title: Dimensions of oppositionality in a Brazilian community sample: testing the DSM-5 proposal and etiological links.
abstract: OBJECTIVE
  Investigating dimensions of oppositional symptoms may help to explain heterogeneity of etiology and outcomes for mental disorders across development and provide further empirical justification for the DSM-5-proposed modifications of oppositional defiant disorder (ODD). However, dimensions of oppositionality have not previously been tested in samples outside Europe or the United States. In this study, we used a large Brazilian community sample to compare the fit of different models for dimensions of oppositional symptoms; to examine the association of psychiatric diagnoses and symptoms with dimensions of oppositionality; and to examine the associations between dimensions of oppositionality and parental history of mental disorders.
  
  
  METHODS
  A Brazilian community sample of 2,512 children 6 through 12 years old were investigated in this study. Confirmatory factorial analyses were performed to compare the fit of alternative models, followed by linear and logistic regression analyses of associations with psychiatric diagnosis and parental history of psychopathology.
  
  
  RESULTS
  A three-factor model with irritable, headstrong, and hurtful dimensions fitted best. The irritable dimension showed a strong association with emotional disorders in the child (p<.001) and history of depression (p<.01) and suicidality (p<.05) in the mother. The headstrong dimension was uniquely associated with attention-deficit/hyperactivity disorder (ADHD) in the child (p<.001) and with maternal history of ADHD symptoms (p<.05). The hurtful dimension was specifically associated with conduct disorder (p< .05).
  
  
  CONCLUSIONS
  Our findings from a large community sample of Brazilian children support a distinction between dimensions of oppositionality consistent with current DSM-5 recommendations and provide further evidence for etiological distinctions between these dimensions.
authors.affiliation: University of São Paulo. fvkrieger@gmail.com
authors.forename: Fernanda Valle
authors.initials: FV
authors.lastname: Krieger
authors.forename: Vanoni Guilherme
authors.initials: VG
authors.lastname: Polanczyk
authors.forename: Robert
authors.initials: R
authors.lastname: Goodman
authors.forename: Luis Augusto
authors.initials: LA
authors.lastname: Rohde
authors.forename: Ana Soledade
authors.initials: AS
authors.lastname: Graeff-Martins
authors.forename: Giovanni
authors.initials: G
authors.lastname: Salum
authors.forename: Ary
authors.initials: A
authors.lastname: Gadelha
authors.forename: Pedro
authors.initials: P
authors.lastname: Pan
authors.forename: Daniel
authors.initials: D
authors.lastname: Stahl
authors.forename: Argyris
authors.initials: A
authors.lastname: Stringaris
mesh_terms: D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D001938:Brazil / Q000453:epidemiology; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological