Oppositional Defiant Disorder (ODD)

Oppositional Defiant Disorder (ODD)

If your child or teen has a persistent pattern of disobedience and hostility toward authority figures for at least 6 months, he or she may have oppositional defiant disorder (ODD). Some symptoms associated with ODD are being argumentative with adults, easily losing the temper, acting aggressively towards peers, persistently being in trouble at school, being touchy or easily annoyed and refusing to follow an adults directions or rules. ODD can be present from early childhood to after puberty and is much more common in boys. The causes for ODD vary and can be a mix of psychological, social and biological issues. It may be difficult to see the difference between ODD and childhood argumentativeness and moodiness. Treatments include individual and family therapy, and medication may be prescribed for mental health conditions related to ODD.

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    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.
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    ODD can negatively affect quality of life not only for children who have the condition, but also for the entire family and others around them. Children who struggle with ODD symptoms in school can be a burden to their teachers and a distraction to the class. A child may have difficult relationships with peers and siblings, creating stressful situations for all involved. Parenting a child with ODD can be very frustrating. Behavior modification techniques learned in therapy must be consistently reinforced. Patience and forgiveness are important qualities to foster in the home during treatment.

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    Oppositional defiant disorder (ODD) is a complex condition, and many different factors are thought to have a role in its development. For that reason, it is unlikely that ODD can be completely prevented in a child who might be predisposed to developing the disorder. However, several environmental factors are thought to play a role. These can be controlled in the home in an attempt to limit the severity of ODD. They include a violent/abusive upbringing, lack of parental supervision, harsh discipline, financial or family instability, and lack of a positive adult figure.

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    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.
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    Although it is a behavioral disorder, oppositional defiant disorder (ODD) can impact both the brain and the body. Some possible causes of ODD are biological, such as an imbalance of serotonin, which is a chemical in the brain. When biological causes of ODD affect the brain, they may leave the child unable to cope with normal behavioral situations. ODD may also have a genetic component, with behavioral characteristics inherited from the child's parents. In addition to the affects on the brain, the condition can indirectly affect the body. Because children with ODD may become violent, they can sustain injury as a result of their actions.

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    Because ODD is a behavioral disorder, parental care is an important element of treatment. In addition to behavioral therapy sessions with a mental health professional, your child will benefit from environmental changes at home. These include setting disciplinary guidelines, establishing rules, and building a consistent routine. Create a team atmosphere at home, and involve the entire family so that everyone is enforcing the rules consistently. Although it can be frustrating to care for a child with ODD, work to maintain your patience as much as possible.

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    Untreated cases of oppositional defiant disorder (ODD) can have serious complications as a child ages. Children who fall behind in school due to their ODD symptoms may continue to struggle academically for years. Because difficulty relating to peers is one effect of ODD, children with the condition can have trouble making and keeping friends. The defiance of authority figures that is a part of ODD can trap a child in a pattern of delinquency. Conduct disorders can develop when children with ODD do not learn how to behave appropriately. Finally, children with ODD are at risk for substance abuse disorders, because they may try to self-medicate their condition as they get older.

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    Some of the genetic and environmental factors that affect ODD can run in families. Inherited factors, such as disposition, may be passed from parent to child. Environmental factors, including substance abuse, physical abuse, and inconsistent parenting, can also occur through several generations of a family. The stress of parenting a difficult child can cause a mother or father to resort to inappropriate, neglectful, or abusive caretaking out of frustration, especially in parents with substance abuse disorders. This cycle can continue in families for generations.

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    ODD is generally recognized by the time a child reaches eight years of age. Therefore, children who are eight years old or younger are at risk for the development of ODD. Boys and girls who live in an abusive, neglectful, or unstable home are at high risk. Those children with developmental disorders, depression, and anxiety are also at increased risk. ODD is most often diagnosed in children who have ADHD, so this group is at highest risk for the condition.

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    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.
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