal effect between the PCR and oppositional defiant symptoms in the samples. Moreover, the causality exhibited heterogeneity. The causal effect was greater in those children with higher baseline AODS, a worse family atmosphere, and lower emotion regulation abilities in themselves or their parents. Conversely, the parenting style played a positive role in causality. These findings enhance our understanding of how the PCR contributes to the development of oppositional defiant symptoms conditioned by factors from a multilevel family system. The heterogeneous causality in the observation data, established using the machine learning approach, could be helpful in forming personalized family-oriented intervention strategies for children with oppositional defiant symptoms.
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Affiliation(s)
- Haiyan Zhou
- Faculty of Information Technology, Beijing University of Technology, Beijing 100124, China
- Beijing International Collaboration Base on Brain Informatics and Wisdom Services, Beijing 100124, China
- Engineering Research Center of Intelligent Perception and Autonomous Control, Ministry of Education, Beijing 100124, China
- Engineering Research Center of Digital Community, Ministry of Education, Beijing 100124, China
| | - Fengkai Han
- Faculty of Information Technology, Beijing University of Technology, Beijing 100124, China
- Beijing International Collaboration Base on Brain Informatics and Wisdom Services, Beijing 100124, China
- Engineering Research Center of Intelligent Perception and Autonomous Control, Ministry of Education, Beijing 100124, China
- Engineering Research Center of Digital Community, Ministry of Education, Beijing 100124, China
| | - Ruoxi Chen
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing 100875, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Jiajin Huang
- Faculty of Information Technology, Beijing University of Technology, Beijing 100124, China
- Beijing International Collaboration Base on Brain Informatics and Wisdom Services, Beijing 100124, China
- Engineering Research Center of Intelligent Perception and Autonomous Control, Ministry of Education, Beijing 100124, China
- Engineering Research Center of Digital Community, Ministry of Education, Beijing 100124, China
| | - Jianhui Chen
- Faculty of Information Technology, Beijing University of Technology, Beijing 100124, China
- Beijing International Collaboration Base on Brain Informatics and Wisdom Services, Beijing 100124, China
- Engineering Research Center of Intelligent Perception and Autonomous Control, Ministry of Education, Beijing 100124, China
- Engineering Research Center of Digital Community, Ministry of Education, Beijing 100124, China
| | - Xiuyun Lin
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing 100875, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing 100875, China
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Pham T, Pasalich D, Tran P, O'Kearney R. A randomized controlled trial of therapist-facilitated brief online behavioral parent training for reducing child disruptive behavior. Int J Clin Health Psychol 2024; 24:100448. [PMID: 38371397 PMCID: PMC10869913 DOI: 10.1016/j.ijchp.2024.100448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 02/01/2024] [Indexed: 02/20/2024] Open
Abstract
Background Addressing child disruptive behavior in low and middle-income countries (LMICs) is challenging. Therapist-facilitated, multisession, brief, online group parent training offers hope for mitigating this issue. However, trials, particularly in Asia, are limited. Objective This study primarily assessed the effectiveness of Brief Behavior Parent Training Vietnam (BBPTV) in reducing child disruptive behavior. Method This study was a randomized controlled trial involving 109 Vietnamese parents (mean age = 34.1, 96 % were mothers) of preschool children displaying ongoing disruptive behaviors. Interventions included the BBPTV group (n = 56) receiving a therapist-facilitated, four-session program conducted through online group meetings and the care-as-usual (CAU) group (n = 53) having a 15 min individual online consultation. Primary outcomes, assessed online at two and six months postintervention, encompassed the intensity and frequency of children's disruptive problems. Secondary outcomes involved parenting practices, coercive interactions, marital conflicts, parenting self-efficacy, and parental mental health. Results In contrast to CAU, the BBPTV group showed lower child disruptive intensity, reduced parent-child coercive interactions, and diminished marital conflicts, with a higher score in involving parenting two months post-intervention. Six months postintervention, BBPTV also exhibited significantly lower scores in child disruptive intensity and problems, harsh parenting, and coercive processes compared to CAU. Conclusions The therapist-facilitated, four-session, internet-delivered group parent intervention resulted in superior and sustained improvements in child disruptive behavior, parenting practices, and parent-child coercive interaction compared to usual care, highlighting the potential for online BBPT to extend mental health care in Vietnam and other LMICs.
