Oppositional Defiant Disorder

What is Oppositional Defiant Disorder (ODD)?

-Is classified as a Disruptive, Impulse-Control, and Conduct Disorder in DSM-V.
-The main attributes of ODD are displaying moods or behaviors that violate the rights of others, or cause significant conflict with societal norms/authority figures.

Symptoms of ODD

• Anger/Irritable Mood
• Argumentative/Defiant Behavior
• Vindictiveness
• Temper Tantrums
• Easily Annoyed
• Speaking harshly or unkindly
• Can vary from mild, moderate to severe

Diagnosis of ODD

Differential diagnosis

• Conduct disorder
• ADHD
• Depressive and bipolar disorders
• Disruptive mood dysregulation disorders
• Intermittent Explosive Disorder
• Intellectual Disability
• Language disorders
• Social Anxiety disorders

Diagnosis of ODD

• 4 or more symptoms within 6 months (both mood and behavioral symptoms)
• The frequency of symptoms should be more of what is considered normal for the individuals age, gender, and culture.
• Symptoms can be present in only setting
• Show a significant impairment in their social functioning

Causes of ODD

• Developmental Theory - Problems start when children are toddlers
• Learning Theory - Negative symptoms of ODD are learned attitudes
• Environment - Parenting issues, family issues, social factors
• Genetics - A child's disposition or temperament

TREATMENT OF ODD

• Early intervention
• Parenting classes
• Psychotherapy
• Social skills classes
• School Based programs

Risk Factors of ODD

• Temperamental
• Environmental
• Genetic & Physiological

Prevalence

• In families where the childcare situation is constantly being disrupted.
• In families with inconsistent or neglectful child-rearing practices.
• Prevalence of ODD ranges form 1%-11%, with and average of 3.3%.
• More prevalent in males than females (before adolescence).

Long Term Effects of ODD

• Can lead to development of more severe conduct disorders (conduct disorder, intermittent explosive disorder, antisocial personality disorder, pyromania, kleptomania.
• Delinquency
• Substance abuse

Comorbidity

• ADHD
• Precedes conduct disorder
• Anxiety disorders
• Major depressive disorders
• Higher rates of drug use

Parent Support

• Individual psychotherapy
• Family psychotherapy
• Parent training
• Parent-child interaction therapy (PCIT)

Educator Support

• Behavioral strategies
• Instructional strategies
• Classroom accomodations

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REFERENCES

• American Academy of Child and Adolescent Psychiatry
• Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) Jones, S.H., 2018.
• Oppositional Defiant Disorder: An Overview and Strategies for Educators, General Music Today. 31(2), 12-16. Doi:10.11177/1048371317708326

Refernces (continued)

• Loeber, R., Burke, J., and Pardini, D., 2009. Development and Etiology of Disruptive and Delinquent Behavior, Annu.Rev.Clin.Psychol. 2009.5:291-310. Doi: 10.1146/annurev.clinpsy.032408.153631

Refernces (continue)

• O’Kerney, R., Salmon, K., Liwag, M., Fortune, C., and Dawel, A., 2016. Emotional Abilities in Children with Oppositional Defiant Disorder (ODD): Impairments in Perspective-Taking and Understanding Mixed Emotions are Associated with High Callous-Unemotional Traits. Child Psychiatry Hum Dev (2017) 48:346-357. Doi: 10.1007/s10578-016-0645-4

References (continued)

• Riley, M., Ahmed, S., Locke, A., 2016. American Family Physician. Aafp.org/afp. Zhu, Y., Ying, K., Wang, J., Su, L., Chen, J., Lin, F., Cai, D., Zhou, M., Wu, D., Guo, C., and Wang, S., 2014. Differences in functional activity between boys with pure oppositional defiant disorder and controls during a response inhibition task: a preliminary study. Brain Imaging and Behavior (2014) 8:588-597. Doi: 10.1007/s11682-013-9275-7

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