The effect of executive function deficits on treatment response in children with Oppositional Defiant Disorder

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Oppositional Defiant Disorder (ODD) occurs in childhood and is characterized by recurrent, developmentally inappropriate, negativistic, defiant, disobedient, and hostile behaviors directed towards authority figures. Such behaviors can significantly interfere with child-peer and child-adult interactions. If left untreated, ODD can result in social, emotional, and academic consequences throughout childhood and into adulthood. Behavioral and cognitive-behavioral interventions such as parent management training (PMT) and collaborative and proactive solutions (CPS) have been shown to be effective treatments for ODD. Previous studies have not yet investigated the role that executive functioning (EF) deficits play in treatment response for ODD symptomology. Since EF deficits often co-occur with ODD, it is important to consider whether those with such deficits respond differently to PMT and CPS, particularly given that an approach such as CPS relies more on EF skills than PMT. No study to date has examined whether EF deficits differentially predict treatment response to PMT or CPS. The current study investigated whether pre-treatment EF deficits predict differential response to treatment as indexed by a reduction in ODD symptoms. We hypothesized that pre-treatment levels of EF would influence treatment response such that those with greater EF deficits at baseline would not see as great a reduction in ODD symptoms in the CPS condition, while EF deficits would not affect response to PMT.

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