A Systematic Review of Multiple Family Factors Associated with Oppositional Defiant Disorder

Oppositional Defiant Disorder Symptoms and Multi-level Family Factors in Chinese Migrant Children: A Network Perspective

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.

Vicious cycle of emotion regulation and ODD symptoms among Chinese school-age children with ODD: a random intercept cross-lagged panel model

A strong link between children's emotion regulation and oppositional defiant disorder (ODD) symptoms has been documented; however, the within-person mechanisms remain unclear. Based on the self-control theory and self-regulation theory, our study investigated the longitudinal, bidirectional relationship between emotion regulation and ODD symptoms in school-age children with ODD using parent- and teacher-reported data, respectively. A total of 256 Chinese elementary school students participated in a three-wave longitudinal study spanning two years. We used the random intercept cross-lagged panel model (RI-CLPM) to investigate the concurrent and longitudinal associations between emotion regulation and ODD symptoms. Results from the RI-CLPMs revealed that ODD symptoms were negatively correlated with emotion regulation and positively correlated with emotion lability/negativity at both the between-person and within-person levels across settings. Additionally, in the school setting, emotion regulation negatively predicted subsequent ODD symptoms but not vice versa, whereas emotion lability/negativity was bidirectionally associated with ODD symptoms over time. The longitudinal associations of ODD symptoms with emotion regulation and lability/negativity were not observed in the home setting. These findings suggest a circular mechanism between children's emotion regulation and ODD symptoms and support the view that emotion regulation, particularly emotion lability/negativity, plays an important role in the development of ODD symptoms.

Contributions of Multilevel Family Factors to Emotional and Behavioral Problems among Children with Oppositional Defiant Disorder in China

Oppositional defiant disorder (ODD) is one of the most prevalent childhood mental health disorders and is extremely affected by family factors. However, limited studies have addressed the issue from the perspective of family systems. The current study examines the associations between multilevel family factors (i.e., family cohesion/ adaptability at system level, mother-child and father-child attachment at a dyadic level, and child self-esteem at an individual level) and emotional and behavioral problems among children with ODD in China. The participants were 256 Chinese children with ODD and their parents and class master teachers. A multiple-informant approach and structural equation model were used. The results revealed that system level factors (family cohesion/adaptability) were associated with child emotional and behavior problems indirectly through factors at the dyadic level (mother-child attachment) and the individual level (child self-esteem) in sequence. Mother-child, but not father-child, attachment, mediated the linkage between family cohesion/adaptability and the emotional problems of children with ODD. Moreover, child self-esteem mediated the association between mother-child attachment and child emotional and behavioral problems. The findings of the present study underscored that multilevel family factors are uniquely related to emotional and behavioral problems in children with ODD.