Oppositional Defiant Disorder

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[edit] Descriptions and Definitions

Oppositional Defiant Disorder, also known as ODD, is a psychiatric behavior disorder that is characterized by aggressiveness and a tendency to purposefully bother and irritate others. These behaviors cause significant difficulties with family and friends and at school or work. -Anthony Kane, MD
Oppositional Defiant Disorder 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. -Jim Chandler, MD
Oppositional Defiant Disorder is defined as an enduring pattern of uncooperative, defiant, and hostile behavior toward authority figures that does not involve major antisocial violations, is not accounted for by the child's developmental stage, and results in significant functional impairment.
- Psychnet-UK

DSM-IV-TR delineates the criteria for ODD as follows:

A. 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 adult 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 or vindictive.

B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functions.

C. The behaviors do not occur exclusively during the course of psychotic or mood disorder.

D. Criteria are not met for Conduct Disorder, and if the individual is age 18 years or older, criteria are not met for Anti-social Personality Disorder.

[edit] Interesting Facts

  • 50-65% of ODD children also have ADD or ADHD.
  • 35% of these children develop some type of affective disorder.
  • 20% of children with ODD have some form of mood disorder, such as Bipolar Disorder or anxiety.
  • 15% develop some form of personality disorder.
  • 75% of children with Oppostional Defiant Disorder above the age of eight will still be defiant later in life.
  • ODD is reported to affect between 2 and 16 percent of children (Medical Center Online)
  • ODD is more common in boys than in girls before puberty
  • Many of these children have learning disorders
  • Once children enter the teen years, it is almost impossible for parents to change the ODD behavior.
  • Children with CD and ODD are also at high risk for criminality and antisocial personality disorders in adulthood.

[edit] Symptoms of ODD

People with ODD show defiant, hostile, and negativistic behaviors lasting at least six months, of which four or more of the following behaviors are present.
  • loses temper
  • argues with adults
  • actively defies or refuses to comply with adults' requests or rules
  • deliberately annoys people
  • blames others for his or her mistakes
  • is angry or resentful
  • is spiteful and vindictive
  • often being touchy or easily annoyed by others
  • mean and hateful talking when upset
  • seeking revenge

[edit] Causes of ODD

There has been no systematic research into the causes of ODD, however there are two theories.
  • Developmental Theory: ODD is really a result of incomplete development. For some reason, ODD children don't master the tasks that other children master during their toddler years. They get stuck in the toddler stage (2-3 years old) and never really grow out of it.
  • Learning Theory: ODD comes as a response to negative interactions. The techniques used by parents and authority figures bring about the oppositional defiant behavior.

[edit] Treatment of ODD

  • Parent Training Programs to help manage behavior
  • Individual Psychotherapy to develop effective anger management
  • Family Psychotherapy to improve communication
  • Cognitive-Behavioral Psychotherapy to assist in problem soving and decrease negativity
  • Social Skills Training to increase flexibility and imrove tolerace to frustration with peers
  • Stimulant Medication is prescribed only when ODD is accompanied by another disorder such as ADD or ADHD.

Treatment is particularly important because children with ODD are also at high risk for criminality and antisocial personality disorders in adulthood.

[edit] What Can Parents Do to Help?

  • Build on the Positives- Give the child praise and positive reinforcement when he shows flexibility or cooperation.
  • Take a Time Out- Take a break if you are about to make the conflict with your child worse. This is good modeling, so be sure to support your child if he/she decides to take a time-out to prevent overreacting.
  • Pick Your Battles- Prioritize the things you want your child to do.
  • Rules and Consequences- Set up reasonable, age-appropriate limits with consequences that can be enforced consistently.
  • Maintain Your Own Interests- Stay involved in things other than your child with ODD, so that your child doesn't take up all of your time and energy. Try to work with other adults that are involved with your child, such as teachers, coaches, and your spouse.
  • Manage Your Stress- Exercise and relax! Use respite care as needed.

[edit] Application in Classrooms and Similar Settings

It is important for teachers to be aware of the disorders that their students are suffering from. Teachers may or may not see symptoms of Oppositional Defiant Disorder at school. Even if the symptoms are not present at school, it is helpful to know what the parents are dealing with at home. The more you communicate with the family and understand the situation, the better you will be able to help.

[edit] Testimonies and Stories

Click here to read several examples of students that suffer from ODD

I am very glad that I opened this link. I had never heard of Oppositional Defiant Disorder, and after reading the symptoms, I think that my brother should be see a doctor about possibly having this disorder. I have noticed symptoms like the ones mentioned in him since he was very young. I have tried to talk to him about it and he has told me that he feels out of control at times with his temper, especially when it comes to people of authority. I found it interesting that many people with ODD have ADHD, because that is what I first thought my brother might suffer from. I hope that the information from this page proves to be helpful for him and others. S. Peduzzi

I have ODD. I don't have any friends, I'm always angry, and my parents just kicked me out of the house. -Tyler Moss

This information has opened my eyes to a possibility that one of my students might have this. I have struggled with this child's emotions all year and it seems that this may be why. -r

My son has Asperger's, and many of the symptoms are the same as those for ODD, which in fact his pediatrician tried to diagnose him with about 10 years ago. One of the differences, however, is that, aside from trying to bother and irritate his sisters, most of the time, though people are irritated with him, he doesn't realize he's doing it! His social skills are so non-existant that he fails to read cues like face and body language. Then when he does realize he's annoyed someone, it doesn't bother him because he feels that he's entitled to say what he thinks. Whether ODD, Asperger's, or any other similar disorder, parents and teachers have their hands full and really need to work together to make school a success for the student. Susan

[edit] References and Other Links of Interest

The Medical Center Online. Child and Adolescent Mental Health. (2002). Behavior Disorders[Online]. http://www.mccg.org/childrenshealth/mentalhealth/bdhub.asp.[October 2002].

Retrieved from "http://wik.ed.uiuc.edu/index.php/Oppositional_Defiant_Disorder"
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