Childhood ODD: A Precursor for Adult Alcohol Dependence

Dr Shelley Hyman

Oppositional defiant disorder (ODD) is characterised by negativistic, defiant, disobedient and hostile behaviours which lead to impairments in everyday life.

Many family attributes are associated with high levels of oppositional behaviour in children (such as poor parenting practices and child abuse), and this behaviour may affect a child’s social, academic and occupational functioning.

Additionally, temperament deviations associated with adolescents at high risk of alcohol abuse have been found in those with ODD, such as reduced attention span, emotional reactivity and negative affect states. The environmental factors in alcohol abuse are also extremely similar to those in ODD.

Research by Ghosh and colleagues (2014) has investigated this relationship further, aiming to investigate the association between childhood ODD and adult alcohol dependence.

They used a sample of 100 adult patients (of less than 50 years old) who were attending a clinic and met the diagnosis of alcohol dependence, as well as 100 people who had never used alcohol in their lifetime in order to form a control group.

The two groups were matched on socio-economic background. The physical, psychological and social manifestations of alcohol dependence, conduct disorder (CD) and ODD were assessed by using the Semi Structured Assessment for the Genetics of Alcoholism (SSAGA-IV).

These measures were used to confirm the diagnosis of alcohol dependence, as well as to determine the occurrence of ODD and CD in the past. Additionally, the Kiddie-Sads-Present and Lifetime Version (K-SADS-PL) was used to assess childhood occurrence of Attention Deficit/Hyperactivity Disorder (ADHD) in the participants.

The results of the study suggest that more people with adult alcohol dependence had ODD in childhood compared to those without alcohol dependence. Even when ADHD and CD were excluded from the analysis this association remained, which indicates that there is a significant association between ODD and adult alcohol dependence.

The real-world implications of this finding are far-reaching, as it indicates that the trajectory of alcohol dependence starts long before the first sip of alcohol is even consumed. This may subsequently lead to preventative strategies targeted at youth suffering from ODD, as this is a much milder and easier to treat disorder.


  • Ghosh, A., Malhotra, S., & Basu, D. (2014). Oppositional defiant disorder (ODD), the forerunner of alcohol dependence: A controlled study. Asian Journal of Psychiatry. Emma Waite
Dr Shelley Hyman

About Dr Shelley Hyman

Senior Clinical Neuropsychologist. BSc (psychol) Hons, MClinNeuropsych, PhD (Med) MAPS CCN. Founder and director of the centre that was founded in 2006.