Thesis (M.A.)--University of Missouri-Columbia, 2004. / Typescript. Includes bibliographical references (leaves 38-42). Also available on the Internet.

Thesis (M.A.)--University of Missouri-Columbia, 2004. / Typescript. Includes bibliographical references (leaves 38-42). Also available on the Internet.

Improving the success rates of children in mental health treatment is an important step to bettering lives. Day treatment programs are intermediate level treatment modalities that help children who are struggling with their mental health. Success rates differ for children in day treatment programs and several studies have been done evaluating various factors. This research addressed whether a child who had been exposed to trauma showed as much success in a program as a child that had not been exposed to trauma. Other variables were to determine if children have different levels of success based on their diagnosis. The study was quasi-experimental and used clinical documentation to assess the different factors and level of success. A Kruskal-Wallis rank sum test and the Pearson chi-squared test were run to determine if there was a difference in success rates for 85 children with different diagnoses. This study determined no significant difference between the success rate for children based on either the diagnosis of depression or oppositional defiant disorder. A one-way ANOVA was run to determine if there was a difference in success rates for children who had experienced trauma and those who had not. This study determined no significant difference between success rates for children who had experienced trauma and those who had not. This study offers day treatment programs additional information to ensure programming offered to children is equally successful for all children.

There is a paucity of research that has examined co-occurring oppositional defiant disorder and generalized anxiety disorder (ODD+GAD) symptoms and oppositional defiant disorder and separation anxiety disorder (ODD+SAD) symptoms among children. To address this gap, I investigated multiple explanations for the co-occurrence of ODD+GAD and ODD+SAD. Specifically, I investigated whether (a) GAD symptoms prospectively predicted ODD symptoms and SAD symptoms prospectively predicted ODD symptoms (Explanation 1), (b) ODD symptoms prospectively predicted GAD symptoms and ODD symptoms prospectively predicted SAD symptoms (Explanation 2), and (c) shared risk processes accounted for the co-occurrence of ODD+GAD and ODD+SAD (Explanation 3). Participants were an ethnic minority, inner-city sample of first through fourth grade children (N = 88, 51% male) and their primary caregivers. I used data collected at the baseline and 1-year follow-up assessments of the Child Health and Behavior Study, a longitudinal survey of families residing in North Philadelphia. Findings provided support for Explanation 2 and Explanation 3 in the development of co-occurring ODD+GAD symptoms and support for Explanation 3 in the development of co-occurring ODD+SAD symptoms. This study contributes to the extant literature by providing the first empirical examination of these multiple explanations in an ethnic minority, inner city sample of children. / Psychology

The co-occurrence of anxiety disorders (ADs) and disruptive behavior disorders affects a substantial proportion of children and may cause significant impairment in functioning. Approximately 40% of clinic-referred youth with oppositional defiant disorder (ODD) meet criteria for an AD (Greene et al., 2002). In spite of the frequent co-occurrence of these disorders, there is little research examining the presence of AD in clinic-referred samples of youth with ODD. Thus, the purpose of the current study was to 1) examine the phenomenology of clinic-referred youth with ODD/AD as compared to youth with ODD alone, and 2) explore the role of cumulative family risk (CFR) in predicting level of impairment in youth with comorbid ODD/AD as compared to youth with ODD alone. There was mixed support for distinct clinical profiles among youth with ODD/AD as compared to youth with ODD alone: youth with ODD/AD had higher levels of anxiety, internalizing symptoms, and parent psychopathology whereas youth with ODD alone had higher levels of conduct problems, hyperactivity, and attention difficulties. However, there was little support for the role of CFR in predicting impairment in youth with ODD/AD. Future research should enlist a multi-informant, multi-contextual approach in examining the role of CFR in predicting impairment levels for youth with comorbid ODD/AD. / Ph. D.

Self-worth is a global self-evaluation of one's value as a person (Harter & Whitsell, 2003). Self-worth in children may be influenced by affective social competence (ASC), which involves abilities to effectively express, identify, and manage emotions when interacting with others (Halberstadt, Denham, & Dunsmore, 2001). Children diagnosed with Oppositional Defiant Disorder (ODD) are likely to have poorer social competence (Burns et al., 2009). ODD is a commonly diagnosed, disruptive behavior disorder in children that involves symptoms of excessive argumentativeness, defiance, and anger (Loney & Lima, 2003; Pfiffner, McBurnett, Rathouz, & Judice, 2005). Children with ODD often report a lower sense of self-worth than non-diagnosed peers. Because experiencing positive emotions may be linked with emotional buffering from stressors and may bolster positive characteristics in individuals (Fredrickson, 2003), I studied components of ASC in regard to positive emotions in children with ODD. With 86 parent-child dyads, children's ability to recognize, encourage, and express emotions was studied alongside parents' reports of children's emotion regulation in relation to children's reports of perceived self-worth. Components of ASC were expected to be positively associated with children's perceptions of self-worth. However, results did not support these expectations. Discussion focuses on methods and future research. / Master of Science

