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The Cost of Oppositional Defiant Disorder and Disruptive Behavior: A Review of the Literature

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Abstract

This purpose of this paper is to review the literature on the treatment of Oppositional Defiant Disorder, with a specific focus on cost analyses. In general the literature shows that while there has been substantial research on Oppositional Defiant Disorder there has been little focus on the costs involved. A search of the major databases in psychology and the social sciences yielded only seven articles even marginally appropriate for a review of costs associated with Oppositional Defiant Disorder and related disruptive behavior. Interestingly, only two of these studies investigated treatment costs specifically associated with Oppositional Defiant Disorder. These studies showed that the treatment of Oppositional Defiant Disorder is much less expensive than the treatment of Conduct Disorder and family therapy is the most cost effective approach. Overall, the review showed that there is a dearth of literature related to treatment costs, which leads to the conclusion that much more research is needed on the cost of treating Oppositional Defiant Disorder.

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References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

    Google Scholar 

  • Angold, A., Costello, E., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40(1), 57–87. doi:10.1111/1469-7610.00424.

    Article  PubMed  Google Scholar 

  • Aos, S., Lieb, R., Mayfield, J., Miller, M., & Pennucci, A. (2004). Benefits and costs of prevention and early intervention programs for youth (no. 04-07-3901). Olympia, WA: Washington State Institute for Public Policy.

  • Borrego, J. R., & Burrell, T. (2010). Using behavioral parent training to treat disruptive behavior disorders in young children: A how-to approach using video clips. Cognitive and Behavioral Practice, 17(1), 25–34. doi:10.1016/j.cbpra.2009.10.003.

    Article  Google Scholar 

  • Boylan, K., Vaillancourt, T., Boyle, M., & Szatmari, P. (2007). Comorbidity of internalizing disorders in children with oppositional defiant disorder. European Child and Adolescent Psychiatry, 16(8), 484–494. doi:10.1007/s00787-007-0624-1.

    Article  PubMed  Google Scholar 

  • Burke, J. D., Loeber, R., & Birmaher, B. (2002). Oppositional defiant disorder and conduct disorder: A review of the past 10 years, part II. Journal of the American Academy of Child and Adolescent Psychiatry, 41(11), 1275–1293. doi:10.1097/00004583-200211000-00009.

    Article  PubMed  Google Scholar 

  • Burke, J. D., Waldman, I., & Lahey, B. B. (2010). Predictive validity of childhood oppositional defiant disorder and conduct disorder: Implications for the DSM-V. Journal of Abnormal Psychology, 119(4), 739–751. doi:10.1037/a0019708.

    Article  PubMed  Google Scholar 

  • Bussing, R., Gary, F. A., Mason, D. M., Leon, C. E., Sinha, K., & Garvan, C. W. (2003). Child temperament, ADHD, and caregiver strain: Exploring relationships in an epidemiological sample. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 184–192.

    Article  PubMed  Google Scholar 

  • Carr, A. (2009). The effectiveness of family therapy and systemic interventions for child-focused problems. Journal of Family Therapy, 31(1), 3–45.

    Article  Google Scholar 

  • Centers for Disease Control and Prevention (2016). Data & statistics. Retrieved from http://www.cdc.gov/ncbddd/adhd/data.html.

  • Charles, J. M., Bywater, T. T., & Edwards, R. T. (2011). Parenting interventions: A systematic review of the economic evidence. Child: Care, Health and Development, 37(4), 462–474. doi:10.1111/j.1365-2214.2011.01217.x.

    Google Scholar 

  • Christenson, J. D., & Crane, D. R. (2014). Integrating costs into marriage and family therapy research. In R. B. Miller & L. Johnson (Eds.), Advanced research methods in family therapy research: A focus on validity and change (pp. 420–436). New York: Taylor and Francis.

    Google Scholar 

  • Cohen, M. A. (1998). The monetary value of saving a high-risk youth. Journal of Quantitative Criminology, 14(1), 5–33. doi:10.1023/A:1023092324459.

    Article  Google Scholar 

  • Cohen, M. A., & Miller, T. R. (1998). The cost of mental health care for victims of crime. Journal of Interpersonal Violence, 13, 93–110.

