Sunday, November 20, 2011

Oppositional Defiant Disorder

It's been awhile since I've posted something. Life hassles has caught the better of me. Oppositional defiant disorder is a condition that is suffered by many children these days but with little or no attention being given by parents. This article aims to give an idea of how parents of today can identify and understand if their kids are going through ODD and what possible ways to overcome it.




Oppositional Defiant Disorder or ODD is a disorder that is commonly found during childhood period. Symptoms of ODD can manifest itself in a child as early as 3 years of age. Unlike an independent seeking behaviour from a child, ODD is more subtle and can be seen when a child has a persistent patterns that comes out as tantrums, constant argumentative behaviour and child is always angry and are constantly showing behaviours of disruptiveness towards authority figures. Despite being tough to recognize at times, there is a range of difference between a child with ODD and an independence seeking behaviour child. A child with ODD often displays behaviours that annoy others, deliberate misbehaviour, spiteful and vengeful and resentful.

The range of difference can be seen between an independence seeking, strong willed or emotional child with one that has ODD is when they exhibit behaviours such as persistency in throwing tantrums, constantly disrupting home and schooling environment. These symptoms may just sound like any ordinary child growing up but if such behaviours continue to be exhibited over the course of more than six months, a child may be having issues of ODD. These symptoms also are normally accompanied with a negative attitude, defiance towards rules and request from parents and hostile attitude towards people. Children with ODD more often than not, also suffer in their academic performance and they have difficulty in maintaining friendship with their peers. If in the span of six months such behaviours continue to persist even with disciplinary actions from parents, it is a clear sign that the child has ODD. It is important that ODD is diagnosed early as possible as it could lead to an array of mental health issues if not addressed. Related mental health issues such as attention deficit/hyperactive disorder (ADHD), anxiety disorders, and depressions.

With such symptoms manifesting, parents could immediately seek advice from their paediatrician, a child psychologist or a behavioural expert on what can be done to resolve the child’s issue. Early detection has better chance in treating, managing and even reversing the effects of ODD on a child. Early treatment will help the child in rebuilding self-esteem and creating positive relationship between the child and parent. It will also indirectly improve relationship and alleviate tensions with people around the child, such as teachers, peers, and relatives. Such are the benefits of an early treatment.

What causes a child to have ODD? It isn’t clear on what causes a child to have oppositional defiant disorder. Despite not having clarity on the cause, several factors are likely to contribute to ODD. It is most likely a combination of heredity and environmental factors. Such are a child’s natural disposition and their lack of control over temperaments, natural disposition are linked to their personality and are likely to be genetically inherited. Imbalance in the production of chemicals in the brain such as serotonin could also be a likely cause. Another likely cause would be limitations and/or developmental delays in child’s cognitive ability to process thoughts and feelings. For example, when a child is faced with a social situation and is not able to immediately react but rather, process the situation later and bottling up their emotions which will manifest itself later on in the form of ODD. Abuse and neglect is also a probable cause of ODD.

Other factors that plays a role in the development of ODD and the variety of influences, circumstances and genetic components are known as risk factors. Risk factors that could drive ODD are for example, parents who suffers from mood disorder or substance abuse, inconsistent and harsh disciplining, lack of parental supervision and/or positive involvement, exposure to violence, or parents who are undergoing severely troubled marriage. Such family instabilities that occur provide an increase in the avenue of a child developing disruptive behaviours. Constant change in environments such as moving houses may cause disrespectful or oppositional behaviour. ODD if not detected early can lead to bigger problems for a child when they reach adolescence and adulthood. Violent behaviours, severe delinquency, and engaging in drug abuse are some of the problems that manifest later in life when ODD is not being treated.
According to the criteria being spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV- TR) that is published by the American Psychiatric Association, a pattern of behaviour lasting over 6 months that is often shown and it includes at least four behaviours of losing tempers, arguing with adults, refusing to comply with adults rules or request, deliberately annoying people, and blames others for their mistakes, touchy or easily annoyed by others, angry and resentful, spiteful or vindictive. These behaviours must be displayed more often than is typical for a child’s peers. In addition, to be diagnosed with ODD, they must cause significant problems at work, school or home, occurs on its own rather than caused by another mental disorder, such as bipolar disorder or depression, must not meet the diagnostic criteria for conduct disorder or, if the person is older than 18 years old, antisocial personality disorder.

Treatments of ODD involves several types of psychotherapy and training for child and parent likewise. Some of the usual treatments for ODD are individual and family therapy, which involves counselling for the child to help them learn to manage anger and how to express their feelings in a healthy way. Family counselling can also help improve collectively the communications and relationship within the family members. Another form of treatment would be Parent-child Interaction therapy (PCIT). This treatment sometimes requires a therapist observing from a two way mirror and guiding parents through strategies that reinforces positive behaviour in a child. This method has shown positive results in decreasing children’s behaviour problems and improves the quality of parent-child relationship. Another highly effective treatment is cognitive problem solving training. This treatment requires parent and child to collaborate and solve problems. Both parties are required to solve problems by identifying it with the child and the child comes up with solutions to overcome their behavioural problems. Other treatments available are social skills training and parent training. This involves therapy to improve the child’s social skills with their peers and parents to learn to deal and cope with the issues that an ODD child faces.

With proper understanding and treatments, ODD can be managed and treated. What is important in this entire process is that parental support is always there. Calmness on the parent’s part in dealing with the issue and constant positive reinforcement to tune the child’s thoughts is paramount in dealing and coping with ODD.