Oppositional defiant disorder

Oppositional defiant disorder
Oppositional Defiant Disorder
Classification and external resources
ICD-10 F91.3
ICD-9 313.81
MeSH D019958

Oppositional defiant disorder (ODD) is a diagnosis described by the Diagnostic and Statistical Manual of Mental Disorders (DSM) as an ongoing pattern of disobedient, hostile and defiant behavior toward authority figures which goes beyond the bounds of normal childhood behavior. People who have it may appear very stubborn and angry.

Contents

Behavioral features

Common features of Oppositional Defiant Disorder (ODD) include excessive, often persistent anger, frequent temper tantrums or angry outbursts, and disregard for authority. Children and adolescents with this disorder often annoy others on purpose, blame others for their mistakes, and are easily annoyed. Parents often observe more rigid and defiant behaviors than in siblings.[1] In addition, these young people may appear resentful of others and when someone does something they don't like they often take revenge on them.[2]

In order for a child or adolescent to qualify for a diagnosis of ODD these behaviors must cause considerable distress for the family and/or interfere significantly with academic or social functioning. Interference might take the form of preventing the child or adolescent from learning school material or making friends, or placing him or her in harmful situations. These behaviors must also persist for at least six months. Effects of ODD can greatly be amplified by other disorders in comorbidity such as ADHD.[3]

Signs and Symptoms

Some signs and symptoms that must be perpetuated for longer than 6 months and must be considered beyond normal child behavior to fit the diagnosis are:[4] [5]

  • Actively defies or refuses to comply with adults' requests or rules[6]
  • Deliberately doing things that will annoy other people [7]
  • Angry and resentful of others[8]
  • Argues with adults[9]
  • Blames others for own mistakes
  • Has few or no friends or has lost friends
  • Is in constant trouble in school
  • Spiteful or seeks revenge
  • Touchy or easily annoyed

Generally, these patterns of behavior will lead to problems at school and other social venues.[10]

Prognosis

According to a 1992 article, if left untreated, about 52% of children with ODD will continue to meet the DSM-IV criteria up to three years later and about half of those 52% will progress into conduct disorder.[11]

Psychosocial treatments

One of the key factors in the development and maintenance of the negative behaviors associated with oppositional defiant disorder results is reinforcement, whether intentional or not, of the unwanted behaviors. The most effective way of treating disruptive behavior disorders is behavioral therapies.[12] Behavioral therapy for children and adolescents focuses primarily on how problematic thoughts or behaviors may accidentally get "rewarded" within a young person's environment.

These rewards or reinforcements often contribute to an increase in the frequency of these thoughts and behaviors. Behavior therapies can be applied to a wide range of psychological symptoms among adults, adolescents, and children. In behavioral therapy, therapists encourage children and adolescents to try new behaviors and not to allow negative "rewards" to dictate the ways in which they act. Furthermore, therapists may work with parents to discontinue ways in which they are unintentionally reinforcing negative behaviors.

Other approaches to the treatment of oppositional defiant disorder, include parent training programs, individual psychotherapy, family therapy, cognitive behavioral therapy, and social skills training.[13][14] According to the American Academy of Child and Adolescent Psychiatry, treatments for ODD are tailored specifically to the individual child, and different treatments are used for pre-schoolers and adolescents.[15]

An approach developed by Russell Barkley[16][17][18] uses a parent training model and begins by focusing on positive approaches to increase compliant behaviours.

In culture

  • The 2007 play ODD by Hal Corley is about a New Jersey teenager with Oppositional Defiant Disorder.[19]
  • In his 2004 book My Prison Without Bars, Pete Rose attributed his gambling to ODD.[20]
  • Judith and Martin Land (2011), Adoption Detective: Memoir of an Adopted Child, page 269, state that birth mothers are not always informed by social workers, medical doctors, or clergy that biological children given to others to raise have a high possibility of exhibiting selective mutism, oppositional defiant disorder, separation syndrome, and other unstable qualities. Giving a biological child to strangers can be a dangerous step to take—a shattering experience that leaves birth parents prone to emotional instability, insecurity, and psychiatric problems. More understanding and exposure of oppositional defiant disorder as a psychological trait characteristically associated with children who are orphaned, fostered, and adopted is encouraged.
  • The David Rovics song by the same name attacks this prognosis.

See also

References

  1. ^ "Children With Oppositional Defiant Disorder". www.aacap.org. Retrieved 2010-9-6.
  2. ^ Phelan, Thomas. 1-2-3 Magic. Glen Ellyn: ParentMagic, Inc., 2003.
  3. ^ Chandler, Jim. "Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) in Children and Adolescents: Diagnosis and Treatment". Web. http://www.klis.com/chandler/pamphlet/oddcd/oddcdpamphlet.htm. Retrieved 11/4/11. 
  4. ^ "Q 00 Oppositional Defiant Disorder". DSM-5. American Psychiatric Association. http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=106#. Retrieved 5 November 2011. 
  5. ^ Kaneshiro, Neil. "Oppositional Defiant Disorder". A.D.A.M. Medical Encyclopedia. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002504/. Retrieved 5 November 2011. 
  6. ^ "Oppositional Defiant Disorder: Symptoms". Psych Central. http://psychcentral.com/disorders/sx73.htm. Retrieved 5 November 2011. 
  7. ^ "Oppositional Defiant Disorder: Symptoms". Psych Central. http://psychcentral.com/disorders/sx73.htm. Retrieved 5 November 2011. 
  8. ^ Kaneshiro, Neil. "Oppositional Defiant Disorder". A.D.A.M. Medical Encyclopedia. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002504/. Retrieved 5 November 2011. 
  9. ^ Kaneshiro, Neil. "Oppositional Defiant Disorder". A.D.A.M. Medical Encyclopedia. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002504/. Retrieved 5 November 2011. 
  10. ^ Kaneshiro, Neil. "Oppositional Defiant Disorder". A.D.A.M. Medical Encyclopedia. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002504/. Retrieved 5 November 2011. 
  11. ^ Lahey, B., Loeber, R., Quay, H., Frick, P., & Grimm, J., (1992) Oppositional defiant and conduct disorders: Issues to be resolved for the DSM-IV. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 539-546.
  12. ^ Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008).
  13. ^ "Children With Oppositional Defiant Disorder". www.aacap.org. http://www.aacap.org/cs/root/facts_for_families/children_with_oppositional_defiant_disorder. Retrieved 2008-07-15. 
  14. ^ AACAP Workgroup On Quality Issues (Principal Authors: Steiner H, Remsing L. Practice Parameters For The Assessment And Treatment Of Children And Adolescents With Oppositional Defiant Disorder. Journal of the American Academy Of Child And Adolescent Psychiatry, 46(1): 126-141, 2007
  15. ^ "FAQs on Oppositional Defiant Disorder". www.aacap.org. http://www.aacap.org/cs/resource_center/odd_faqs#ODDFAQ3. Retrieved 2008-07-15. 
  16. ^ Barkley, R., (1997) Defiant Children: A Clinician's Manual for Assessment and Parent Training, NY: Guilford Press
  17. ^ Barkley, R., & Benton, C., (1998), Your Defiant Child, NY: Guilford Press
  18. ^ Barkley, R., Edwards, G., & Robin, A., (1999), Defiant Teens: A Clinician's Manual for Assessment and Family Intervention, NY: Guilford Press
  19. ^ Venutolo, Anthony "Play about rejects is worth salvaging". The Star-Ledger September 10, 2007
  20. ^ "Pete Rose". CNN. http://sportsillustrated.cnn.com/multimedia/photo_gallery/0907/weird.excuses/content.17.html. 

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