Impact of comorbid oppositional or conduct problems on attention-deficit hyperactivity disorder

Objective: To investigate whether the presence of comorbid oppositional defiant disorder (ODD) or conduct disorder (CD) alters the correlates of attention-deficit hyperactivity disorder (ADHD). Method: Three groups of children (33 ''pure'' ADHD, 46 ADHD+ODD, and 12 ADHD+CD) were compared on measures of ADHD, aggression, anxiety, parental psychopathology, self-esteem, school, and social-emotional functioning. Results: Findings indicated that the presence of comorbid oppositional or conduct problems in children with ADHD altered the correlates of ADHD across a number of areas, including greater ADHD symptom severity and social dysfunction. Nevertheless, some correlates were more closely linked with the comorbid condition of ADHD+CD (e.g., higher aggression, anxiety, and maternal pathology, as well as decreased self-esteem), while others appeared more closely linked with ADHD+ODD (e.g., social withdrawal, elevated academic achievement paired with higher perceived scholastic competence). Conclusions: Findings support the distinctive profiles of the disruptive behavior disorder groups and emphasize the deleterious effects on the quality of life experienced by the comorbid conditions. The need for syndrome-specific interventions is stressed.