Oppositional Defiant Disorder (Part 1 of 2)

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Contributed by David L. Bastin (2012) [David Lee Bastin studies social work as a graduate student at Tennessee State University. David’s interest in social work stems from his work as a therapist for the Tennessee state mental institution. David plans to continue working with those suffering from serious mental conditions such as schizophrenia and psychotic disorders. Follow David on Twitter @DAVIDBASTIN2]

Oppositional Defiant Disorder (ODD) is a disruptive behavior recognized in children and adolescents.

It is not to be confused with Conduct Disorder, but sometimes it is. A child with ODD may often feel bad about their behavior. This is one important difference between ODD and Conduct Disorder. In Conduct Disorder, a lack of feelings often persists.

DSM IV (1994) describes Oppositional Defiant Disorder (313.81) as a pattern of behavior which supports negative, defiant, disobedient, and hostile actions toward authority figures which last for at least six months. These behaviors must occur fairly frequently and be characterized by at least four of the following behaviors.

1) Losing temper.
2) Arguing with adults.
3) Actively defying or refusing to comply with the request or rules of adults.
4) Deliberately doing things that will annoy other people.
5) Blaming others for their own mistakes or misbehavior.
6) Being touchy or easily annoyed by others.
7) Being angry or disrespectful.
8) Being spiteful.

Diagnosis of ODD is dependent on the above behaviors displayed by the child/adolescent at a more frequent rate than by their peers. These behaviors must also cause a significant impairment of social, academic, or occupational roles. After puberty, ODD is generally equal between males and females, however before puberty males are more likely to present these symptoms (DSM IV, 1994).

Contributors to Oppositional Defiant Behavior

Family and health habits are important in the development Oppositional Defiant Behavior. Family issues which may contribute to ODD are:
1) Child care that is switched often between a series caregivers.
2) Harsh treatment of the child by family members or caregivers.
3) Inconsistent treatment of the child by family or caregivers.
4) A pattern of neglect or neglectful care while raising the child.

DSM IV (1994) also notes that Attention-Deficit/Hyperactivity Disorder is common in children diagnosed with Oppositional Defiant Disorder. Also, Learning Disorders and Communication Disorders are sometimes linked to ODD. 

The family should be aware that ODD symptoms usually start before 8 years of age or will surface at the onset of early adolescent years. Such oppositional behavior may increase with age. These symptoms usually begin in the home, but often stretch-out to other settings like school or day-care over a period of time.

ODD diagnosis has a demonstrated link to parental history of Mood Disorder, ODD, Conduct Disorder (as a child/adolescent), Anti-Social Personality Disorder, and/or Substance-Related Disorder. Also, families with serious marital discord present a higher rate of children with Oppositional Defiant Behavior (DSM IV, 1994).

[Part 2 of 2: Oppositional Defiant Disorder]

Reference List

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, 4th ed. Washington, D.C.: American Psychiatric Association.

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