Every child has their challenging moments, no matter how good they may normally be! Temper tantrums and fights with siblings are all part and parcel of the developmental process. Some behaviour however, exceeds the limits of what is normal. If your child or teenager seems to be persistently angry and defiant towards figures of authority, then it is possible they may have what is termed oppositional defiant disorder or ODD.
ODD can be extremely challenging for parents and families alike as it causes immense stress and strain. If you suspect your child has ODD you do not have to go it alone as there are a range of mental health experts who can help as well as numerous treatments available.
What to Look Out For
Symptoms of Oppositional Defiant Disorder may include excessive arguments (particularly with adults or authority figures), regular temper tantrums and purposefully behaving in an irritating and mean manner.
The signs of ODD normally appear by preschool and almost always before the teen years. Whist some behavioural issues are common (particularly in the teenage years) ODD causes significant disruption in the school and the home. It is important not to confuse ODD with merely being stubborn or emotional!
In order to accurately diagnose individuals with ODD, The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association has drawn up a list of criteria. This manual is the handbook most commonly used by mental health professionals to diagnose mental disorders.
DSM-5 criteria state that in order to meet the requirements for a diagnosis of ODD the individual must demonstrate four symptoms from each of the following under the headings: “angry and irritable mood”, “argumentative and defiant behaviour” and “vindictiveness”.
Angry and irritable mood:
Loses temper frequently
Is often sensitive and/ or easily irritated by others
Is often angry and resentful
Argumentative and defiant behavior:
Frequently starts arguments with figures of authority
Frequently defies orders and rules laid out by figures of authority
Deliberately irritates people
History of blaming others for his/ her mistakes
Frequently demonstrates spiteful/ vindictive behaviour
Has demonstrated this behaviour twice in the last six months
In order to classify for a diagnosis, if present, these behaviours must be markedly more apparent than is typical for the child’s peer group. These behaviours must also be apparent with individuals outside the family unit. If the child behaves in this manner towards siblings only, they cannot be classified as having ODD!
The pattern of disruptive behaviour must cause significant problems in the domains of work, school or home and last at least six months so it really is very evident in day- to- day life.
An important point is that the difficulties associated with ODD occur separately to any other behavioural or mental health issue. So if your child suffers from another disorder which may explain the disruptive symptoms, than ODD may not be the diagnosis required.
As with many disorders ODD can affect individuals to varying degrees. Mild ODD for example may occur only in the school- setting whereas severe will be visible in all settings including the home, school or work.
What Causes ODD?
Unfortunately, there is no one answer to this question. Like many disorders, scientists believe it may be a complex relationship between biological, psychological and social factors that contribute to ODD.
In terms of biological factors studies have found a brain- chemical imbalance to be associated with ODD. They have also noted that having a parent with a history of ODD or ADHD puts children at risk. There are also environmental factors which have been implicated such as smoking during pregnancy or poor diet.
Psychological factors contributing to ODD include a poor relationship with parents or a neglectful or absent parent. For these reasons ODD is also often linked to parents with substance abuse. Social factors may include poverty and family instability amongst others.
Whilst these are some factors that have been linked to ODD it is important to note that scientists really don’t have one answer. A family may not meet any of the criteria above yet still find themselves facing the disruptive behaviour of a child with ODD.
Can ODD Be Prevented?
Early intervention, school- based programmes and individual therapy can all help to prevent ODD. If intervention is provided at pre-school i.e. via the Head Start Programme the outcomes are actually quite good.
Among adolescents talk therapy, social training and providing academic help can help to alleviate behaviours. Recently school- based programmes have also shown some effectiveness so it is important that intervention take place in multiple environments.
Treatement For ODD
Treatment for ODD has to be tailored to each individual child. For this reason it is difficult to pinpoint what treatment will entail. Most likely, however, it will include some psychotherapy or CBT, social skills training and parent-management training. In child therapy sessions the clinician will most likely teach the child ways to manage stress and triggering situations.
Parent-management training provides parents with the tools they need to effectively manage children’s behaviour, as well as care for their own needs. Parent management training teaches discipline techniques and positive parenting practices such as providing supportive and consistent supervision and discipline. It discourages harsh punishment.
Medication may sometimes be prescribed in severe cases of ODD, or when another disorder is present like ADHD. Even with medication, children can still benefit from some of the treatments described above.
If you are affected by any of the above, or suspect your child may have ODD, it is important to contact your nearest health professional for advice and support.
American Psychiatric Association (1980), Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III). Washington, DC: American Psychiatric Press
Connor DF (2002), Aggression and Antisocial Behavior in Children and Adolescents: Research and Treatment. NewYork: The Guilford Press
Loeber R, Burke JD, Lahey BB, Winters A, Zera M (2000), Oppositional defiant and conduct disorder: a review of the past 10 years, part I. J Am Acad Child Adolesc Psychiatry 39:1468-1484
Staff, Mayo Clinic. "Oppositional Defiant Disorder (ODD)." - Mayo Clinic. Mayi Clinic, 01 Feb. 2015. Web. 17 May 2016