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Oppositional Defiant Disorder

(ODD)

Definition

Oppositional defiant disorder (ODD) is a behavior disorder in children and teens. Those with this disorder show negative, angry, and defiant behaviors much more often than most people of the same age. These behaviors begin to adversely affect the person’s relationships and ability to perform successfully in school, work, and family situations.

Causes

The cause of ODD is unknown. Like other psychiatric disorders, ODD results from a combination of genetic, family, and social factors. Children with ODD may inherit chemical imbalances in the brain that make them more likely to have the disorder.
Child's Brain
Child Brain
A chemical imbalance in the brain may be responsible for ODD.
Copyright © Nucleus Medical Media, Inc.

Risk Factors

Factors that increase a child's risk for ODD include:
  • Sex: male
  • Age: childhood and teen years
  • A parent with a mood, conduct, attention deficit, or substance abuse disorder
  • Marital conflict
  • Child abuse
  • Inconsistent parental attention
  • Low socioeconomic status

Symptoms

Symptoms usually begin around age 8 and increase over several months.
Children with ODD often:
  • Argue with adults
  • Lose their tempers
  • Refuse to follow adults' requests or rules
  • Deliberately annoy others and are annoyed by others
  • Are angry and resentful
  • Are spiteful or vindictive
  • Blame others for their own mistakes
  • Have low self-esteem

Diagnosis

The doctor will ask about symptoms, medical history, and family history. A physical exam will be done. The doctor will also look for other conduct disorders.
Diagnosis of ODD is based on these criteria:
  • Child displays at least four common symptoms.
  • Symptoms occur more often and have more serious consequences than is typical in children of a similar age.
  • Symptoms lead to significant problems in school, work, or social life.
  • Symptoms are continuously present for at least 6 months.

Treatment

Treatment may include the following:

Parent Training

Training is designed to help parents manage their child's behavior.

Child Psychotherapy

The purpose of the psychotherapy is to teach the child better ways to manage anger.

Family Psychotherapy

Family therapy helps to improve family communication skills.

Cognitive-Behavior Therapy

This type of therapy helps the child and family members learn problem-solving skills and decrease negativity.

Social Skills Training

This is training to help the child reduce frustration with peers.

Prevention

There are no guidelines for preventing ODD.

RESOURCES

American Academy of Child and Adolescent Psychiatry http://www.aacap.org

American Psychiatric Association http://www.psych.org

CANADIAN RESOURCES

Canadian Psychiatric Association http://www.cpa-apc.org

Canadian Psychological Association http://www.cpa.ca

References

Children with oppositional defiant disorder. American Academy of Child and Adolescent Psychiatry website. Available at: http://www.aacap.org/AACAP/Families%5Fand%5FYouth/Facts%5Ffor%5FFamilies/Facts%5Ffor%5FFamilies%5FPages/Children%5FWith%5FOppositional%5FDefiant%5FDisorder%5F72.aspx . Accessed July 17, 2013.

Oppositional defiant disorder. Boston Children's Hospital website. Available at: http://www.childrenshospital.org/az/Site1385/mainpageS1385P1.html . Accessed July 17, 2013.

Oppositional defiant disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated December 7, 2012. Accessed July 17, 2013.

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