Dual Diagnosis: Intellectual Disability and Oppositional Defiant Disorder
Children with intellectual disabilities (ID) represent an underserved minority in the public health domain. Yet this population demonstrates an elevated rate of comorbid mental health disorders and disruptive behavior disorders in particular. Given the elevated rates of behavior problems seen in children with ID, however, the validity and significance of a disruptive behavior diagnosis for this population remains unknown. In this light, the current study examines the dual diagnosis of Oppositional Defiant Disorder (ODD), one of the most common disruptive behavior disorders, in children and adolescents with intellectual disabilities over a 10-year time period. The study examines the clinical presentation, etiology and outcomes associated with ODD for children with and without ID to determine whether this is the same disorder for both populations. Findings suggest that children with ID and those with borderline intellectual functioning demonstrate higher rates of ODD and a higher comorbidity with other disruptive behaviors disorders such as Attention-Deficit Hyperactivity Disorder. However, the disorder otherwise appears the same for children with and without ID, and the stability, age of onset, symptom presentation, etiology and outcomes (on measures of later behavior problems, friendships and risk-taking) do not differ for children with ODD with and without ID. Accordingly, the results of the current study suggest that ODD is the same disorder for children with and without ID and that the same interventions may be useful for both populations.