Oppositional Defiant Disorder- Strategies to Manage

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Oppositional defiant disorder (ODD) is a childhood behavioral disorder, which is characterized by hostile, disobedient, vindictive, and defiant behaviors, which are usually directed at adults. This behaviour often lasts, for more than six months, and is severe in nature, as compared to what is usual for the child’s age group.  ODD is also characterized by a child displaying a pattern of angry and irritable moods. They are additionally also diagnosed with other behavioral issues, such as ADHD, autism, mood distress, etc. Some children may also develop a more serious condition conduct disorder

Cause and risk factors:

The exact causes of ODD cannot be determined, however, research suggest that it is a combination of biological, genetic, and environmental factors.

Genetic: In families, where members and relatives have history of mental illnesses, like mood disorders, personality disorders, and anxiety, have more chances of producing an offspring, who is more susceptible to developing oppositional defiant disorder This fact suggests that there is most likely a genetic component that leads a person to be more susceptible, as opposed to a person who has not next been exposed to the same type of genetics.

Biological: Some research indicates that congenital defects, or brain injuries can cause serious behavioural problems in children. ODD has also, been attributed to abnormal functioning of certain brain chemicals, or neurotransmitters. 

Environmental:  Factors such as a discord family, a family history of mental illnesses, or substance abuse by parents are important etiologic factors. Similarly, if the children have abusive friends and family, hey are more likely to display behavioural symptoms of ODD.

Symptoms of Oppositional Defiant Disorder

Symptoms of ODD includes:

  • Throwing temper tantrums.
  • Constant arguing with parents, teachers, and other authoritative adults.
  • Non-compliance with rules and regulations.
  • Purposely annoying or irritating others.
  • Unable to accept one’s mistake.
  • Having frequent anger outbursts.
  • Being vengeful and spiteful
  • Abusing or using obscene language
  • Disobedient
  • Compromised self-esteem
  • Inability to make new friends.
  • Emotionally unavailable.
  • Substance abuse

Prevalence of Oppositional Defiant Disorder

Approximately 2%-16% of children and teens have ODD. In younger children, it is more prevalent in boys; however, in older children, it occurs equally in boys and in girls. The age of onset is usually 8.

Diagnosis:

If the above stated symptoms are present, the physician commences evaluation by performing a complete medical history, followed by physical exam. Unfortunately, there are no lab tests to specifically diagnose ODD, however, neuroimaging studies, or stool tests can be used for reference. The doctor may also will look for signs for other conditions which often occur along with ODD, such as ADHD or depression

If the physical cause cannot be identified, the child is referred to mental health professionals.

Treatment:

. Treatment usually consists of a combination of the following:

  • Psychotherapy: Psychotherapy helps the child to develop effective coping and problem-solving skills, various ways to suppress anger.

Cognitive-behavioural therapy

The most common therapy used is cognitive-behavioural therapy, which aims to reorient the child’s thought process (cognition), in general. 

Family therapy

Family therapy is used to improve family discord and provide a healthy environment for the child to live in. A specialized therapy called parent management training (PMT) enables parents to positively change their child’s behavior. It also includes techniques like positive and negative reinforcements.

Medications:

While there is no specific medication for ODD formally approved to treat yet,  Symptomatic relief can be provided with the medications prescribed for other mental illnesses such as ADHD or depression.