Comparison of Neuropsychological Factors and Childhood Maltreatment Between Children with DMDD and ODD: A Cross-Sectional Comparative Study
Keywords:
Childhood Maltreatment, Neuropsychological Factors, Disruptive Mood Dysregulation Disorder, Oppositional Defiant DisorderAbstract
Objective: The present study aimed to compare executive function domains and childhood maltreatment experiences between children diagnosed with Disruptive Mood Dysregulation Disorder (DMDD) and those diagnosed with Oppositional Defiant Disorder (ODD).
Methods and Materials: This cross-sectional comparative study was conducted during 2024–2025 among children and adolescents referred to psychiatric clinics in Fars Province, Iran. The final sample consisted of 63 participants, including 30 children with DMDD and 33 children with ODD, selected through purposive sampling. Diagnoses were confirmed according to DSM-5 criteria by a child and adolescent psychiatrist. Data collection involved the parent-report Behavior Rating Inventory of Executive Function (BRIEF) and the child self-report Child Maltreatment Questionnaire. Executive functioning was assessed across eight domains, including inhibition, working memory, initiation, planning, and emotional control. Childhood maltreatment was evaluated in three domains: neglect, physical abuse, and psychological/emotional abuse. Data were analyzed using SPSS version 28. Multivariate analysis of variance (MANOVA) was employed to compare executive function and maltreatment scores between the two groups.
Findings: The findings demonstrated significant differences between the DMDD and ODD groups in several executive function domains. Children with ODD obtained significantly higher scores, indicating greater dysfunction, in initiation (F=5.79, p=0.019), working memory (F=10.09, p=0.002), planning (F=5.61, p=0.021), and organization of materials (F=6.14, p=0.016). Working memory showed the largest effect size (η²=0.142). No significant differences were observed in inhibition, emotional control, attention shifting, or self-monitoring. Regarding childhood maltreatment, children with ODD reported significantly higher levels of physical abuse (F=11.98, p<0.001) and psychological/emotional abuse (F=4.14, p=0.046) compared with children with DMDD, whereas neglect did not significantly differ between the groups.
Conclusion: The results suggest that although both DMDD and ODD are associated with executive dysfunction and adverse childhood experiences, children with ODD exhibited more severe impairments in specific executive function domains and reported greater exposure to childhood maltreatment. These findings highlight important neuropsychological and environmental distinctions between the two disorders and emphasize the need for comprehensive trauma-informed and neuropsychological assessment in the differential diagnosis and treatment planning of disruptive behavioral disorders in children and adolescents. Longitudinal studies are recommended to clarify causal pathways and developmental mechanisms underlying these associations.
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