Oppositional defiant disorder (ODD) is well known as a psychiatric dysfunction that results to intentionally create difficulty towards others, and aggressiveness of an individual from his early years. Disorders may vary depending on its origin and. According to Cosmides & Tooby (1999), if it is only physical, the probability of its effect will only direct the individual with such disease or illness. In contrast, behaviors often affect many people at once, creating the possibility of conflicting assessments of value by each affected person” (p. 457). When an individual has ODD “a pattern of negativistic, hostile, and defiant behavior” Chandler says, shows at least four of the following characteristics:
• Often loses temper • often argues with adults • often actively defies or refuses to comply with adults’ 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 and vindictive
Etiology “There’s no clear cause underpinning oppositional defiant disorder … Behavioral and mental health conditions are difficult to definitively diagnose. There’s no blood test or imaging technique that can pinpoint an exact cause of behavioral symptoms, though these tests are sometimes used to rule out certain conditions.
Physicians and other health professionals rely on their clinical judgment and experience, information gathered from parents and teachers who may fill out questionnaires, and possibly from interviewing the child” stated Mayo Foundation for Medical Education and Research (2008) in an article from CNN (2005). Where does ODD rooted may depend on the underlying factors in the environment where “there may be no harmony of values among the individual generating the behavior, family members, law enforcement officials, friends, victims, therapists, and so on” (Cosmides & Tooby, 1999, p. 457).
Moreover, Baker and Scarth (2002) rolled out the reasons why such factors contribute to having a disorder. If a child is growing up with a single parent, family suffering from poverty, rejected/neglected by parents, inconsistent parents using harsh disciplinary actions, sexual and physical abuse, unsupervised, left in an institution, “frequent changes of caregivers”, huge family, “association with delinquent peer group”, “parent with antisocial personality disorder and/or substance abuse problems”, and “parent with history of violence, conflict with the law, arrests/imprisonment” (p. 1).
On the other hand, Cosmides & Tooby (1999) mentioned that “In contrast, most biomedical scientists strive for a causal account of diseases and disorders; they classify a disorder by symptom clusters only when they lack knowledge of its etiology and cause, as an interim measure. This is, in part, because the best hope for finding new and more effective ways of relieving human suffering is by understanding the causes and nature of the condition generating the distress’ (454).
Prevalence Mayo Foundation for Medical Education and Research (2008) claimed that “It may be tough at times to recognize the difference between a strong-willed or emotional child and a child who has oppositional defiant disorder. And certainly there is a range between the normal independence-seeking behavior of children and oppositional defiant disorder. It’s normal for children to exhibit oppositional behaviors at certain stages of their development.
However, if your child’s oppositional behaviors are persistent, have lasted at least six months and are clearly disruptive to the family and home or school environment, the issue may be oppositional defiant disorder. ” Many children, according to Chandler, may get ODD. “This is the most common psychiatric problem in children. Over [five percent] of children has this. In younger children it is more common in boys, than girls, but as they grow older, the rate is the same in males and females” (Chandler).
Baker and Scarth (2002) also provided the statistics as when a conduct disorder occurs. “Onset of [conduct disorder] can be as early as 5-6 years of age, but is typically in late childhood or early adolescence. Onset after 16 years of age is unusual. Early onset is associated with a more negative outcome in adult adjustment … The severity of the behaviour problems can vary. Some children demonstrate the minimum number of problems required to receive the diagnosis and their behaviour causes minor harm to others.
Other children exhibit more behavioural problems that required to receive the diagnosis and their behaviour may cause considerable harm to others” (p. 10). Additionally, the drawback in the behaviour must be based upon the grave incidents “with social, school or work related functioning to be diagnosed. The starting point in childhood occurs before reaching 10 years, while the starting point for adolescent happens “when the characteristics of [disorder]” appears only after reaching 10 years (Baker and Scarth, 2002, p. 3).
Treatment Based on studies, treatment of oppositional defiant disorder would take not just a prescription of a doctor and series of therapy sessions, but more importantly the dedication of an individual to cure himself. For children, it is factual that they cannot be on their own. According to Mayo Foundation for Medical Education and Research (2008) “[It] is not something your child can overcome on his or her own, nor can it be solved with medication, herbal supplements, vitamins or a special diet.