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Affiliation(s)
- Triet Pham
- School of Medicine and Psychology, ANU College Health and Medicine, The Australian National University, Building 39, Science Road, Canberra, ACT 2601, Australia
- Children's Hospital 1 (Benh vien Nhi dong 1), 341 Su Van Hanh street, District 10, Ho Chi Minh City, Viet Nam
| | - Dave Pasalich
- School of Medicine and Psychology, ANU College Health and Medicine, The Australian National University, Building 39, Science Road, Canberra, ACT 2601, Australia
| | - Phu Tran
- Children's Hospital 1 (Benh vien Nhi dong 1), 341 Su Van Hanh street, District 10, Ho Chi Minh City, Viet Nam
| | - Richard O'Kearney
- School of Medicine and Psychology, ANU College Health and Medicine, The Australian National University, Building 39, Science Road, Canberra, ACT 2601, Australia
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Lavigne JV, Hopkins J, Ballard RJ, Gouze KR, Ariza AJ, Martin CP. A Precision Mental Health Model for Predicting Stability of 4-year-olds' Attention Deficit/Hyperactivity Disorder Symptoms to Age 6 Diagnostic Status. Acad Pediatr 2024; 24:433-441. [PMID: 37865171 PMCID: PMC10997456 DOI: 10.1016/j.acap.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE Estimates of the stability of a preschooler's diagnosis of Attention Deficit/Hyperactivity Disorder (ADHD) into early elementary school vary greatly. Identified factors associated with diagnostic instability provide little guidance about the likelihood a particular child will have ADHD in elementary school. This study examined an approach to predicting age 6 ADHD-any subtype (ADHD-any) from preschoolers' demographics and ADHD symptoms. METHOD Participants were 796 preschool children (Mage = 4.44; 51% boys; 54% White, non-Hispanic) recruited from primary pediatric care and school settings. Parents completed ADHD Rating Scales at child ages 4 and 5 years, and a structured diagnostic interview (DISC-YC) at ages 4 and 6. Classification tree analyses (CTAs) examined the predictive utility of demographic and symptom variables at ages 4 and 5 years for age 6 ADHD. RESULTS Over half (52.05%) of preschoolers meeting diagnostic criteria for ADHD-any at age 4 did not meet those criteria at age 6; more than half (52.05%) meeting criteria for ADHD-any at age 6 had not met those criteria at age 4. A CTA conducted at age 4 predicted age 6 ADHD-any diagnosis 65.82% better than chance; an age 5 CTA predicted age 6 ADHD-any 70.60% better than chance. At age 4, likelihood of age 6 ADHD-any diagnosis varied from <5% to >40% across CTA tree branches and from <5% to >78% at age 5. CONCLUSIONS Parent-reported patterns of preschool-age symptoms may differentially predict ADHD-any at age 6. Psychoeducation regarding these patterns may aid in decision about pursuing multidisciplinary evaluations or initiating treatment.
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Affiliation(s)
- John V Lavigne
- Pritzker Department of Psychiatry and Behavioral Health (JV Lavigne, RJ Ballard, KR Gouze, and CP Martin), Ann and Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Ann and Robert H. Lurie Children's Hospital, Chicago, Ill.
