Oppositional Defiant Disorder

WHAT IS OPPOSITIONAL DEFIANT DISORDER?

Oppositional Defiant Disorder (ODD) is a psychiatric disorder that is characterised by two different sets of problems. These are aggressiveness and a tendency to purposefully bother and irritate others. The main features observed are persistent disobedience and opposition to authority figures (such as parents, teachers or other adults). However the basic rights of others are still respected and age appropriate societal rules and behaviour are not violated. Before puberty the disorder is more frequently found in males than females, after puberty the ratio equals out.

Outward behaviour includes irritability, temper outbursts, frustration and intolerance. The child’s self-esteem is usually low (although child may project an image of “toughness”). Additional symptoms of anxiety and depression are also common.

A pattern of negative, hostile, and defiant behaviour lasting at least six months during which five or more of the following are present:

• Child often loses temper.
• Child often argues with adults.
• Child often actively defies or refuses adult requests or rules (e.g. refuses to complete work).
• Child often deliberately does things intended to annoy others (e.g. flicks stationary at staff or pupils).
• Child often blames others for child’s own mistakes.
• Child is often touchy or easily annoyed by others.
• Child often angry and resentful.
• Child is often spiteful or vindictive.
• Child often swears or uses obscene language.

WHAT ARE THE CAUSES OF ODD?

There's no clear cause underpinning oppositional defiant disorder. Contributing causes may include:

• The child's inherent temperament
• The family's response to the child's style
• A genetic component that when coupled with certain environmental conditions, such as lack of supervision, poor quality daycare or family instability, increases the risk for ODD
• A biochemical or neurological factor
• The child's perception that he or she isn't getting enough of the parent's time and attention

IS IT POSSIBLE TO TREAT ODD?

Treatment of oppositional defiant disorder has poor outcomes. When the parents are overly restrictive, the child fights back more, resulting in a power struggle. Some individual therapies and family therapies have been successful, but not to a great extent.

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