Co-occurrence of ODD and Anxiety: Shared Risk Processes and Evidence for a Dual-Pathway Model.

Although oppositional defiant disorder (ODD) and anxiety disorders (ADs) often co-occur, the literature is mixed regarding the effects of such co-occurrence. For example, there is evidence that AD symptoms may mitigate ODD symptoms (buffer hypothesis) or exacerbate ODD symptoms (multiple problem hypothesis). A dual-pathway model incorporates previous research and addresses both hypotheses. We describe several possible etiological or risk processes that may underlie each of these ODD-AD pathways, including child temperament, aggression, limbic system processes, executive functioning abilities, and social information-processing biases, and suggest an integrated model. We conclude with implications for the model and directions for future research involving co-occurring ODD and ADs.