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Three Dimensions of Oppositionality in Autism Spectrum Disorder

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Abstract

In autism spectrum disorder (ASD), symptoms of oppositional defiant disorder (ODD) are common but poorly understood. DSM-5 has adopted a tripartite model of ODD, parsing its features into ‘angry and irritable symptoms’ (AIS), ‘argumentative and defiant behavior’ (ADB) and ‘vindictiveness’. This was based on findings in non-autistic populations that each of these dimensions of oppositionality has a distinct constellation of associations with internalising and externalising psychopathology. We applied the tripartite DSM-5 ODD model to ASD to test its generalisability beyond non-ASD populations; and to elucidate the nature of ODD symptoms in ASD. Participants were 216 verbally-fluent young people (mean age = 9.6 years, range 3.0 to 16.2 years, 82 % male) with ASD. Cross-sectional parent-and teacher-report data were analysed using bootstrap multiple regression to test the following predictions, derived from studies of non-ASD young people: (1) AIS will be the main predictor of internalising problems; (2) ADB will be the main predictor of ADHD symptoms; (3) all ODD traits will independently predict conduct disorder symptoms; (4) vindictiveness will be the main predictor of aggressive conduct problems. Our findings using both parent and teacher data were consistent with the non-ASD ODD literature. AIS were associated with internalising but not externalising problems; ADB and vindictiveness were associated with externalising but not internalising problems; and vindictiveness was the main predictor of aggression. The DSM-5 tripartite model of ODD appears to be generalisable to ASD: for people with an autistic disorder, AIS, ADB and vindictive dimensions of oppositionality have distinct associations with concurrent psychopathology, suggesting the need to assess them as separate constructs.

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Notes

  1. The DSM-5 constructs of ‘angry/irritable symptoms’, ‘argumentative disruptive behavior’ and ‘vindictiveness’ are sometimes referred to as ‘irritable’, ‘headstrong’ and ‘hurtful’ dimensions of oppositionality, notably by Stringaris and Goodman (2009a; 2009b). In the interests of clarity, we have chosen to use only the DSM-5 nomenclature when reviewing the literature.

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Acknowledgements

The authors wish to thank Richard Warrington whose 3Di software made this study possible, as well as the anonymous reviewers for their helpful suggestions and comments.

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Authors and Affiliations

  1. Research Department of Clinical, Educational and Health Psychology, UCL, Gower Street, WC1N 6BT, London, UK

    William Mandy

  2. Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children, London, UK

    Laura Roughan

  3. Behavioural and Brain Science Unit, UCL Institute of Child Health, Guilford Street, London, UK

    David Skuse

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  1. William Mandy
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  2. Laura Roughan
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  3. David Skuse
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Correspondence to William Mandy.

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Mandy, W., Roughan, L. & Skuse, D. Three Dimensions of Oppositionality in Autism Spectrum Disorder. J Abnorm Child Psychol 42, 291–300 (2014). https://doi.org/10.1007/s10802-013-9778-0

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