12.Oppositional Defiant Disorder

12.1.What Is Oppositional Defiant Disorder?

Oppositional defiant disorder (ODD) is a behavior disorder, usuallydiagnosed in childhood, that is characterized by uncooperative, defiant,negativistic, irritable and annoying behaviors toward parents, peers, teachersand other authority figures.

12.2.Causes of Oppositional Defiant Disorder

Some experts believe that a developmental sequence of experiences occursin oppositional defiant disorder. This sequence may start with ineffectiveparenting practices, followed by difficulty with other authority figures andpoor peer interactions.

As these experiences compound and continue, oppositional and defiantbehaviors develop into a pattern of behavior. Early detection and interventioninto negative family and social experiences may be helpful in disrupting thesequence of experiences that leads to more oppositional and defiant behaviors.

Early detection and intervention with more effective communication,parenting, conflict resolution and anger management skills can disrupt thepattern of negative behaviors and decrease the interference of oppositional anddefiant behaviors in interpersonal relationships with adults and peers, andschool and social adjustment.

The goal of early intervention is to enhance the child's normal growth anddevelopmental process, and improve the quality of life experienced by childrenwith oppositional defiant disorder.

12.3.Incidence of Oppositional Defiant Disorder

Behavior disorders, as a category, are by far the most common reason forreferrals to mental health services for children and adolescents.

Oppositional defiant disorder is reported to affect between 2 percent and16 percent of children and adolescents in the general population. ODD is morecommon in boys than in girls.

12.4.Signs and Symptoms

Most symptoms of ODD also occur at times in individuals without thisdisorder, especially during the teenage years. However, in children andadolescents with oppositional defiant disorder, these symptoms occur morefrequently and interfere with learning, school adjustment and, sometimes, withthe adolescent's relationships with others.

Symptoms of Oppositional Defiant Disorder

Excessive arguments

Refusal to comply with appropriate requests

Always questioning rules; refusal to follow rules

Behavior intended to annoy or upset others

Blaming others for his / her misbehaviors or mistakes

Easily annoyed by others

Frequently has an angry attitude

The symptoms of ODD may resemble other medical conditions or behaviorproblems. Always consult your adolescent's physician for an evaluation.

12.5.Diagnosis of Oppositional Defiant Disorder

Parents, teachers and other authority figures in child settings oftenidentify the individual with ODD. A detailed history of the child's behaviorfrom 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 can help by seeking anevaluation and treatment early. Early treatment can often prevent futureproblems. Further, oppositional defiant disorder often coexists with othermental health disorders, including mood disorders, anxiety disorders, conductdisorder and attention deficit / hyperactivity disorder, increasing the needfor early diagnosis and treatment. Consult your adolescent's physician for moreinformation.

12.6Treatment for Oppositional Defiant Disorder

Specific treatment for the adolescent with oppositional defiant disorderwill be recommended to you by your child's physician or mental healthprofessional based on:

Overall health and medical history

Severity of symptoms

Tolerance for specific medications, procedures or therapies

Expectations for the course of the condition

Types of Treatments

Individual psychotherapy: Usescognitive-behavioral approaches to improve problem-solving skills,communication skills, impulse-control and anger-management skills.

Family therapy: Often focused on makingchanges within the family system, such as improving communication skills andfamily interactions. Parenting children with ODD can be very difficult andtrying for parents. Parents need support and understanding as well as help withdeveloping more effective parenting approaches.

Peer group therapy: Often focused on developingsocial skills and interpersonal skills.

Medication: While not consideredeffective in treating ODD, medication may be used if other symptoms ordisorders are present and are responsive to medication.