Is Emotional Lability Distinct From "Angry/Irritable Mood," "Negative Affect," or Other Subdimensions of Oppositional Defiant Disorder in Children With ADHD?

OBJECTIVE

Emotional lability (EL) and oppositional defiant disorder (ODD) frequently co-occur with ADHD. This study evaluates whether EL merely represents the negative "mood/affect" component of ODD or forms a distinct dimension.

METHOD: EL and ODD data from 1,317 ADHD participants were analyzed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) for binary data.

RESULTS

Within ADHD, 39.4% children had ODD and 42.6% had EL. A sizable proportion expressed only either ODD or EL: 16.6% had ODD-only, 19.7% had EL-only, and 22.9% expressed both. In both EFA and CFA, EL forms a separate dimension from ODD items and the "mood/affect" subdimensions (whether classified by Diagnostic and Statistical Manual of Mental Disorders [5th ed.; DSM-5] or the Burke et al. models or the de novo ODD subdimensions derived from our data). This factorial structure remains invariant across gender.

CONCLUSION

EL is distinct from ODD and its "mood/affect" subdimensions. In line with emerging evidence, our findings provide further evidence of factorial validity for EL as a separate construct from ODD.