    Article  Google Scholar 

  • Cohen, M. A., & Piquero, A. R. (2009). New evidence on the monetary value of saving a high risk youth. Journal of Quantitative Criminology, 25(1), 25–49. doi:10.1007/s10940-008-9057-3.

    Article  Google Scholar 

  • Crane, D. R., Hillin, H. H., & Jakubowski, S. F. (2005). Costs of treating conduct disordered medicaid youth with and without family therapy. The American Journal of Family Therapy, 33(5), 403–413.

    Article  Google Scholar 

  • Crane, D. R., & Payne, S. H. (2011). Individual versus family psychotherapy in managed care: Comparing the costs of treatment by the mental health professions. Journal of Marital and Family Therapy, 37(3), 273–289. doi:10.1111/j.1752-0606.2009.00170.x.

    Article  Google Scholar 

  • Cunningham, N., & Ollendick, T. H. (2010). Comorbidity of anxiety and conduct problems in children: Implications for clinical research and practice. Clinical Child and Family Psychology Review, 13(4), 333–347. doi:10.1007/s10567-010-0077-9.

    Article  PubMed  Google Scholar 

  • Evans, S. W., Sibley, M., & Serpell, Z. N. (2009). Changes in caregiver strain over time in young adolescents with ADHD: The role of oppositional and delinquent behavior. Journal of Attention Disorders, 12(6), 516–524. doi:10.1177/1087054708322987.

    Article  PubMed  Google Scholar 

  • Farris, J. R., Nicholson, J. S., Borkowski, J. G., & Whitman, T. L. (2011). Onset and progression of disruptive behavior problems among community boys and girls: A prospective longitudinal analysis. Journal of Emotional and Behavioral Disorders, 19(4), 233–246. doi:10.1177/1063426610370746.

    Article  Google Scholar 

  • Foster, M. E., & Jones, D. E. (2005). The high costs of aggression: Public expenditures resulting from conduct disorder. American Journal of Public Health, 95(10), 1767–1772. doi:10.2105/AJPH.2004.061424.

    Article  PubMed  PubMed Central  Google Scholar 

  • Foster, E., & Murrihy, R. (2011). Evidence-based treatment programs for conduct problems: Are they cost effective? In R. Murrihy (Ed.), Clinical handbook of assessing and treating conduct problems in youth (pp. 395–404). New York: Springer.

    Google Scholar 

  • Frick, P. J., Lahey, B. B., Loeber, R., Stouthamer-Loeber, M., Christ, M. A. G., & Hanson, K. (1992). Familial risk factors to oppositional defiant disorder and conduct disorder: parental psychopathology and maternal parenting. Journal of Consulting and Clinical Psychology, 60(1), 49–55.

    Article  PubMed  Google Scholar 

  • Frick, P. J., & Nigg, J. T. (2012). Current issues in the diagnosis of attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. Annual Review of Clinical Psychology, 8, 241–255. doi:10.1146/annurev-clinpsy-032511-143150.

    Article  Google Scholar 

  • Gibson, V. (1993). Stress in the workplace: A hidden cost factor. HR Focus, 70, 15.

    Google Scholar 

  • Goldfine, M. E., Wagner, S. M., Branstetter, S. A., & Mcneil, C. B. (2008). Parent-child interaction therapy: An examination of cost-effectiveness. Journal of Early and Intensive Behavior Intervention, 5(1), 119–136.

    Article  Google Scholar 

  • Greene, R. W., & Doyle, A. E. (1999). Toward a transactional conceptualization of oppositional defiant disorder: Implications for assessment and treatment. Clinical Child and Family Psychology Review, 2(3), 129–148. doi:10.1023/A:1021850921476.

    Article  PubMed  Google Scholar 

  • Guevara, J. P., Mandell, D. S., Rostain, A. L., Zhao, H., & Hadley, T. R. (2003). National estimates of health services expenditures for children with behavioral disorders: an analysis of the medical expenditure panel survey. Pediatrics, 112(6), e440–e446.

    Article  PubMed  Google Scholar 

  • Hazell, P. L., Tarren-Sweeney, M., Vimpani, G. V., Keatinge, D., & Callan, K. (2002). Children with disruptive behaviours II: Clinical and community service needs. Journal of Paediatrics and Child Health, 38(1), 32–40.

