Emotional Mechanisms of Oppositional Defiant Disorder (ODD) in Adults: Links to Functional Impairment

Introduction: Oppositional Defiant Disorder (ODD) is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR; American Psychiatric Association, 2022) as a childhood disorder characterized by angry/irritable mood, argumentative/defiant behavior, and vindictiveness. Although evidence suggests that ODD symptoms often persist into adulthood, research on adult ODD remains limited. This gap is partly attributable to diagnostic guidelines that do not characterize ODD beyond age 18 and instead imply diagnostic supersession by Antisocial Personality Disorder. This omission is consequential, as adults with ODD histories show elevated psychiatric comorbidity, interpersonal conflict, and occupational and educational impairment. Emerging literature conceptualizes ODD as comprising two dimensions: antagonistic/defiant behavior and negatively oriented affect, particularly irritability. Irritability has been linked to depression, anxiety, and functional impairment and may represent a central mechanism driving adverse outcomes. Emotion dysregulation and emotional impulsivity—characterized by heightened emotional reactivity and poor regulatory control—have also been implicated in ODD and related psychopathology. The present study aims to clarify emotional mechanisms contributing to functional impairment in adult ODD by examining associations between ODD symptoms, functional impairment (including relationship satisfaction and substance use), irritability, emotion dysregulation, and emotional impulsivity; testing irritability and emotional impulsivity as mediators; and evaluating the psychometric properties of a novel adult ODD measure.

Methods: Participants were 168 adults (49% female; mean age = 42.84, SD = 13.01) recruited via Prolific. No additional inclusion/exclusion criteria were implemented. Participants completed self-report measures of ODD symptoms, functional impairment, emotional impulsivity, emotion dysregulation, and irritability. All procedures were approved by the institutional review board.

Results: Regression-based mediation models will be used to test study hypotheses.

Conclusions: Findings are expected to support a neurodevelopmental model of adult ODD, highlighting emotional impulsivity and irritability as key mechanisms linking ODD symptoms to functional impairment and identifying potential targets for assessment and intervention.