Oppositional Defiant Disorder: Symptoms And Treatment

Oppositional Defiant Disorder is a behavioral child disorder that has come to gain a lot of recognition in recent times, primarily because of the difficulties it generates for the parents and family in managing the child. It is marked by persistent hostile, aggressive and disobedient behavior, and needs medical advice and counseling. Timely recognition can save the child as well as the family...
Oppositional Defiant Disorder: Symptoms and Treatment
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Medical advancement has made it possible to treat childhood diseases, which were earlier not even recognized as such. However, to be able to benefit from these developments, one must first be aware of the existence of the disease, its characteristics and the possibilities of its treatment. Early diagnosis may depend upon parental awareness and hold the key of child’s future.

Oppositional Defiant Disorder or ODD'

Oppositional defiant disorder or ODD' is a psychiatric developmental abnormality of childhood wherein the child demonstrates undue hostile, aggressive and disobedient behavior present for at least six months without any other identifiable cause, that interferes with

his relationships and performance at home and school. Such children create a lot of distress around them and those taking care of them are left wondering how to deal with their defiant and abnormal aggressiveness.

Identifying a Child with ODD’

There is no single characteristic symptom or abnormality for identification of this condition. Like most psychiatric disorders, its diagnosis depends on the presence of certain criteria. The Diagnostic and statistical manual published by the American Psychiatric Association has prescribed the following criteria for diagnosing Oppositional defiant disorder.

1. A pattern of negative, hostile and defiant behavior lasting at least six months during which four or more of the following are present: often loses temper, argues with adults, actively defies adults' requests, deliberately annoys people, blames others, touchy or easily annoyed, angry or resentful or spiteful or vindictive.

2. This behavior causes clinically significant impairment in social, academic or occupational functioning.

3. The behavior doesn't exclusively occur during a psychotic or mood disorder.

4. The behavior doesn't meet the criteria for conduct disorder or antisocial personality disorder.

In spite of these criteria, diagnosis can often be difficult in children because of the presence of other conditions like Attention deficit disorder, or in the presence of circumstances which may be able to explain the behavior of affected child as reactive behavior instead of being a result of inherent psychiatric abnormality.

Long Term Prognosis of Oppositional Defiant Disorder

Without any treatment more than half of the children with this condition will continue to show the abnormalities. Around 52% of them may go on to develop Conduct Disorder', another psychiatric condition of young adulthood, wherein the affected person demonstrates aggressive, anti-social, cruel, deceitful and destructive behavior. Early identification

and treatment can, however, bring remission or moderate its progression.

Prevention and Treatment of Oppositional Defiant Disorder

Oppositional defiant disorder is believed to result from negative reinforcement practices, ineffective parenting, and difficulty with peer and authority figures, which gradually develop into oppositional and defiant behavior patterns.

Thus, early identification of the condition followed by improvement of parental practices, conflict resolution and communication within the family and training for anger management can help restricting the severity of the disorder and may bring about early remission.

Later, in older children, following treatment modalities can be used, individually or in combination depending upon the severity, related conditions and personal preferences.

1. Individual psychotherapy - It uses cognitive-behavioral approaches to improve the behavior of the affected person by improving problem solving skills, communication skills, impulse control, and anger management skills. Emphasis is given on using positive reinforcement of compliant behavior as a means to reduce defiance and opposition.

2. Family therapy - It attempts changes within the family environment by improving communication and family interactions within the family. It also focuses on supporting parents taking care of an ODD child, and help them deal with this challenge.

3. Peer group therapy - Peer group therapy focuses on improving peer relationships of affected child by developing social skills and interpersonal skills.

4. Medication - It is not effective in treating ODD, but can be useful for additional symptoms or disorders.

Family Counseling in case of Oppositional Defiant Disorder

For parents of an affected child, it is important to understand the condition and be patient with his behavior. Though information on the condition is easily available on the Internet, it is preferable to have counseling sessions with the treating psychotherapists or professional counselors as part of family therapy.

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