| | - Joyce Hopkins
- Department of Psychology (J Hopkins and CP Martin), Illinois Institute of Technology, Chicago, Ill
| | - Rachel J Ballard
- Pritzker Department of Psychiatry and Behavioral Health (JV Lavigne, RJ Ballard, KR Gouze, and CP Martin), Ann and Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Ann and Robert H. Lurie Children's Hospital, Chicago, Ill
| | - Karen R Gouze
- Pritzker Department of Psychiatry and Behavioral Health (JV Lavigne, RJ Ballard, KR Gouze, and CP Martin), Ann and Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Ann and Robert H. Lurie Children's Hospital, Chicago, Ill
| | - Adolfo J Ariza
- Department of Pediatrics (AJ Ariza and CP Martin), Ann and Robert H. Lurie Children's Hospital of Chicago, Ann and Robert H. Lurie Children's Hospital, Chicago, Ill
| | - Caroline P Martin
- Pritzker Department of Psychiatry and Behavioral Health (JV Lavigne, RJ Ballard, KR Gouze, and CP Martin), Ann and Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Ann and Robert H. Lurie Children's Hospital, Chicago, Ill; Institute for Child Success (CP Martin), Greenville, SC
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de Lacy N, Ramshaw MJ. Selectively predicting the onset of ADHD, oppositional defiant disorder, and conduct disorder in early adolescence with high accuracy. Front Psychiatry 2023; 14:1280326. [PMID: 38144472 PMCID: PMC10739523 DOI: 10.3389/fpsyt.2023.1280326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/13/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction The externalizing disorders of attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) are common in adolescence and are strong predictors of adult psychopathology. While treatable, substantial diagnostic overlap complicates intervention planning. Understanding which factors predict the onset of each disorder and disambiguating their different predictors is of substantial translational interest. Materials and methods We analyzed 5,777 multimodal candidate predictors from children aged 9-10 years and their parents in the ABCD cohort to predict the future onset of ADHD, ODD, and CD at 2-year follow-up. We used deep learning optimized with an innovative AI algorithm to jointly optimize model training, perform automated feature selection, and construct individual-level predictions of illness onset and all prevailing cases at 11-12 years and examined relative predictive performance when candidate predictors were restricted to only neural metrics. Results Multimodal models achieved ~86-97% accuracy, 0.919-0.996 AUROC, and ~82-97% precision and recall in testing in held-out, unseen data. In neural-only models, predictive performance dropped substantially but nonetheless achieved accuracy and AUROC of ~80%. Parent aggressive and externalizing traits uniquely differentiated the onset of ODD, while structural MRI metrics in the limbic system were specific to CD. Psychosocial measures of sleep disorders, parent mental health and behavioral traits, and school performance proved valuable across all disorders. In neural-only models, structural and functional MRI metrics in subcortical regions and cortical-subcortical connectivity were emphasized. Overall, we identified a strong correlation between accuracy and final predictor importance. Conclusion Deep learning optimized with AI can generate highly accurate individual-level predictions of the onset of early adolescent externalizing disorders using multimodal features. While externalizing disorders are frequently co-morbid in adolescents, certain predictors were specific to the onset of ODD or CD vs. ADHD. To our knowledge, this is the first machine learning study to predict the onset of all three major adolescent externalizing disorders with the same design and participant cohort to enable direct comparisons, analyze >200 multimodal features, and include many types of neuroimaging metrics. Future study to test our observations in external validation data will help further test the generalizability of these findings.
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Affiliation(s)
- Nina de Lacy
- Huntsman Mental Health Institute, Salt Lake City, UT, United States
- Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
| | - Michael J. Ramshaw
- Huntsman Mental Health Institute, Salt Lake City, UT, United States
- Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
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Zhang W, Tang Y, Wu Q, Zhou N, Lin X. Oppositional Defiant Disorder Symptoms and Multi-level Family Factors in Chinese Migrant Children: A Network Perspective. Res Child Adolesc Psychopathol 2023:10.1007/s10802-023-01074-9. [PMID: 37162687 DOI: 10.1007/s10802-023-01074-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 05/11/2023]
Abstract
Based on the network theory of mental disorders, this study used network analysis to examine the network of ODD symptoms and multilevel family factors and identify the most crucial family factors influencing ODD symptoms in children. A total of 718 Chinese migrant children aged 7-14 years participated in this study. This study measured ODD symptoms, family system-level variables (3 factors), family dyadic-level variables (6 factors), and family individual-level variables (6 factors) with factors selected based on the multilevel family factors theory of ODD symptoms. The results indicated that (1) "annoy" was the center symptom of ODD, (2) "annoy" and "vindictive" was the main bridge connecting the multilevel family factors, and (3) family cohesion at the family system level, parent-child conflict at the family dyadic level, and parental depression at the family individual level were critical central and bridging influencing factors. The findings of this study highlight the critical role of "annoy" and "vindictive" symptoms in the activation of ODD symptom networks in children and provide a basis for future improvements in diagnostic criteria. These potential core and bridge factors might become key intervention targets for childhood ODD.
