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Oppositional Defiant Disorder

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Kalifa Fletcher

on 19 November 2013

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Transcript of Oppositional Defiant Disorder

Oppositional Defiant Disorder
Throughout the most recent years Oppositional Defiant Disorder has become a common disorder among adults and adolescent children. We chose this topic to study in order to help you all get a better understanding of what this disorder is, who it affects, at what age and to also give you all some signs or clues on spotting what this disorder in young adolescents.

Research Conducted & understanding the problem
Research now is showing ODD to be a disorder of a genetic and psychiatric basis. For example, due to the strong hereditary link, current research focuses more on defining neurotransmitters that play a role in aggression. Medications such as Atomoxetine serve as neurotransmitter inhibitors, with the intention of quelling some of the seemingly uncontrollable behaviors associated with the disorder.
More in depth research suggests that the onset of ODD and some other conduct disorders are likened to the onset of psychopathy in other adolescents and children in the sense that the disconnection between negative behaviors and impending punishment/punishment severity stems from a dysfunctional amygdala. Studies conducted on individuals suffering from ODD and conduct disorder using a functional magnetic resonance imaging (FMRI) machine consistently show an overabundance of “grey matter” in the right or left side of the amygdala as well as a reduction in amygdala responsiveness to fearful or stressful stimuli.


Oppositional defiant disorder is thought to occur in about 6% of all children in the United States. It is more common in families of lower socioeconomic status. In one study, 8% of children from low-income families were diagnosed with ODD.
The disorder is often apparent by the time a child is about six years old. Boys tend to be diagnosed with this disorder more often than girls in the preteen years, but it is equally common in males and females by adolescence.
It is estimated that about one-third of children who have attention-deficit/hyperactivity disorder (ADHD) also have ODD. Children who have ODD are also often diagnosed with anxiety or depression.

Oppositional defiant disorder refers to a persistent pattern of inappropriate levels of negative defiant, disobedient, and hostile behavior toward authority figures among adults and adolescents. The behaviors associated with oppositional defiant disorder—include actively defying or refusing to comply with adult rules and requests, frequent temper outbursts, and excessive arguing. These types of behaviors can significantly impede adaptive adult-child and child-peer development and interactions.
Problem Statement
• ODD is defined as pattern of disobedient, hostile and defiant behavior towards authority figures.
• Children and adolescents often rebel, are stubborn, argue with adults, and refuse to obey rules and guidelines given.
Consequences for development
Children and adolescents with this disorder often outgrow it, however, there are some cases where the disease is either not treated or the treatment does not work
This often lead to more serious disorders like antisocial personality disorder in adulthood.
Psychological factors
• A poor relationship with one or more parent
• A neglectful or absent parent
• A difficulty or inability to form social relationships or process social cues

Social Factors
• Poverty
• Chaotic environment
• Abuse
• Neglect
• Lack of supervision
• Uninvolved parents
• Inconsistent discipline
• Family instability (such as divorce or frequent moves)

Biological Factors
Children and adolescents are more susceptible to developing ODD if they have:
• A parent with a history of attention-deficit/ hyperactivity disorder (ADHD), ODD, or CD
• A parent with a mood disorder (such as depression or bipolar disorder)
• A parent who has a problem with drinking or substance abuse
• Impairment in the part of the brain responsible for reasoning, judgment, and impulse control
• A brain-chemical imbalance
• A mother who smoked during pregnancy
• Exposure to toxins
• Poor nutrition

Demographic Characteristics

One to sixteen percent of all school-age children and adolescents have ODD. The causes of ODD are unknown, but many parents report that their child with ODD was more rigid and demanding than the child’s siblings from an early age.
ODD is the most common comorbid disorder associated with ADHD and occurs in up to 60% of all children with ADHD. ODD is characterized by a pattern of developmentally negativism, hostile and defiant behaviors causing clinically significant impairment in social, family or academic functioning.
ODD usually appears in late preschool or early school-aged children. In younger children, ODD is more common in boys than girls. However, in school-age children and adolescents the condition occurs about equally in boys and girls. Although the disorder seems to occur more often in lower socioeconomic groups, ODD affects families of all backgrounds

Prevention, Intervention & Treatment
Because of the multifaceted nature of most conduct disorders, treatment usually includes a myriad of approaches including medications, teaching parenting skills, family therapy and consultation with school teachers and officials. Studies have shown this to be the case especially when dealing with youth that harbor predatory and severe feelings of aggression. These youth have shown that they are likely not to respond to conventional treatment methods that do not include medication. Often the medication prescribed is akin to that prescribed for ADD and ADHD and mainly include stimulants.

One treatment program that has proven to be an effective method for treating problems related to emotion dysregulation such as ODD is dialectical behavioral therapy (DBT). DBT consists of a combination of interventions that are carried out concurrently and includes individual therapy sessions, group skills training, telephone coaching and team consultation. The therapy and training sessions are set upon a hierarchical array of objectives. The ultimate goal seated at the root of all of these objectives is the critical realization of the current dysfunction within the patient’s interaction with parents, teachers.
Parent Management training is touted as one of the most effective methods of curbing some of the behaviors associated with a child who suffers from ODD. The training focuses on the reinforcement of positive parenting techniques while discouraging negative ones such as the use of harsh punishment practices and overt focus on negative or inappropriate behaviors. Additionally, the training reinforces the notion of consistent, predictable and immediate punishment for incorrect behaviors.
Snircova, E., Kulhan, T., Nosalova, G., & Ondrejka, I. (2012). Atomoxetine in the treatment of the most common comorbid disorders of attention-deficit/hyperactivity disorder, oppositional defiant disorder and anxiety disorders. ACTA MEDICA MARTINIANA, 11(39), 28-36.

Jose, M., Azucina, G., & Cristina, B. (2013). Dialectical behavioural therapy for oppositional defi ant disorder in adolescents: A case series. Psicotherna,25(2), 158-163.

Walter, M., Louk, V., Dennis, S., & John, L. (2012). Impaired neurocognitive functions affect social learning processes in oppositional defiant disorder and conduct disorder: Implications for interventions.Clinical Child and Family Psychological Review,15, 234-246.

The American Academy of Child and Adolescent Psychiatry, (2009). Odd: A guide for families by the american academy of child and adolescent psychiatry. Retrieved from The American Academy of Child and Adolescent Psychiatry website: aacap.org

Oppositional defiant disorder as it relates to adolescence is a correlation that researchers continue to engross them in, as the topic is relevant for the implications of social work and mental health as a whole. The information provided can be helpful in improving practice strategies through offering empirical research on the etiology of the disorder. Researchers agree that there is no single cause for oppositional defiant disorder. Rather, it is best understood in the context of bio psychological model in which a child’s biologic vulnerabilities and protective factors interact complexly with the protective and harmful aspects of his or her environment to determine the likelihood of developing this disorder. Understanding the symptomatology through research and practical work, allows the social worker to implement effective strategies via micro and macro level interventions. For one to develop social policy it is imperative that they are fully aware of effective strategies currently in place. Program evaluation is important in this aspect to assist in the reconstructing or development of new programs.



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