Effectiveness of a Multidimensional Intervention Based on Non-invasive Brain Stimulation and Cognitive–Behavioral Skill Training on Response Inhibition and Threat-Related Attentional Bias in Children with Oppositional Defiant Disorder

Purpose Oppositional Defiant Disorder (ODD) is associated with deficits in executive functioning, including impaired response inhibition and heightened threat-related attentional bias. This study examined the effectiveness of a multidimensional intervention combining non-invasive transcranial direct current stimulation (tDCS) and cognitive–behavioral skill-based training (CBT) in improving these cognitive processes among children with ODD. Methods A quasi-experimental pretest–posttest design with a control group was used. Forty-five children aged 10–12 years diagnosed with ODD were randomly assigned to three groups: tDCS, CBT, and control (n = 15 per group). Response inhibition was assessed using the computerized Stroop Test, and threat-related attentional bias was measured using a pictorial dot-probe task. Interventions were delivered across nine sessions. After confirming statistical assumptions, data were analyzed using multivariate analysis of covariance (MANCOVA). Results Both tDCS and CBT significantly improved response inhibition—reflected in reduced errors, increased correct responses, and faster reaction times—and significantly reduced threat-related attentional bias compared to the control group. Effect sizes were large across all variables. tDCS showed comparatively stronger effects than CBT in both cognitive domains. Conclusions The findings provide preliminary evidence that non-invasive brain stimulation and cognitive–behavioral skill training can effectively enhance executive functioning in children with ODD. tDCS appears a potentially useful complementary approach as a complementary intervention for cognitive and behavioral dysregulation.