    Article  PubMed  Google Scholar 

  • Henggeler, S. W., & Sheidow, A. J. (2003). Conduct disorder and delinquency. Journal of Marital and Family Therapy, 29(4), 505–522.

    Article  PubMed  Google Scholar 

  • Insel, T. R. (2008). Assessing the economic cost of serious mental illness. American Journal of Psychiatry, 165(6), 663–665.

    Article  PubMed  Google Scholar 

  • Kashdan, T. B., Jacob, R. G., Pelham, W. E., Lang, A. R., Hoza, B., Blumenthal, J. D., & Gnagy, E. M. (2004). Depression and anxiety in parents of children with ADHD and varying levels of oppositional defiant behaviors: Modeling relationships with family functioning. Journal of Clinical Child and Adolescent Psychology, 33(1), 169–181. doi:10.1207/S15374424JCCP3301_16.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E., & Weisz, J. R. (1998). Identifying and developing empirically supported child and adolescent treatments. Journal of Consulting and Clinical Psychology, 66(1), 19.

    Article  PubMed  Google Scholar 

  • Kelsberg, G., & St. Anna, L. (2006). What are the effective treatments for oppositional defiant behaviors in adolescents? The Journal of Family Practice, 55(10), 911–913.

    PubMed  Google Scholar 

  • Kohlboeck, G., Romanos, M., Teuner, C. M., Holle, R., Tiesler, C. M., Hoffmann, B., & Heinrich, J. (2014). Healthcare use and costs associated with children’s behavior problems. European Child and Adolescent Psychiatry, 23(8), 701–714.

    PubMed  Google Scholar 

  • Lavigne, J. V., Cicchetti, C., Gibbons, R. D., Binns, H. J., Larsen, L., & DeVito, C. (2001). Oppositional defiant disorder with onset in preschool years: Longitudinal stability and pathways to other disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 40(12), 1393–1400. doi:10.1097/00004583-200112000-00009.

    Article  PubMed  Google Scholar 

  • Law, D. D., & Crane, D. R. (2000). The influence of marital and family therapy on health care utilization in a health-maintenance organization. Journal of Marital and Family Therapy, 26(3), 281–292.

    Article  PubMed  Google Scholar 

  • Loeber, R., Burke, J. D., & Lahey, B. B. (2002). What are adolescent antecedents to antisocial personality disorder? Criminal Behaviour and Mental Health, 12(1), 24–36.

    Article  PubMed  Google Scholar 

  • Loeber, R., Burke, J. D., Lahey, B. B., Winters, A., & Zera, M. (2000). Oppositional defiant and conduct disorder: A review of the past 10 years, Part I. Journal of the American Academy of Child and Adolescent Psychiatry, 39(12), 1468–1484. doi:10.1097/00004583-200012000-00007.

    Article  PubMed  Google Scholar 

  • Loeber, R., Burke, J., & Pardini, D. A. (2009). Perspectives on oppositional defiant disorder, conduct disorder, and psychopathic features. Journal of Child Psychology and Psychiatry, 50(1–2), 133–142. doi:10.1111/j.1469-7610.2008.02011.x.

    Article  PubMed  Google Scholar 

  • Malloy, J. D. (2014). Cost-effectiveness of treating oppositional defiant disorder: A comparison by treatment modality and mental health provider type. (Unpublished master’s thesis). Brigham Young University, Provo, UT.

  • Matza, L. S., Paramore, C., & Prasad, M. (2005). A review of the economic burden of ADHD. Cost Effectiveness and Resource Allocation,. doi:10.1186/1478-7547-3-5.

    PubMed  PubMed Central  Google Scholar 

  • Maughan, B., & Rowe, R. (2004). Conduct disorder and oppositional defiant disorder in a national sample: developmental epidemiology. Journal of Child Psychology and Psychiatry, 45(3).

  • Mireault, G., Rooney, S., Kouwenhoven, K., & Hannan, C. (2008). Oppositional behavior and anxiety in boys and girls: A cross-sectional study in two community samples. Child Psychiatry and Human Development, 39(4), 519–527.

