Oppositional Defiant Disorder : Causes, Symptoms and Treatment

ODD is a psychiatric disorder that is characterized by two different sets of problems. These are aggressiveness and a tendency to purposefully bother and irritate others. It is often the reason that people seek treatment. When ODD is present with ADHD, depression, tourette's, anxiety disorders, or other neuropsychiatric disorders, it makes life with that child far more difficult. For Example, ADHD plus ODD is much worse than ADHD alone, often enough to make people seek treatment. The criteria for ODD are: A pattern of negativistic, hostile, and defiant behavior lasting at least six months during which four or more of the following are present:

Often loses temper
often argues with adults
often actively defies or refuses to comply with adults' requests or rules
often deliberately annoys people
often blames others for his or her mistakes or misbehavior
is often touchy or easily annoyed by others
is often angry and resentful
is often spiteful and vindictive The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning. How often is "often"?

All of the criteria above include the word "often". But what exactly does that mean? Recent studies have shown that these behaviors occur to a varying degree in all children. These researchers have found that the "often" is best solved by the following criteria.

Occurs at least twice a week
Is touchy or easily annoyed by others?
Loses temper
Argues with adults
Actively defies or refuses to comply with adults' requests or rules

Occurs at least four times per week

Is angry and resentful
Deliberately annoys people

Causes of Oppositional Defiant Disorder

No one knows for certain. The usual pattern is for problems to begin between ages 1-3. If you think about it, a lot of these behaviors are normal at age 2, but in this disorder they never go away. It does run in families. If a parent is alcoholic and has been in trouble with the law, their children are almost three times as likely to have ODD. That is, 18% of children will have ODD if the parents are alcoholic and the father has been in trouble with the law. How can you tell if a child has it?

ODD is diagnosed in the same way as many other psychiatric disorders in children. You need to examine the child, talk with the child, talk to the parents, and review the medical history. Sometimes other medical tests are necessary to make sure it is not something else. You always need to check children out for other psychiatric disorders, as it is common the children with ODD will have other problems, too.

Symptoms of Oppositional Defiant Disorder

Losing one's temper
Arguing with adults
Actively defying requests
Refusing to follow rules
Deliberately annoying other people
Blaming others for one's own mistakes or misbehavior
Being touchy, easily annoyed
Being easily angered, resentful, spiteful, or vindictive.
Speaking harshly, or unkind when upset
Seeking revenge
Having frequent temper tantrums

Oppositional Defiant Disorder Treatment

Medical Treatment
Psychosocial Treatment

Medical Treatment

Basic Principles

Research has shown that oppositional defiant disorder is relatively persistent (75% of children with this diagnosis still fulfill the criteria several years later). The majority of children with oppositional defiant disorder do not develop conduct disorder. Research hasn't yet identified what happens to these children in adulthood. Few, if any, controlled studies are available on the treatment outcome of oppositional defiant disorder.

Stimulant Drugs

Stimulant medication is indicated only when oppositional defiant disorder coexists with attention-deficit/hyperactivity disorder. No research is currently available on the use of other psychiatric drugs in the treatment of oppositional defiant disorder.

Psychosocial Treatment

Basic Principles

Parent management training focuses on teaching the parents more effective, specific techniques for handling the child's opposition and defiance.

Individual Psychotherapy

There is no research on the success rate of individual psychotherapy in the treatment of this disorder. However, it is known that individual psychotherapy for this disorder has a dropout rate of 30% a year.

Family Therapy

he effectiveness of family therapy for this disorder has not yet been properly researched.

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