Oppositional Defiant Disorder

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New York Online Access to Health!
Mental Health . Com
American Academy of child & adolescent Psychiatry
www.klis.com

Introduction

Oppositional Defiant Disorder (ODD) is a disorder in which a child is outwardly defiant: breaking rules, disrespectful to authority figures, lying, theft, etc. Many children with ODD will respond to the positive parenting techniques. Parents may ask their pediatrician or family physician to refer them to a child and adolescent psychiatrist, who can diagnose and treat ODD and any coexisting psychiatric condition

What Causes ODD?

The cause of Oppositional Defiant Disorder is unknown at this time. The following are some of the theories being investigated:

It may be related to the child's temperament and the family's response to that temperament.

A predisposition to ODD is inherited in some families.

There may be problems in the brain that cause ODD.

It may be caused by a chemical imbalance in the brain.

Characteristics

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

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.

Has occurred at all during the last three months-

8. Is spiteful and vindictive
5. Blames others for his or her mistakes or misbehavior

Occurs at least twice a week-

6. Is touchy or easily annoyed by other
1. Loses temper
2. Argues with adults
3. Actively defies or refuses to comply with adults' requests or rules

Occurs at least four times per week-

7. Is angry and resentful
4. Deliberately annoys people

Helpful tips for parents

A child with ODD can be very difficult for parents. These parents need support and understanding. Parents can help their child with ODD in the following ways:

Always build on the positives, give the child praise and positive reinforcement when he shows flexibility or cooperation.
Take a time-out or break if you are about to make the conflict with your child worse, not better. This is good modeling for your child. Support your child if he decides to take a time-out to prevent overreacting.
Pick your battles. Since the child with ODD has trouble avoiding power struggles, prioritize the things you want your child to do. If you give your child a time-out in his room for misbehavior, don't add time for arguing. Say "your time will start when you go to your room."
Set up reasonable, age appropriate limits with consequences that can be enforced consistently.
Maintain interests other than your child with ODD, so that managing your child doesn't take all your time and energy. Try to work with and obtain support from the other adults (teachers, coaches, and spouse) dealing with your child.
Manage your own stress with exercise and relaxation. Use respite care as needed.

What Can I do to Deal with my ODD?

Attend therapy sessions.
Use self time-outs.
Identify what increases anxiety.
Talk about feelings instead of acting on them.
Find and use ways to calm yourself.
Remind yourself often of your goals.
Get involved in tasks and physical activities that provide a healthy outlet for your energy.
Learn how to talk with others.
Develop a predictable, consistent, daily schedule of activity.
Figure out ways to have fun and feel good.
Learn how to get along with other people.
Find ways to avoid getting too riled up.
Learn to admit mistakes in a matter-of-fact way

What can I do to keep the Symptoms from Coming back once They’re in Control?

During a period of good adjustment, the patient and his family and the therapist should plan what steps to take if signs of relapse appear. The plan should include what specific symptoms are important warnings of relapse. Make an agreement to call the therapist right away when those specific symptoms occur, and at the same time to notify friends and other people who can help. Plan ahead for specific ways to limit stress and stimulation and to make the daily schedule more predictable and consistent if warning signs of relapse appear.

Questions

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