What is oppositional defiant disorder (ODD)?
What is oppositional defiant disorder (ODD)? Oppositional
defiant disorder (ODD) is a behavior disorder, usually diagnosed
in childhood, that is characterized by uncooperative, defiant,
negativistic, irritable, and annoying behaviors toward parents,
peers, teachers, and other authority figures. Children and
adolescents with ODD are more distressing or troubling to others
than they are distressed or troubled themselves.
What causes oppositional defiant disorder? While the cause of
ODD is not known, there are two primary theories offered to
explain the development of ODD. A developmental theory suggests
that the problems begin when children are toddlers. Children and
adolescents who develop ODD may have had a difficult time
learning to separate from their primary attachment figure and
developing autonomous skills. The bad attitudes characteristic
of ODD are viewed as a continuation of the normal developmental
issues that were not adequately resolved during the toddler
years.
Learning theory suggests, however, that the negativistic
characteristics of ODD are learned attitudes reflecting the
effects of negative reinforcement techniques used by parents and
authority figures. The use of negative reinforcers by parents is
viewed as increasing the rate and intensity of oppositional
behaviors in the child as it achieves the desired attention,
time, concern, and interaction with parents or authority figures.
Who is affected by oppositional defiant disorder? Behavior
disorders, as a category, are, by far, the most common reason
for referrals to mental health services for children and
adolescents. Oppositional defiant disorder is reported to affect
between 10 percent and 15 percent of children and adolescents in
the general population. ODD is more common in boys than in girls.
What are the symptoms of oppositional defiant disorder? Most
symptoms seen in children and adolescents with oppositional
defiant disorder also occur at times in children without this
disorder, especially around the ages or 2 or 3, or during the
teenage years. Many children, especially when they are tired,
hungry, or upset, tend to disobey, argue with parents, or defy
authority. However, in children and adolescents with
oppositional defiant disorder, these symptoms occur more
frequently and interfere with learning, school adjustment, and,
sometimes, with the child's (adolescent's) relationships with
others.
Symptoms of oppositional defiant disorder may include:
frequent temper tantrums excessive arguments with adults
refusal to comply with adult requests always questioning rules;
refusal to follow rules behavior intended to annoy or upset
others, including adults blaming others for his/her misbehaviors
or mistakes easily annoyed by others frequently has an angry
attitude speaking harshly, or unkind deliberately behaving in
ways that seek revenge The symptoms of ODD may resemble other
medical conditions or behavior problems. Always consult your
child's (adolescent's) physician for a diagnosis.
How is oppositional defiant disorder diagnosed? Parents,
teachers, and other authority figures in child and adolescent
settings often identify the child or adolescent with ODD.
However, a child psychiatrist or a qualified mental health
professional usually diagnoses ODD in children and adolescents.
A detailed history of the child's behavior from parents and
teachers, clinical observations of the child's behavior, and,
sometimes, psychological testing contribute to the diagnosis.
Parents who note symptoms of ODD in their child or teen can help
by seeking an evaluation and treatment early. Early treatment
can often prevent future problems.
Further, oppositional defiant disorder often coexists with other
mental health disorders, including mood disorders, anxiety
disorders, conduct disorder, and attention-deficit/hyperactivity
disorder, increasing the need for early diagnosis and treatment.
Always consult your child's (adolescent's) physician for more
information.
Treatment for oppositional defiant disorder: Specific treatment
for children with oppositional defiant disorder will be
determined by your child's (adolescent's) physician based on:
your child's (adolescent's) age, overall health, and medical
history extent of your child's (adolescent's) symptoms your
child's (adolescent's) tolerance for specific medications,
procedures, or therapies expectations for the course of the
condition your opinion or preference Treatment may include:
individual psychotherapy Individual psychotherapy for ODD often
uses cognitive-behavioral approaches to improve problem solving
skills, communication skills, impulse control, and anger
management skills. family therapy Family therapy is often
focused on making changes within the family system, such as
improving communication skills and family interactions.
Parenting children with ODD can be very difficult and trying for
parents. Parents need support and understanding as well as
developing more effective parenting approaches. peer group
therapy Peer group therapy is often focused on developing social
skills and interpersonal skills. medication While not considered
effective in treating ODD, medication may be used if other
symptoms or disorders are present and responsive to medication.
Prevention of oppositional defiant disorder in childhood: Some
experts believe that a developmental sequence of experiences
occurs in the development of oppositional defiant disorder. This
sequence may start with ineffective parenting practices,
followed by difficulty with other authority figures and poor
peer interactions. As these experiences compound and continue,
oppositional and defiant behaviors develop into a pattern of
behavior. Early detection and intervention into negative family
and social experiences may be helpful in disrupting the sequence
of experiences leading to more oppositional and defiant
behaviors. Early detection and intervention with more effective
communication skills, parenting skills, conflict resolution
skills, and anger management skills can disrupt the pattern of
negative behaviors and decrease the interference of oppositional
and defiant behaviors in interpersonal relationships with adults
and peers, and school and social adjustment. The goal of early
intervention is to enhance the child's normal growth and
developmental process, and improve the quality of life
experienced by children or adolescents with oppositional defiant
disorder.