Developmental Relations Between Oppositional Defiant Disorder and Depression in Childhood: A Symptom Level Perspective.

BackgroundOppositional defiant disorder (ODD) has substantial comorbidity with depression. However, their comorbidity at the symptom level, including potential gender differences, is currently underspecified. This study aimed to explore the comorbidity network of ODD and depression in a longitudinal sample, as well as the gender differences.MethodThe sample included Chinese children aged 7 to 12 years (N = 418, Mage = 9.02, SD = 1.44, 59.6% boys). Children and their parents completed questionnaires about ODD (parent-reported) and depression (child-reported) symptoms in two surveys conducted 6 months apart. The cross-sectional and cross-lagged panel networks of ODD and depression symptoms were estimated.Results(1) In the cross-sectional network, ODD and depression were linked via associations between interpersonal symptoms of depression and behavioral or emotional symptoms of ODD; (2) In the cross-sectional network, behavioral symptoms of ODD connecting ODD and depression symptoms differed by gender, with "annoy" and "defy" specific to boys and "argue" to girls; (3) In the longitudinal network, behavioral symptoms of ODD played important roles in predicting depression symptoms at the later timepoint; (4) There were positive paths from depression to ODD symptoms in the boys' longitudinal network while there were negative paths from ODD to depression symptoms in the girls' longitudinal network.ConclusionsThese findings identify symptom connections between ODD and depression and associated gender differences, providing new insights into screening and intervention for the co-occurrence of ODD and depression which are informed by symptom prominence.