Oppositional defiant disorder
Overview
Oppositional defiant disorder is a psychiatric category listed in the Diagnostic and Statistical Manual of Mental Disorders where it is described as an ongoing pattern of disobedient, hostile, and defiant behavior toward authority figures which goes beyond the bounds of normal childhood behavior.
Symptoms
It may be tough at times to recognize the difference between a strong-willed or emotional child and one with oppositional defiant disorder. Certainly there's a range between the normal independence-seeking behavior of children and oppositional defiant disorder. It's normal to exhibit oppositional behaviors at certain stages of a child's development. However, your child's issue may be oppositional defiant disorder if your child's oppositional behaviors: * Are persistent * Have lasted at least six months * Are clearly disruptive to the family and home or school environment The following are behaviors associated with ODD: * Negativity * Defiance * Disobedience * Hostility directed toward authority figures These behaviors might cause your child to regularly and consistently show these symptoms: * Frequent temper tantrums * Argumentativeness with adults * Refusal to comply with adult requests or rules * Deliberate annoyance of other people * Blaming others for mistakes or misbehavior * Acting touchy and easily annoyed * Anger and resentment * Spiteful or vindictive behavior * Aggressiveness toward peers * Difficulty maintaining friendships * Academic problems
Causes
There's no clear cause underpinning oppositional defiant disorder. (2) Contributing causes may include: * The child's inherent temperament * The family's response to the child's style * A genetic component that when coupled with certain environmental conditions — such as lack of supervision, poor quality child care or family instability — increases the risk of ODD * A biochemical or neurological factor * The child's perception that he or she isn't getting enough of the parent's time and attention
Diagnosis
Because many of these behaviors are found frequently in normal children, making the diagnosis of Oppositional Defiant Disorder can be difficult. There are no blood tests for this condition. The diagnosis is best made by a psychiatrist, psychologist, or some other qualified mental health professional after a comprehensive diagnostic evaluation.
Prognosis
Childhood Oppositional Defiant Disorder is strongly associated with later developing Conduct disorder. 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
Treatment
There are a variety of approaches to the treatment of Oppositional Defiant Disorder, including parent training programs, individual psychotherapy, family therapy, cognitive behavioral therapy, and social skills training. 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. An approach developed by Russell Barkley uses a parent training model and begins by focusing on positive approaches to increase compliant behaviours. Only later in the program are methods introduced to extinguish negative or noncompliant behaviours.