Multiple Levels of Family Factors and Oppositional Defiant Disorder Symptoms Among Chinese Children

• Author: Xiuyun Lin,Peilian Chi,Xiaoyi Fang,Shousen Xu,Longfeng Li,Melissa A. Heath
• Published date: 01 March 2018
• Date: 01 March 2018
• DOI: http://doi.org/10.1111/famp.12269

Multiple Levels of Family Factors and Oppositional

Defiant Disorder Symptoms Among Chinese

Children

XIUYUN LIN*

,†

LONGFENG LI*

MELISSA A. HEATH

‡

PEILIAN CHI

§

SHOUSEN XU

¶

XIAOYI FANG*

,

**

Family factors are closely associated with child developmental outcomes. This study

examined the relationship of oppositional defiant disorder (ODD) symptoms and factors at

whole family, dyadic, and individual levels in Chinese children. Participants, who were

recruited from 14 primary schools in north, east, and south-west China, included 80

father-child dyads and 169 mother-child dyads. Children in the participating dyads were

previously diagnosed with ODD. Results revealed that family cohesion/adaptability was

indirectly associated with ODD symptoms via parent–child relationship and child emotion

regulation. Parent–child relationship affected ODD symptoms directly and indirectly

through child emotion regulation. In addition, the effects of family cohesion/adaptability

on parent emotion regulation and child emotion regulation were mediated by the parent–

child relationship. The tested model provides a comprehensive framework of how family

factors at multiple levels are related to child ODD symptoms and highlights the impor-

tance of understanding child emotional and behavioral problems within the family context,

more specifically within the multiple levels of family relationships.

Keywords: Oppositional Defiant Disorder Symptoms; Multiple Levels of Family Factors;

Whole Family Factors; Dyadic Factors; Individual Factors

Fam Proc 57:195–210, 2018

*School of Psychology, Institute of Developmental Psychology, Beijing Normal University, Beijing, China.

†

Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University,

Beijing, China.

‡

Department of Counseling Psychology and Special Education, Brigham Young University, Provo, UT.

§

Department of Psychology, University of Macau, Macau, China.

¶

School of Kinesiology and Health, Capital University of Physical Education and Sports, Beijing, China.

**Academy of Psychology and Behaviour, Tianjin Normal University, Tianjin, China.

Correspondence concerning this article should be addressed to Shousen Xu, School of Kinesiology and

Health, Capital University of Physical Education and Sports, Beijing 100191, China. E-mail: shouse

nxu@126.com.

The study described in this report was funded by Open Research Fund of the State Key Laboratory of

Cognitive Neuroscience and Learning in 2015 (CNLZD1503), and Supported by Beijing Natural Science

Foundation (7162115). The content is solely the responsibility of the authors and does not necessarily rep-

resent the official views of State Key Laboratory Foundation and Beijing Organization Committee. We are

appreciative of the parents, children, and teachers who participated in our study and the many people who

assisted in data collection.

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Family Process, Vol. 57, No. 1, 2018 ©2016 Family Process Institute

doi: 10.1111/famp.12269

INTRODUCTION

Oppositional defiant disorder (ODD) is a collection of emotional and behavioral prob-

lems characterized by a recurrent pattern of angry/irritable, argumentative/defiant,

and vindictive behavior toward authority figures (American Psychiatric Association

[APA], 2013). Genetic, environmental, and individual factors and the interplay between

them may account for the onset of the disorder and the severity of the disorder’s symptoms

(Reiss, Plomin, & Hetherington, 1991). Among them, a significant body of literature has

identified a range of family factors, including family functioning (Lavigne, Gouze, Hop-

kins, Bryant, & LeBailly, 2012), marital conflict (Bornovalova et al., 2014), and negative

parent–child relationships (Burke, Loeber, & Birmaher, 2002), that are related to

increased or decreased number and severity of ODD symptoms. However, in general, pre-

vious studies have singularly focused on either the whole family factors (e.g., family con-

text), dyadic factors (e.g., parent–child interaction), or individual factors (e.g., children’s

emotion regulation), which has restricted the understanding of the effects of family factors

on ODD symptoms to a single level (Cox & Paley, 2003). Knowledge about the mechanis m

of the effects of family factors at multiple levels on child ODD symptoms remains limited.

In this study, we tested a comprehensive framework to explain how multiple levels of fam-

ily factors are uniquely and interactively related to child ODD symptoms.

Several studies have investigated the relationship among family factors and the extent

to which family factors are similarly or otherwise related to child ODD symptoms. One

important research was conducted by Lavigne et al. (2012), who examined the effects of

family factors across multiple domains, including family context, parenting, parental

depression, and child characteristics, on ODD symptoms among 4-year-old children. They

found that family conflict and life stress were associated with more ODD symptoms. More

importantly, negative parenting and parental depression resulted from family conflict and

life stress led to more ODD symptoms. Furthermore, child characteristics, such as ne ga-

tive emotion, poor effortful control, and poor sensory regulation mediated the negative

effect of parenting characteristics on ODD symptoms. Also, the negative relationship

between parent–child attachment and ODD symptoms was mediated by child effortful

control and sensory regulation (Lavigne et al., 2012).

Although Lavigne et al.’s (2012) multidomain model proved helpful in explaining the

effects of various family factors on ODD symptoms, the model did not clearly describe the

details of multilevel interplay and interacting dynamics in the family system. According to

the family system theory, family is a dynamic and interactive system with interdependent

factors at multiple levels (Cox & Paley, 2003). In other words, factors at the whole family

level, the dyadic level, and the individual level play important roles in shaping and influ-

encing the personality and social development of a child (Cox & Paley, 2003). Moving for-

ward, a theory-based model is needed to provide a more accurate understanding of the

mechanism and interplay of how individual and family factors at multiple levels affect

ODD symptoms.

Guiding Framework of the Current Study

Building on previously mentioned rationales of family system theory (Cox & Paley,

2003) and social ecological theory (Bronfenbrenner, 2009), Lin et al. (2013) proposed a

multilevel family model to explain the effects of factors—at multiple levels in the family

system—on the development and maintenance/exacerbation of ODD symptoms. Lin

et al.’s model reflects the dy namic interaction among factors at the whole family level, the

dyadic level, and the individual level. At the dyadic level, the model includes not only

the parent–child interaction but also the couple’s interaction. At the individual level, the

model incorporates both child and parent perspectives. Inspired by social ecological theory

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