Co-occurring Oppositional Defiant and Depressive Symptoms: Emotion Dysregulation as an Underlying Process and Developmental Patterns across Middle Childhood

Abstract

Although there has been a recent surge in research examining comorbidity between externalizing and internalizing disorders in childhood, relatively less work has examined relations between specific externalizing conditions (i.e., oppositional defiant disorder (ODD) symptoms) and their co-occurrence with specific internalizing conditions (i.e., depressive symptoms). Furthermore, little empirical work has evaluated potential underlying processes, such as emotion dysregulation, which may explain relations between co-occurring ODD and depressive symptoms. There is also a paucity of research examining developmental patterns of co-occurring ODD and depressive symptoms. In the present study, I used latent class and latent transition analyses to (a) identify groups of children based on ODD and depressive symptom levels, (b) determine whether emotion dysregulation predicted co-occurring ODD and depressive symptoms, and (c) examine developmental patterns of change and continuity in groups across middle childhood within a community-based sample. Children were characterized by three latent classes based on ODD and depressive symptom severity: a group with very low levels of ODD or depressive symptoms, an ODD-only group with low levels of symptoms, and a co-occurring ODD and depressive symptom group with moderate levels of ODD and low levels of depressive symptoms. Furthermore, emotion dysregulation predicted to the class with moderate levels of ODD and low levels of depressive symptoms, although prediction from emotion dysregulation to class membership depended on the methodology used to index emotion dysregulation. Results of the LTA analyses suggested that symptom severity was relatively stable across middle childhood, with little evidence of changes in developmental patterns of ODD and depressive symptoms. Overall, the results of this study provide an important foundation for more sophisticated empirical inquiry regarding co-occurring ODD and depressive symptoms in childhood and potential processes that may explain their onset and development.