Problem Behaviors in Children Linked to Later Depression

Oppositional defiant disorder (ODD) is characterized by multiple negative emotions and behaviors. When youngsters exhibit such signs at one age, it appears that they are they likely to do so at other ages as well, according to researchers in a study published in the September Journal of the American Academy of Child and Adolescent Psychiatry.

The lead researcher was Edward Barker, Ph.D., director of the Developmental Psychopathology Lab at the Institute of Psychiatry, King’s College London.

More than 6,000 children and their mothers participated in this longitudinal study. The children were evaluated for three emotions or behaviors that often characterize ODD—irritability, being headstrong, and being intentionally hurtful—at ages 8, 10, and 13. The Development and Well-Being Assessment, a well-validated measure developed for the British Child Mental Health surveys, was used for this evaluation. Both parents and teachers contributed to the evaluation.

The researchers first evaluated whether children who displayed one of the ODD-related emotions or behaviors at one age were also likely to display the same emotion or behavior later in childhood or adolescence. Their data showed that such a pattern did indeed exist. For example, those who were irritable at age 8 were also likely to be irritable at ages 10 and 13.

The researchers then assessed whether the three emotions or behaviors of interest tended to remain developmentally distinct from one another over the years studied, with little crossover (for example, from being headstrong to being irritable). This turned out to be the case. However, being headstrong at age 10 was associated with being irritable at age 13, but not the converse, suggesting that being headstrong might be driving some of the later irritability.

They also evaluated the children to determine if being irritable, headstrong, or intentionally hurtful at age 8, 10, or 13 predicted depression or conduct problems at age 16. Depression was assessed with the adolescent-reported Mood and Feelings Questionnaire Short Form. Conduct problems were assessed with the Strengths and Difficulties Questionnaire, which the children’s mothers filled out.

The researchers found that irritability predicted increased risk for depression and that being headstrong predicted increased risk for conduct problems. Being intentionally hurtful was not associated with elevated risk for either condition.

The findings have clinical implications, the researchers believe. For instance, if being headstrong truly drives later irritability, and irritability in turn leads to depression, then treating headstrong behavior might reduce the risk for later irritability and depression. They noted as well that children scoring high on irritability might benefit from cognitive-behavioral therapy to reduce their future risk of depression.

The study was funded by the U.K. Medical Research Council, the Wellcome Trust, the University of Bristol, the Economic and Social Research Council, and the U.S. National Institutes of Health. ■