Oppositional defiant disorder (ODD) is a diagnosis described by the Diagnostic and Statistical Manual of Mental Disorders (DSM) as an ongoing pattern of disobedient, hostile and defiant behavior toward authority figures which goes beyond the bounds of normal childhood behavior. People who have it may appear very stubborn and angry.

Behavioural features

Common features of Oppositional Defiant Disorder (ODD) include excessive, often persistent anger, frequent temper tantrums or angry outbursts, and disregard for authority. Children and adolescents with this disorder often annoy others on purpose, blame others for their mistakes, and are easily annoyed. Parents often observe more rigid and defiant behaviors than in siblings. In addition, these young people may appear resentful of others and when someone does something they don’t like they often take revenge on them.

In order for a child or adolescent to qualify for a diagnosis of ODD these behaviors must cause considerable distress for the family and/or interfere significantly with academic or social functioning. Interference might take the form of preventing the child or adolescent from learning school material or making friends, or placing him or her in harmful situations. These behaviors must also persist for at least six months.

Prognosis

According to a 1992 article, if left untreated, about 52% of children with ODD will continue to meet the DSM-IV criteria up to three years later and about half of those 52% will progress into conduct disorder.

Psychosocial treatments

One of the key factors in the development and maintenance of the negative behaviors associated with oppositional defiant disorder results is reinforcement, whether intentional or not, of the unwanted behaviors. The most effective way of treating disruptive behavior disorders is behavioral therapies. Behavioral therapy for children and adolescents focuses primarily on how problematic thoughts or behaviors may accidentally get “rewarded” within a young person’s environment.

These rewards or reinforcements often contribute to an increase in the frequency of these thoughts and behaviors. Behavior therapies can be applied to a wide range of psychological symptoms among adults, adolescents, and children. In behavioral therapy, therapists encourage children and adolescents to try new behaviors and not to allow negative “rewards” to dictate the ways in which they act. Furthermore, therapists may work with parents to discontinue ways in which they are unintentionally reinforcing negative behaviors.

Other approaches to the treatment of oppositional defiant disorder, include parent training programs, individual psychotherapy, family therapy, cognitive behavioral therapy, and social skills training. According to the American Academy of Child and Adolescent Psychiatry, treatments for ODD are tailored specifically to the individual child, and different treatments are used for pre-schoolers and adolescents.

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