Successful treatment of oppositional defiant disorder requires commitment and follow-through by you as parents and others involved in your child’s care. But most important in treatment is for you to show consistent, unconditional love and acceptance of your child — even during difficult and disruptive situations. Doing so can be tough for even the most patient parents. Ideally, treatment for oppositional defiant disorder involves your primary care doctor and a qualified mental health or child development professional. ”
Furthermore, “To be a treatable condition, there must be (a) a characterizable condition in a person; (b) a person or social decision-making unit whose values and decisions will govern the actions taken with respect to the condition; (c) a valuation by that person or unit that the condition is negative and that it ought to be changed (that is, that the persistence of the condition is “harmful,” “undesirable,” or “unhealthy”); and (d) knowledge of a method for changing the condition in the desired direction” (Cosmides & Tooby, 1999, p. 456).
There are treatment options suggested by Better Health Channel (2007) for reference: • Parental training – to help the parents to better manage and interact with their child, including behavioural techniques that reinforce good behaviour and discourage bad. This is the primary form of treatment and the most effective. Social support is increased if the parents are trained in groups with other parents who have children with ODD. • Functional family therapy – to teach all family members to communicate and problem solve more effectively. Consistency of care – all carers of the child (including parents, grandparents, teachers, child care workers and so on) need to be consistent in the way they behave towards and manage the child. Mayo Foundation for Medical Education and Research (2008) provided some useful ways for parents to stay foot on the treatment of their children as well: “…counseling can provide an outlet for your own mental health concerns that could interfere with the successful treatment of your child’s symptoms.
A depressed or anxious parent may disengage from his or her child, and that can trigger or worsen oppositional behaviors. Learn ways to calm yourself, take time for yourself, and be forgiving. ” Co-morbidity Rarely a physician encounters a patient with ODD alone. Chandler had explained that the usual case for a child that has ODD apparently has “other neuropsychiatirc disorder” as well. The tendency is that based on Baker and Scarth (2002), “Children in this category often exhibit disruptive behaviour in early childhood and the severity of bahaviour problems escalates with age.
These children are more likely to have other problems such as Attention Deficit Hyperactivity Disorder (ADHD), Learning Disabilities (LD), and poor academic performance” (p. 14). “Recent studies suggest that children with ODD have substantial [co-morbidity] with anxiety and depressive (internalizing) disorders, as well. Identifying the pattern of internalizing [co-morbidity] with ODD in childhood and adolescence and how this varies across age and gender may help to identify mechanisms of such [co-morbidity] … Data from cross-sectional and longitudinal studies in clinic, community and epidemiologic samples are considered separately.
Findings suggest that while internalizing [co-morbidity] with ODD is present at all ages, the degree of [co-morbidity] may vary over time in particular groups of children. Girls and boys appear to have different patterns of ODD [co-morbidity] with either anxiety or depression, as well as ages of onset of ODD, however more large studies are required. Children with ODD in early life require further study as they may be a subgroup at increased risk for anxiety and affective disorders” (Boylan et al. 2007, Abstract). Prognosis
ODD has a connection with other disorders. “Without intervention and treatment, some children with ODD progress to develop conduct disorder (CD), which is characterised by aggressive and delinquent behaviours [such as] lying, and being sadistic or cruel to animals and people” (Better Health Channel, 2007). In addition, ‘behaviors associated with conduct disorder’ as bullying, vandalism, assault, shoplifting, running away, fire setting, break and enter, rape, con games, and truancy are also identifying factors of conduct disorder (Baker and Scarth, 2002, p. 10).
If these conditions are left untreated, managing ODD can be very difficult for the parents, and frustrating for the affected child. Kids with oppositional defiant disorder may have trouble in school with teachers and other authority figures and may struggle to make friends” (Mayo Foundation for Medical Education and Research, 2008). Baker and Scarth (2002) also suggested that “Individuals in this group have a high incidence of substance abuse, employment problems, marital problems, and abuse of their partners and children as they move into adulthood” (p. 14).
Consequently, Chandler’s findings coincide with these studies as he stated, “Perhaps about 30% of conduct disorder children continue with similar problems in adulthood. It is more common for males with CD to continue on into adulthood with these types of problems than females. Females with CD more often end up having mood and anxiety disorders as adults. Substance abuse is very high. About 50-70% of ten year olds with conduct disorder will be abusing substances four years later … Antisocial Personality Disorder is basically a continuation of Conduct Disorder.
Recent studies have shown that children who have certain psychiatric problems are much more likely to get personality disorders as adults. ” Additionally from Chandler, if an individual has a personality disorder as a teenager, chances are he will attempt to commit suicide (6-10 %); seriously assault someone (25-35%); drop out from school (25%); and endure failed relationships (20-30 %). ”
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