Association between abnormal psychosocial situations in childhood, generalized anxiety disorder and oppositional defiant disorder

Objective: Psychosocial stressors are important in the pathogenesis of most mental disorders. However, little is known about the way psychosocial stressors uniquely combine to create risk for different expressions of child and adolescent psychopathology. The purpose of this study was to determine whether core dimensions of stressful psychosocial situations are differentially associated with childhood generalized anxiety disorder and oppositional defiant disorder. Method: A case-control design conducted in Trondheim (Norway) from 2002 to 2004 comparing exposure to ICD-10-defined abnormal psychosocial situations (Z-codes) among 21 children with oppositional defiant disorder (ODD) and 22 children with generalized anxiety disorder (GAD) recruited from a university outpatient clinic with 42 non-patient school controls. Results: Multigroup discriminant analysis extracted two significant dimensions within the psychosocial variables assessed. Function 1 was characterized by overprotection, parental pressures and acute life events and was associated with GAD. Function 2 was characterized by parental abuse/hostility and interpersonal stress and was associated with ODD. Both dimensions were able to correctly classify 89.7% of the cases, compared to 35.9% by chance. Conclusions: The results indicate that specific psychosocial dimensions are differentially related to childhood GAD and ODD. This may be useful in targeting at-risk populations for preventive intervention as well as informing more accurate alignment of psychosocial resources for treatment.