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Affiliation(s)
- Wenrui Zhang
- Institute of Developmental Psychology, School of Psychology, Beijing Normal University, Beijing, 100875, China
| | - Yingying Tang
- Institute of Developmental Psychology, School of Psychology, Beijing Normal University, Beijing, 100875, China
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, 78705, United States
| | - Qinglu Wu
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai, China
| | - Nan Zhou
- Faculty of Education, University of Macau, Macau, China
| | - Xiuyun Lin
- Institute of Developmental Psychology, School of Psychology, Beijing Normal University, Beijing, 100875, China.
- Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, Beijing, 100875, China.
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Kerley LJ, Meredith PJ, Harnett PH. The Relationship Between Sensory Processing and Attachment Patterns: A Scoping Review. Can J Occup Ther 2023; 90:79-91. [PMID: 35611458 DOI: 10.1177/00084174221102726] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Clinicians and researchers have observed that sensory processing and attachment difficulties frequently co-occur; however, little is known about which sensory processing and attachment patterns are interrelated across populations. Purpose. To review evidence of empirical relationships between sensory processing and attachment patterns across the life span. Method. Using the Arksey and O'Malley framework, four databases were searched up to June 2021 for studies that investigated relationships between sensory processing and attachment patterns. Findings. Twenty-two studies met inclusion criteria: nine considered sensory and attachment patterns in children/adolescents and thirteen in adults. In children, sensory modulation was positively associated with attachment security. In adults, more extreme patterns of sensory modulation (e.g., higher sensory sensitivity) were generally associated with attachment insecurity. Implications. Findings indicate empirical relationships between sensory processing and attachment constructs in children and adults that warrant further investigation. Occupational therapists should consider both sensory processing and attachment patterns when planning interventions.
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Lin X, He T, Heath M, Chi P, Hinshaw S. A Systematic Review of Multiple Family Factors Associated with Oppositional Defiant Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10866. [PMID: 36078582 PMCID: PMC9517877 DOI: 10.3390/ijerph191710866] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/26/2022] [Accepted: 08/27/2022] [Indexed: 05/25/2023]
Abstract
Oppositional Defiant Disorder (ODD) is characterized by a recurrent pattern of angry/irritable emotional lability, argumentative/defiant behavior, and vindictiveness. Previous studies indicated that ODD typically might originate within a maladaptive family environment, or was at least maintained within such an environment. As such, the present review summarized pertinent research from the last 20 years that focused on the pathways connecting family risk factors to the development of child ODD symptoms. A systematic search of electronic databases was completed in August 2020, resulting in the inclusion of 62 studies in the review. The review established a multi-level framework to describe the mechanisms underlying the pathway from familial factors to ODD psychopathological symptoms: (a) the system level that is affected by the family's socioeconomic status and family dysfunction; (b) the dyadic level that is affected by conflict within the marital dyad and parent-child interactions; and (c) the individual level that is affected by parent and child factors. Additionally, from the perspective of family systems theory, we pay special attention to the interactions among and between the various levels of the pathway (moderation and mediation) that might be associated with the occurrence and severity of ODD symptoms. Considering future prevention and intervention efforts, this three-level model emphasizes the necessity of focusing on familial risk factors at multiple levels and the mechanisms underlying the proposed pathways.
