Separating the domains of oppositional behavior: comparing latent models of the conners' oppositional subscale.
OBJECTIVE
Although oppositional defiant disorder (ODD) is usually considered the mildest of the disruptive behavior disorders, it is a key factor in predicting young adult anxiety and depression and is distinguishable from normal childhood behavior. In an effort to understand possible subsets of oppositional defiant behavior (ODB) that may differentially predict outcome, we used latent class analysis of mother report on the Conners' Parent Rating Scales Revised Short Forms (CPRS-R:S).


METHODS
Data were obtained from mother report for Dutch twins (7 years old, n = 7,597; 10 years old, n = 6,548; and 12 years old, n = 5,717) from the Netherlands Twin Registry. Samples partially overlapped at ages 7 and 10 years (19% overlapping) and at ages 10 and 12 years (30% overlapping), but not at ages 7 and 12 years. Oppositional defiant behavior was measured using the six-item Oppositional subscale of the CPRS-R:S. Multilevel LCA with robust standard error estimates was performed using the Latent Gold program to control for twin-twin dependence in the data. Class assignment across ages was determined and an estimate of heritability for each class was calculated. Comparisons with maternal report Child Behavior Checklist (CBCL) scores were examined using linear mixed models at each age, corrected for multiple comparisons.


RESULTS
The LCA identified an optimal solution of four classes across age groups. Class 1 was associated with no or low symptom endorsement (69-75% of the children); class 2 was characterized by defiance (11-12%); class 3 was characterized by irritability (9-11%); and class 4 was associated with elevated scores on all symptoms (5-8%). Odds ratios for twins being in the same class at each successive age point were higher within classes across ages than between classes. Heritability within the two "intermediate" classes was nearly as high as for the class with all symptoms, except for boys at age 12. Children in the Irritable class were more likely to have mood symptoms on the CBCL scales than children in the Defiant class but demonstrated similar scores on aggression and externalizing scales. Children in the All Symptoms class were higher in both internalizing and externalizing scales and subscales.


CONCLUSIONS
The LCA indicates four distinct latent classes of oppositional defiant behavior, in which the distinguishing feature between the two intermediate classes (classes 2 and 3) is the level of irritability and defiance. Implications for the longitudinal course of these symptoms, association with other disorders, and genetics are discussed.
Vermont Center for Children, Youth, and Families at the University of Vermont, Burlington, VT 05401, USA.
Ana V
AV
Kuny
Robert R
RR
Althoff
William
W
Copeland
Meike
M
Bartels
C E M
CE
Van Beijsterveldt
Julie
J
Baer
James J
JJ
Hudziak
D000293:Adolescent; D001007:Anxiety / Q000175:diagnosis*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000145:classification / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D057189:Checklist; D002648:Child; D002652:Child Behavior; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D040582:Inheritance Patterns; D007508:Irritable Mood / Q000145:classification*; D016015:Logistic Models; D008297:Male; D008960:Models, Psychological; D009035:Mothers; D011569:Psychiatric Status Rating Scales; D011599:Psychopathology; D015203:Reproducibility of Results; D014427:Twins / Q000523:psychology