Oppositional defiant disorder

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Basics

  • aka ODD
  • Essential feature is a recurrent pattern of negativistic, defiant, disobedient, and hostile behaviour towards authority figures lasting for 6 months or more
  • Manifestations are invariably present at home but may not be evident at school or in the community
  • Found in 16-22 % of school age children and 2-16% of the general population

Diagnosis

  1. pattern of negativistic, hostile, and defiant behaviours lasting at least 6 months during which 4 or more of the following are present
    • 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/her mistakes or misbehaviour
    • is often touchy or easily annoyed by others
    • is often angry and resentful
    • is often spiteful or vindictive
  2. The disturbance causes clinically significant impairment in social, academic, or occupational functioning
  3. The behaviours do not occur exclusively during the course of a psychotic or mood disorder.
  4. Criteria are not met for Conduct Disorder and if the person is 18 years or older criteria are not met for Antisocial Personality disorder

Possible etiology

  • Children with a constitutional or temperamental predisposition to strong will, strong preferences or great assertiveness particularly when parents are overly concerned with power & control
  • more common when there has been a succession of adult caregivers or where harsh, inconsistent or neglectful child-rearing practices are frequently used
  • more common in unwanted children

Comorbidity

Treatment

  • Individual psychotherapy for the child
    • Develop new social skills
    • Understand self-destructive patterns
    • Be able to express self safely
    • Develop competencies in school

Resources