Oppositional Defiant Disorder (ODD) is a behavior disorder that affects children and adolescents. Five to fifteen percent of all school-age children have Oppositional Defiant Disorder, similar to the better known Attention-Deficit Hyperactivity Disorder (ADHD). Its symptoms mirror normal childhood behavior that becomes a problem of excess.
While ADHD is characterized by excess hyperactivity, impulsiveness, or inattention, children afflicted with ODD are more likely to challenge adult authority figures openly. They may argue, talk back, disobey and defy teachers, parents, and other adults.
Again, this behavior isn’t necessarily abnormal. Most children are oppositional from time to time, particularly when tired, hungry, upset, or stressed. But children with oppositional defiant disorder manifest an ongoing pattern of misbehavior that seriously impedes their day-to-day functioning.
Most children suffering from Oppositional Defiant Disorder also have some other neuropsychiatric disorder.
Some research indicates that Oppositional Defiant Disorder is a precursor to other conduct and personality disorders.
Causes of Oppositional Defiant Disorder
According to the American Academy of Child & Adolescent Psychiatry, the causes of Oppositional Defiant Disorder are unknown, though biological and environmental factors may both play a role.
For example, it may be more common in children whose parents have marital problems. Studies also indicate that children are more likely to suffer from Oppositional Defiant Disorder if they are alcoholics and the father has been in trouble with the law.
Oppositional Defiant Disorder: Symptoms & Diagnosis
Douglas Tynan, Ph.D. defines –“ODD happens when a child has persistently or constantly shown disobedience and aggression toward parents, teachers, or other surrounding people.”
The American Academy of Child & Adolescent Psychiatry lists the following specific symptoms:
• frequent temper tantrums
• excessive arguing with adults
• rejection to accept adult requests and rules
• purposeful attempts to irritate or distress people
• always give responsibility to others for his or her error or misbehavior
• often being irritable or easily upset by others
• frequent anger and resentment
• mean and hateful talking when upset
• seeking revenge
MentalHealth.com offers a similar list of symptoms, suggesting that the presence of four or more symptoms over a period of at least six months is a danger sign.
The symptoms are usually more noticeable at home or in school, though they may be observed in various settings. Many parents report that their children with ODD were more rigid and demanding than the children’s siblings from an early age.
A child who displays ODD symptoms should be given a comprehensive evaluation that tests for other disorders that may be present (e.g., attention-deficit hyperactive disorder, depression, bipolar disorder, learning disabilities, and anxiety disorders).
Treatment of Oppositional Defiant Disorder
Pediatricians and family physicians can refer parents to the child and adolescent psychiatrists to diagnose and treat ODD and any coexisting psychiatric conditions. In fact, improving the symptoms of oppositional defiant disorder may be difficult without treating the coexisting disorder.
Stimulant medication is used to treat ODD only when a patient is also suffering from attention-deficit/hyperactivity disorder. Treatment of ODD generally consists of various therapies and training programs that target not just the patient but also parents and other people associated with the patient.
Patients may be treated with individual psychotherapy and cognitive-behavioral therapy (to develop more effective anger management and assist in problem-solving, respectively. Skills training helps patients improve interactions with their peers.
Special training programs can help teach parents how to manage their children’s behavior.
They may use a system similar to the carrot-and-stick approach used in many classrooms. Students with behavioral problems are praised for good behavior and informed of consequences for bad behavior.
Parents may also need to learn how to manage their own stress levels.
Family psychotherapy can help improve communication between a patient and his or her parents and siblings. Parents of children afflicted with ODD should use great care in choosing a school and teacher for their child.
Long Term Outlook
Few, if any, controlled studies have been done on the treatment outcome of oppositional defiant disorder. However, about three-quarters of children with this diagnosis remain afflicted with it several years later.
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