Abstract
Objective: The overall aim of the present study was to gain a better understanding of irritability and emotional dysregulation among children with oppositional defiant disorder (ODD) with and without chronic irritability-anger as in the International Classification of Diseases, 11th Revision (ICD-11). Specifically, the purpose was to investigate the ability of measures from Child Behavior Checklist (CBCL) and Behavior Rating Inventory of Executive Function (BRIEF) in assessing irritability and emotional dysregulation. To the extent of the authors knowledge, no studies to date have examined ODD with chronic irritability-anger in a Norwegian sample. Methods: The sample in this cross-sectional study consisted of eleven children with ODD from an outpatient sample, ages seven to twelve (Mdn = 9), four girls and seven boys. Their scores on selected CBCL and BRIEF measures constituted the data material. Fulfillment of diagnostic criteria for ODD was determined by Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version DSM-5. Those who met the criteria for co-occuring disruptive mood dysregulation disorder (DMDD) were grouped as ODD with chronic irritability-anger. Associations between CBCL and BRIEF measures were investigated, the two groups were compared along all measures, and the discriminatory ability of measures was assessed. The dataset is a subset from the research project Severe Emotional Dysregulation in Children, a collaboration between Nic Waals Institute and Oslo University Hospital. Results: The scales CBCL Irritability and BRIEF Emotional control were significantly associated. Children with ODD with chronic irritability-anger had notably higher scores on CBCL Internalizing than did children with ODD without chronic irritability-anger. The same scale showed significant predictive power in distinguishing between the two groups. Conclusion: First, correlational results support the notion of irritability and emotional regulation as related constructs and underlines the need for construct clarification and differentiation. Second, group differences in emotional problems indicate that the expansion of the ODD diagnosis is meaningful, while at the same raising questions about its conceptualization in ICD-11. Finally, CBCL Internalizing could be useful in identifying children with ODD with chronic irritability-anger, which could be valuable in diagnostic evaluations. Although caution is warranted in the interpretation due to the small sample size, measures from CBCL and BRIEF show promise in reflecting irritability and emotional dysregulation in children with ODD. The findings lay the grounds for applying the present design and methods on a larger sample.