Herzhoff Kathrin, Tackett Jennifer L
Department of Psychology, University of Houston, Houston, TX, USA.
J Child Psychol Psychiatry. 2016 Jan;57(1):18-29. doi: 10.1111/jcpp.12423. Epub 2015 Apr 22.
Structural models of oppositional defiant disorder (ODD) symptoms have gained empirical support but await greater empirical scrutiny on issues such as reconciliation between competing models, evidence for gender differences, and delineation of external correlates. More extensive validation evidence is particularly necessary in consideration of their incorporation in psychiatric nomenclature.
We fitted previously proposed, but competing, models to ODD symptoms assessed with the Computerized Diagnostic Interview Schedule for Children (Shaffer et al., 2000, J. Am. Acad. Child Adolesc. Psychiatry, 39, 28) in a community sample and then fitted the best-fitting model in a replication sample (combined N = 730, M = 9.89, SD = 0.75). Analyses also examined potential classes based on resulting subfactors, gender differences, longitudinal associations with later behavioral problems, and concurrent personality associations.
Burke's (2010) two-factor model composed of Irritability and Oppositionality subfactors best fit the data. Irritability and Oppositionality showed convergent and divergent patterns of association with personality traits at T1 and with externalizing and internalizing problems at T2. Latent class analyses revealed three classes (low severity, irritable/combined, and oppositional) which showed parallel divergence in externalizing and internalizing problem comorbidity. These findings were largely robust across gender and samples.
These findings support Irritability/Oppositionality subfactors of ODD in two mixed-gender samples, demonstrate strong evidence for a lack of gender differences in such subfactors, and demonstrate their convergent and divergent validity in emergent latent classes, later behavioral problems, and personality correlates.
对立违抗障碍（ODD）症状的结构模型已获得实证支持，但在诸如竞争模型之间的协调、性别差异证据以及外部相关因素的界定等问题上，还需更多实证审查。鉴于这些模型已被纳入精神疾病命名法，尤其需要更广泛的验证证据。
我们将先前提出但相互竞争的模型应用于通过儿童计算机化诊断访谈量表（Shaffer等人，2000年，《美国儿童与青少年精神病学杂志》，39卷，28期）评估的社区样本中的ODD症状，然后在一个复制样本中拟合最佳拟合模型（合并样本量N = 730，均值M = 9.89，标准差SD = 0.75）。分析还基于所得子因素、性别差异、与后期行为问题的纵向关联以及同时期的人格关联，研究了潜在类别。
伯克（2010年）提出的由易激惹和对立性子因素组成的双因素模型最符合数据。易激惹和对立性在T1时与人格特质以及在T2时与外化和内化问题呈现出趋同和不同的关联模式。潜在类别分析揭示了三个类别（低严重程度、易激惹/合并型和对立型），它们在外化和内化问题共病方面呈现出平行的差异。这些发现在不同性别和样本中大多具有稳健性。
这些发现支持了两个混合性别样本中ODD的易激惹/对立性子因素，有力证明了这些子因素不存在性别差异，并证明了它们在新兴潜在类别、后期行为问题和人格关联方面的趋同和不同效度。
