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1.11.09

Oppositional Defiant Disorder


What is Oppositional Defiant Disorder?

It is common for kids and teenagers to display bouts of irritability, frustration, and disobedience over the course of their growth and development. For example, the 4 year old who throws a tantrum because she has to stop playing; the 8 year old who picks on his younger sister; the 13 year old who argues with her mother about going to a movie. Still, there are many families who struggle with child behavior that goes beyond stubbornness or occasional talking back. Some kids and teenagers have such an inflexible and hostile nature and their behavior can be so uncooperative and defiant that they disrupt the functioning of whole households and classrooms, not to mention their own learning and well-being in relationships. One out of every ten kids or teenagers displays this type of disposition and behavior with such regularity that they are thought to have Oppositional Defiant Disorder (ODD).

According to the American Psychiatric Association, OPPOSITIONAL DEFIANT DISORDER is characterized by a chronic pattern of negativity, hostility, and non-compliant child behavior that is most often directed toward authority figures and has existed for at least 6 months. This behavior is severe enough that it interferes with everyday functioning at home and, in some cases, at school and other activities, and it stands out as more severe compared with kids of the same age and developmental level. Signs and symptoms of OPPOSITIONAL DEFIANT DISORDER:

• Act angry or resentful toward others
• Act spiteful or seek revenge on others

• Actively defy or refuse to comply with adults’ requests or rules

• Argue with adults

• Be touchy or easily annoyed by others

• Blame others for his or her mistakes or misbehavior

• Deliberately try to annoy or upset other people

• Lose his or her temper and throw tantrums


The exact cause of OPPOSITIONAL DEFIANT DISORDER is not known. Research suggests that it evolves out of a complex interaction of many different factors related to the basic biological, psychological, and social nature of the youngster and his or her relationships with the family and other environments, such as school. Also, it is not uncommon for kids with Attention Deficit/Hyperactivity Disorder (AD/HD), depression, or anxiety to display symptoms of OPPOSITIONAL DEFIANT DISORDER.

Effect on Families & Relationships—

Parenting a youngster with OPPOSITIONAL DEFIANT DISORDER can be a tremendous challenge not only because he or she may seem so willing to defy adult authority, but also because intervention strategies that work with most kids, such as time-outs, removal of privileges, and grounding, often do not work with OPPOSITIONAL DEFIANT DISORDER. Studies actually indicate that these kids may not respond well to punishments. Other studies have found that kids and teenagers with severe cases of OPPOSITIONAL DEFIANT DISORDER and/or aggression may feel threatened by situations where there are unclear messages, rules, or expectations, which can trigger hostile reactions. In addition, they often have poor frustration tolerance, which only makes it more difficult for them to get through situations where they feel uncomfortable, threatened, or where they may see little pay-off for their efforts. The result of these factors are kids and teenagers who seem to be easily annoyed or angered, yet are difficult to soothe and calm.

This pattern of behavior can leave many families feeling powerless, as if they have to “walk on eggshells” out of fear that one wrong move can cause a serious tantrum. It can also leave the youngster or teenager feeling isolated, anxious, and unsure of herself as others anticipate her irritability and explosive behavior even before it occurs. They likely will be aware of any feelings of disappointment and resentment that other family members feel toward them due to their oppositional and defiant behavior. Unfortunately, it is not enough to help change the behavior.

Parenting Tip: Be Decisive

It is easy for moms and dads who feel like they have to walk on eggshells to become wishy-washy; they are often unsure of when, where, and how, to give directions or enforce rules with their kids and teenagers. However, wishy-washiness can actually be a trigger for OPPOSITIONAL DEFIANT DISORDER behavior. It is important to be decisive!

Most parents with kids and teenagers with OPPOSITIONAL DEFIANT DISORDER have learned the hard way that it is much better to say “no” than to say “we’ll see” if “no” is the answer they really mean. The youngster may throw a tantrum with either response; however, telling the youngster “we’ll see” only heightens the intensity of her reaction because it gives her hope that she can still get what she wants. She is then likely to badger the parents until she gets her way or is finally told “no,” with the meltdown that follows being even more intense. So, go ahead and say “no” and stick to it; your youngster will learn over time that you mean what you say and that goes a long way to curbing anxiety and increasing compliant behavior. This also applies to setting plans for any activity, such as going to school, taking a trip, or running errands. Be clear about what is going to happen and alert and prepare the youngster before any changes to the plan take effect.

When to Seek Help—

It may never be too soon to seek help for your youngster or teenager if they are displaying the type of behavior associated with OPPOSITIONAL DEFIANT DISORDER, as it can be difficult to know whether it is a part of typical development or a problem that needs treatment. The more frequent and severe your youngster displays the symptoms listed above, the more likely there is to be intense family conflict and the more likely he or she is to have problems with peers, have difficulty maintaining friendships, and suffer academic problems.

Intervention—

The key to successful interventions for OPPOSITIONAL DEFIANT DISORDER is parent involvement. It is critical that moms and dads be firm and consistent not only with their discipline strategies, but also with the love and acceptance in their responses to the youngster. The most effective interventions are considered to be those that emphasize Parent Training, which provide a framework for understanding the nature of OPPOSITIONAL DEFIANT DISORDER in kids and teenagers and help reinforce specific parenting skills, as well as teach creative strategies for managing OPPOSITIONAL DEFIANT DISORDER behavior.

Moms and dads who are not able to respond to OPPOSITIONAL DEFIANT DISORDER behavior in a manner that can calm and soothe the youngster only add fuel to the fire. It is a lot to ask of a parent who is constantly under attack from oppositional behavior to react calmly, and it probably seems impossible if you are feeling demoralized and exasperated. This is why it is often a good idea to seek the help of a mental health professional who can not only help you learn strategies to confront this kind of extreme behavior, but also learn ways of coping with the stress of parenting in the face of such difficult circumstances.

My Out-of-Control Child

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