{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:22:00Z","timestamp":1787725320011,"version":"build-2784847793"},"reference-count":52,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child Adoles Psych Nursing"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Attention\u2010deficit\/hyperactivity disorder (ADHD) affects 5%\u20137% of school\u2010aged children globally and is characterized by a 40%\u201360% comorbidity rate with oppositional defiant disorder (ODD). Irritability has emerged as a key transdiagnostic construct linking ADHD severity to oppositional defiant behavior (ODB); however, whether the structural pattern of associations among these constructs differs across clinical and non\u2010clinical populations remains unexamined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      This study employed multi\u2010group path analysis within the SEM framework to test whether the structural pathways linking ADHD symptom severity, child irritability, and ODB are invariant across a Clinical ADHD Group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200942) and a Healthy Control Group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200943; total\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200985). Maternal psychological distress was controlled as an exogenous covariate across all groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross\u2010sectional design was employed. ADHD severity, child irritability, ODB, and maternal distress were assessed via validated parent\u2010report instruments (CPRS\u2010R\/S, ARI, BSI). Observed\u2010variable multi\u2010group path analysis was performed in R using the lavaan package (Rosseel,\u20092012) (see Supplementary Material S1 for reproducible code and fit index selection) via a nested model comparison, with omnibus structural invariance evaluated using the Chi\u2010square difference test (\u0394\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      ); ODB was regressed on ADHD severity, child irritability, and maternal distress, with the three exogenous variables permitted to covary. Bias\u2010corrected bootstrapping (2000 resamples) was used for parameter confidence intervals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The omnibus test of structural invariance was statistically significant, \u0394\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      (3)\u2009=\u200910.494,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015, indicating that the structural associations among the focal constructs differ across groups. In the Healthy Control Group, ODB was most strongly associated with child irritability (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.636,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with ADHD severity showing a weaker association (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.358,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001;\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.560). In the Clinical ADHD Group, the pattern differed: ODB was most strongly associated with ADHD symptom severity (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.667,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), whereas the association with irritability was weaker (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.232,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.044;\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.585). Maternal psychological distress was not uniquely associated with ODB in either group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Child irritability was the strongest correlate of ODB in neurotypical children, consistent with frustration\u2010based oppositional expression. In clinical ADHD, oppositional behavior was more strongly associated with ADHD symptom severity than with irritability, a pattern consistent with conceptualizations emphasizing executive dysfunction. These findings carry distinct assessment and intervention implications for psychiatric\u2010mental health nursing practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jcap.70066","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:04:23Z","timestamp":1784286263000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["ADHD Symptom Severity and Oppositional Defiant Behavior: Divergent Structural Pathways Across Clinical and Non\u2010Clinical Populations\u2014A Multi\u2010Group Path Analysis Investigation"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5431-8247","authenticated-orcid":false,"given":"Berke","family":"Ta\u015fc\u0131","sequence":"first","affiliation":[{"name":"Institute of Forensic Sciences Ankara University Balkiraz Ankara Ankara T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association.2013.Diagnostic and Statistical Manual of Mental Disorders(5th ed.).https:\/\/doi.org\/10.1176\/appi.books.9780890425596.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1087054710370567"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.121.1.65"},{"key":"e_1_2_13_5_1","volume-title":"Attention\u2010Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment","author":"Barkley R. 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