    Article  PubMed  Google Scholar 

  • Nelson-Gray, R. O., Keane, S. P., Hurst, R. M., Mitchell, J. T., Warburton, J. B., Chok, J. T., & Cobb, A. R. (2006). A modified DBT skills training program for oppositional defiant adolescents: Promising preliminary findings. Behaviour Research and Therapy, 44(12), 1811–1820.

    Article  PubMed  Google Scholar 

  • Newcorn, J. H., Spencer, T. J., Biederman, J., Milton, D. R., & Michelson, D. (2005). Atomoxetine treatment in children and adolescents with attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 44(3), 240–248.

    Article  PubMed  Google Scholar 

  • Odgers, C. L., Milne, B. J., Caspi, A., Crump, R., Poulton, R., & Moffitt, T. E. (2007). Predicting prognosis for the conduct-problem boy: Can family history help? Journal of the American Academy of Child and Adolescent Psychiatry, 46(10), 1240–1249.

    Article  PubMed  Google Scholar 

  • Pfiffner, L. J., McBurnett, K., Rathouz, P. J., & Judice, S. (2005). Family correlates of oppositional and conduct disorders in children with attention deficit/hyperactivity disorder. Journal of Abnormal Child Psychology, 33(5), 551–563. doi:10.1007/s10802-005-6737-4.

    Article  PubMed  Google Scholar 

  • Robinson, K. E., Dow, R. T., & Nicholas, P. M. (1996). Expanding a continuum of care: A report on a partial-day treatment program. Child and Youth Care Forum, 28(3), 221–228.

    Article  Google Scholar 

  • Seipp, C. M., & Johnston, C. (2005). Mother–son interactions in families of boys with attention-deficit/hyperactivity disorder with and without oppositional behavior. Journal of Abnormal Child Psychology, 33(1), 87–98.

    Article  PubMed  Google Scholar 

  • Sexton, T. L., Ridley, C. R., & Kleiner, A. J. (2004). Beyond common factors: Multilevel-process models of therapeutic change in marriage and family therapy. Journal of Marital and Family Therapy, 30(2), 131–149. doi:10.1111/j.1752-0606.2004.tb01229.x.

    Article  PubMed  Google Scholar 

  • Sim, L. J., & England, M. J. (Eds.). (2009). Depression in parents, parenting, and children: Opportunities to improve identification, treatment, and prevention. Washington DC: National Academies Press.

    Google Scholar 

  • Steiner, H., Petersen, M., Saxena, K., Ford, S., & Matthews, Z. (2003). A randomized clinical trial of divalproex sodium in conduct disorders. Journal of Clinical Psychiatry, 64, 1183–1191.

    Article  PubMed  Google Scholar 

  • Steiner, H., & Remsing, L. (2007). Practice parameter for the assessment and treatment of children and adolescents with oppositional defiant disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 46(1), 126–141.

    Article  PubMed  Google Scholar 

  • Thompson, R. W., Ruma, P. R., Schuchmann, L. F., & Burke, R. V. (1996). A cost-effectiveness evaluation of parent training. Journal of Child and Family Studies, 5(4), 415–429.

    Article  Google Scholar 

  • Webster-Stratton, C., & Taylor, T. (2001). Nipping early risk factors in the bud: Preventing substance abuse, delinquency, and violence in adolescence through interventions targeted at young children (0–8 years). Prevention Science, 2(3), 165–192.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Marriage and Family Therapy, Mount Mercy University, 1330 Elmhurst Dr. NE, Cedar Rapids, IA, 52402, USA

    Jacob D. Christenson & Shannon Parker

  2. Marriage and Family Therapy, Brigham Young University, 234 TLRB, Provo, UT, 84602, USA

    D. Russell Crane & Julie Malloy

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  1. Jacob D. Christenson
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  2. D. Russell Crane
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  3. Julie Malloy
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Correspondence to Jacob D. Christenson.

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Christenson, J.D., Crane, D.R., Malloy, J. et al. The Cost of Oppositional Defiant Disorder and Disruptive Behavior: A Review of the Literature. J Child Fam Stud 25, 2649–2658 (2016). https://doi.org/10.1007/s10826-016-0430-9

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