The purpose of this study was to determine whether the Anxiety Disorders Interview Schedule for DSM–IV: Parent Version (ADIS–P) is a valid diagnostic tool in assessing Oppositional Defiant Disorder (ODD) in youth. Although there is considerable evidence that the ADIS–P is effective when diagnosing anxiety disorders in youth, no studies have yet examined its utility in assessing ODD, even though the ADIS–P contains an ODD module. In contrast, a number of studies support the Diagnostic Interview Schedule for Children–Version IV (DISC–IV) as a reliable and valid tool for assessing ODD. The two diagnostic interviews have not been compared to determine whether the ADIS–P might be equally valid to the DISC–IV in diagnosing ODD. In this study, the ADIS–P and DISC–IV ODD modules were administered in a counterbalanced order to the parents of a clinical sample of 53 children between 8 and 13 years of age referred for the treatment of ODD. It was hypothesized that the ODD module of the ADIS–P would be reliable, as evidenced by inter-rater correspondence, and valid as determined by its concurrent validity with the DISC–IV and its relations with the Behavior Assessment System for Children (BASC) Aggression and Conduct Problems scales as well as the Disruptive Behavior Disorders rating scale (DBD). Both of these latter instruments were completed by parents and teachers of the referred youth. Results suggest that the ADIS–P provides a valid assessment of ODD, giving clinicians and researchers another empirically-supported interview to use when assessing children's disruptive behaviors. / Master of Science

Studying disruptive behavior disorders in adolescents is critical; however, there is a paucity of literature on methods for differentially diagnosing the two main disruptive behavior disorders: Oppositional Defiant Disorder and Conduct Disorder. Conduct Disorder is defined as a persistent pattern of behavior where the basic rights of others or other major social norms are violated whereas Oppositional Defiant Disorder is usually diagnosed in childhood or adolescence, and is defined by a pattern of disobedient, hostile, or defiant behavior towards authority figures. Despite some similarities in presentation, the majority of research supports the notion that these two disorders are distinct. Finding accurate ways to differentiate these two disorders is important for discovering and implementing empirically validated treatments. The primary purpose of this study was to determine how the Millon Adolescent Clinical Inventory, a commonly used self-report scale, distinguished between adolescents presenting with either Oppositional Defiant or Conduct Disorder who had been admitted to a residential treatment facility. A secondary component of the current study examined gender differences in the two disorders.Multivariate Analysis of Variance was used to determine if the two diagnostic or gender groups were significantly different. If so, discriminant function analysis was employed to determine where the difference occurred. Although some scales approached significance, there were no statistical differences among adolescents with Conduct Disorder and Oppositional Defiant Disorder across any of the dependent variables. There were, however, gender and age differences found across several scales. Unfortunately, because there were no interactions with diagnosis on any scales, differences occurred equally among adolescents from either diagnostic group. This result raises questions as to whether the Millon Adolescent Clinical Inventory is a useful diagnostic instrument for disruptive behavior disorders. This instrument may be more useful to determine individual characteristics that would impact treatment than as an instrument for researchers studying empirically validated interventions for Conduct Disorder and Oppositional Defiant Disorder. / Department of Educational Psychology

Children with Disruptive Behavior Disorders (DBD), including Attention-Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) have poorer language skills compared to typically developing children; however, language as a potential risk factor for DBD has received little empirical attention or evaluation. Receptive, expressive, and pragmatic language skills in preschoolers with DBD were examined. Participants were 82 preschool-age children and their primary caregivers. Primary caregivers completed a semi-structured interview and symptom and language questionnaires. Preschoolers completed measures of receptive and expressive language. Results indicated that preschoolers with DBD were more impaired on receptive, expressive, and pragmatic language compared to non-DBD children. Pragmatic language appears particularly impaired in children with DBD, and language problems appear most linked with increased hyperactivity-impulsivity (vs. inattention or oppositional-defiance). This work suggests the need for early assessment of language in preschoolers with DBD, as well as the possibly utility of tailored interventions focusing on improving pragmatic language.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent and impairing childhood disorders (5%; American Psychiatric Association, 2013), yet it is often studied in isolation. Such an approach is at odds with the clinical reality, where ADHD has a high comorbidity with oppositional defiant disorder, anxiety, and depression (Jensen, Martin, & Cantwell, 1997). Based on the possible presentations of ADHD with both externalizing and internalizing symptoms, there may be differences in associated characteristics, areas of impairment, and resulting assessment interventions. Therefore, the present study investigated how ADHD comorbidities manifested in a population of 233 elementary age children and how these profiles varied in already established characteristics (i.e., traits, social behaviors) and areas of deficit for children with ADHD (i.e., social functioning, academics, narrative comprehension). Characteristics and outcomes were examined using rating scales, behavior observations, laboratory tasks, and grades. Based on latent profile analyses, different patterns of comorbidity were identified using both parent and teacher ratings of ADHD. Based on parent and teacher report, those with high ADHD/ODD symptoms had more negative characteristics and outcomes. Network analyses corroborated these results, showing that internalizing symptoms were less relevant for associated characteristics and outcomes compared to ADHD and ODD symptoms. Overall, these results suggest that ADHD comorbidities may be primarily driven by ADHD and ODD symptoms, with this profile displaying more severe negative characteristics and outcomes.