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Affiliation(s)
- Xiuyun Lin
- School of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Ting He
- School of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Melissa Heath
- McKay School of Education, Brigham Young University, Provo, UT 84602, USA
| | - Peilian Chi
- Department of Psychology, University of Macau, Macau 999078, China
| | - Stephen Hinshaw
- Department of Psychology, University of California, Berkeley, CA 94720, USA
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Atherton OE, Lawson KM, Ferrer E, Robins RW. The role of effortful control in the development of ADHD, ODD, and CD symptoms. J Pers Soc Psychol 2019; 118:1226-1246. [PMID: 30920279 DOI: 10.1037/pspp0000243] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Many adolescents have difficulty regulating their impulses and become prone to externalizing problems (e.g., attention-deficit/hyperactivity disorder [ADHD], oppositional defiant disorder [ODD], and conduct disorder [CD]) and other adverse consequences. Using multimethod data from a longitudinal study of Mexican-origin youth (N = 674), assessed annually from age 10 to 16, we examined the relations between effortful control and ADHD, ODD, and CD symptoms over time. Bivariate latent growth curve models showed negative correlations between the trajectories of effortful control and ADHD, ODD, and CD, indicating that steeper decreases in effortful control were related to steeper increases in ADHD, ODD, and CD symptoms. Using a novel statistical technique, the factor of curves model (FOCUS), we found that ADHD, ODD, and CD share a common "externalizing" trajectory during adolescence. Although effortful control was strongly associated with this common trajectory, it had few unique associations with the individual disorder trajectories, above and beyond their shared trajectory. When we extended the FOCUS model to include the effortful control trajectory as an indicator, we found that ADHD and ODD had strong loadings, whereas effortful control and CD had comparatively weak loadings on the shared developmental trajectory. Follow-up analyses showed that a two-factor solution, with externalizing symptom trajectories on one factor and the effortful control facet trajectories on a separate factor, was a better fit to the data than a one-factor solution. Finally, parent ASPD symptoms were related to increases in CD, but had no significant influence on effortful control, ADHD, or ODD. We discuss the implications for personality and externalizing problem development. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | - Emilio Ferrer
- Department of Psychology, University of California, Davis
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Abstract
Disruptive behavior disorders (DBDs), specifically oppositional defiant disorder and conduct disorder, are common, serious, and treatable conditions among preschoolers. DBDs are marked by frequent aggression, deceitfulness, and defiance, and often persist through the lifespan. Exposure to harsh or inconsistent parenting, as frequently seen with parental depression and stress, increases DBD risk. Candidate genes that may increase DBD risk in the presence of childhood adversity have also been identified, but more research is needed. Neurophysiologic and structural correlates with DBD also exist. Parent management training programs, focusing on increasing parenting competence and confidence, are the gold standard treatment of preschool DBDs.
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Affiliation(s)
- Mini Tandon
- Division of Child and Adolescent Psychiatry, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, Box 8134, St Louis, MO, USA
| | - Andrea Giedinghagen
- Division of Child and Adolescent Psychiatry, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, Box 8134, St Louis, MO, USA.
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Lavigne JV, Bryant FB, Hopkins J, Gouze KR. Age 4 Predictors of Oppositional Defiant Disorder in Early Grammar School. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2017; 48:93-107. [PMID: 28278601 DOI: 10.1080/15374416.2017.1280806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Our ability to predict which children will exhibit oppositional defiant disorder (ODD) at the time of entry into grammar school at age 6 lags behind our understanding of the risk factors for ODD. This study examined how well a set of multidomain risk factors for ODD assessed in 4-year-old children predicted age 6 ODD diagnostic status. Participants were a diverse sample of 796 4-year-old children (391 boys).The sample was 54% White, non-Hispanic; 16.8% African American, 20.4% Hispanic; 2.4% Asian; and 4.4% Other or mixed race. The classification accuracy of two models of multidomain risk factors, using either a measure of overall ODD symptoms or dimensions of ODD obtained at age 4, were compared to one another, to chance, and to a parsimonious model based solely on parent-reported ODD using Automated Classification Tree Analysis. Effect Strength for Sensitivity (ESS), a measure of classification accuracy, indicated a multidomain model including a general measure of ODD symptoms at age 4 yielded a large effect (56.29%), a 13.7% increase over the ESS for the parsimonious model (ESS = 42.9%). The ESS (51.23%) for a model including two ODD dimensions (behavior and negative affect) was smaller than that for the model including a measure of overall ODD symptoms. The Classification Tree Analysis approach showed a small but distinct advantage that would be useful in screening for which children would most likely meet criteria for age 6 ODD.
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Affiliation(s)
- John V Lavigne
- a Department of Child and Adolescent Psychiatry , Ann & Robert H. Lurie Children's Hospital of Chicago.,b Feinberg School of Medicine, Northwestern University.,c Mary Ann and J. Milburn Smith Child Health Research Program, Children's Hospital of Chicago Research Center
| | - Fred B Bryant
- d Department of Psychology , Loyola University of Chicago
| | - Joyce Hopkins
- e College of Psychology , Illinois Institute of Technology
| | - Karen R Gouze
- a Department of Child and Adolescent Psychiatry , Ann & Robert H. Lurie Children's Hospital of Chicago.,b Feinberg School of Medicine, Northwestern University
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