Oppositional Defiant Disorder Critique - Term Paper Example

? Oppositional Defiant Disorder Oppositional Defiant Disorder is a diagnosis illustrated as an enduring pattern of noncompliant, aggressive and insolent behavior toward influential dignitaries or personage which goes further than the limits and standards of typical childhood behavior. People who have it may appear very willful and often furious. Common features of Oppositional Defiant Disorder or ODD consists of extreme, usually lasting rage, recurrent temper tantrums or angry outbursts, and disregard for authority. Children and adolescents with this disorder frequently irritate others on purpose, condemn others for their errors, and are easily provoked. Parents often observe more rigid and defiant behaviors than with their other siblings. Furthermore, these young people may appear resentful of others and when someone does something they do not enjoy they usually take revenge on them. Oppositional defiant disorder or ODD is thought to be related to conduct disorder, but a less understood division of the disorder. The main difference between the two is that ODD lacks the severe physical aggressiveness that conduct disorder exhibits. There also seems to be a strong relationship between Attention Deficit Hyperactive Disorder or ADHD and ODD. The difference being that ODD is thought to not arise from impulsiveness as ADHD would. Oppositional Defiant Disorder Oppositional Defiant Disorder or ODD is defined by Weiner and Craighead (2010) as a recurrent pattern of negativistic, disobedient and hostile behavior by young people toward authority figures (p. 1129). Conversely, Ayd (2000) emphasized that ODD is pervasive opposition to all in authority regardless of self-interest, continuous argumentativeness and unwillingness to respond to reasonable persuasion (p. 724). Ollendick and Schroeder (2003) cited that ODD is one of the disruptive behaviors listed in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition or DSM-IV, under the heading Disorders usually First Diagnosed in Infancy, Childhood or Adolescence (p. 429). According to Rutherford and Nickerson (2010), ODD is an increasingly common behavioral disorder in children, which affects between 1 and 6 percent of children today (p. 47). Furthermore, they added that this disorder is more typical in boys before puberty while after puberty; it affects boys and girls at the same rate. Furthermore, Rapoport and Ismond (1996) stressed that this insolent behavior should last at least 6 months to be diagnosed as having such (p. 154). Rutherford and Nickerson (2010) also added that this disorder develops gradually over a period of a few months or even years (p. 48). Moreover, Kotarsky (2008) highlighted that this disorder may affect many areas of the home, school and community domains (p. 9). Symptoms of ODD According to the official diagnostic manual of the American Psychiatric Association or APA, a diagnosis of ODD can be made when a child habitually exhibits a pattern of four or more of the following behaviors for six months or more and these include: loss of temper, arguments with adults, active defiance of tenet and requests, blaming of others for misbehavior, anger, resentment, spitefulness, vindictiveness and being deliberately annoying toward others, in addition to that, individuals with this disorder are easily irritated by others (Rutherford & Nickerson, 2010, p. 47-48). Links between ODD, CD and ADHD Frequency, duration and severity of the aforementioned behaviors are all essential in making a diagnosis of ODD; however, a diagnosis of ODD cannot be made if the child’s symptoms point to conduct disorder (Rutherford & Nickerson, 2010, p. 48). Conduct Disorder or CD as defined by Ayd (2000) is an enduring pattern of behavior beginning in childhood or adolescence in which the rights of others or societal norms or tenet are violated, often preceded by another disorder, such as Oppositional Defiant Disorder or ODD or Attention-Deficit Hyperactivity Disorder or ADHD, with which it is inextricably intertwined (p. 268). Conversely, Attention-Deficit Hyperactivity Disorder is labeled by Rutherford and Nickerson (2010) as one of the most famous childhood disorders. Children with ADHD are characterized as having trouble staying on task, paying attention, waiting in line, following through after being given instructions, sitting still and ignoring distractions; moreover, ADHD can be a huge hindrance to classroom learning if it is not treated effectively (Rutherford & Nickerson, 2010, p. 51). Comorbidity ADHD and CD are often typical childhood disorders with higher comorbidity together as given emphasis by Ayd (2000, p. 268). Conduct disorder, however, is considered more extreme than ODD, and what looks like ODD at first can develop into CD over time if it goes untreated (Rutherford & Nickerson, 2010, p. 50). Rutherford and Nickerson (2010) highlighted that a child cannot have ODD and CD simultaneously as mentioned also by Burke, Waldman and Lahey (2010) in their study. On the other hand, Rutherford and Nickerson (2010) mentioned that a child can have ADHD and ODD at the same time; likewise, it is quite usual to find these two disorders together for about half of the kids with ADHD also have ODD (p. 50-51). Studies linking ADHD and ODD symptoms provide evidence of relations between impulsivity and externalizing behaviors in childhood; moreover, impulsivity is recognized as the underlying core behavioral deficit of ADHD often co-occurs with ODD (Lanza & Drabick, 2010, 83-94). Possible Causes of ODD According to Ollendick and Schroeder (2003), studies revealed that Oppositional Defiant Disorder or ODD is usually linked with child, familial and environmental factors. Conversely, Barker (2004) highlighted that ODD is of biopsychosocial origin; however, it is seldom possible to pinpoint a particular reason for a child’s antisocial behavior (p. 44). Barker (2004) proposed that in addition with the mentioned categories of factors, genetic factors and chromosome abnormalities, physical injury and disease and temperament may contribute to ODD. Child Factors Studies showed that Oppositional Defiant Disorder or ODD is often associated with higher levels of attention problems, thought problems, aggressive or delinquent behavior, social problems, academic problems and teen pregnancy (Ollendick & Schroeder, 2003, p. 429). Familial Factors Ollendick and Schroeder (2003) enumerated the familial causes of ODD which are higher levels of coercive parenting, minimal parental guidance, and other difficult family relations. Environmental Factors Ollendick and Schroeder (2003) stressed that children with ODD tend to come from homes that have lower socioeconomic standing and with increased rates of unpleasant life occurrences. Genetic Factors and Chromosome Abnormalities Barker (2004) suggested that antisocial behaviors tend to run in families, but this is not absolutely attributed to genetic causes. Barker (2004) further rationalized that it is more probable that a subject’s genetic make-up may result in certain personality and temperamental attributes that make the development of ODD more possible (p. 45). Moreover, chromosome abnormalities have been thought to play a role in the genesis of aggressive behavior; males are more aggressive than females for they possess a Y chromosome whereas an individual with Klinefelter’s Syndrome who have an XXY complement have been reported to be more aggressive (Barker, 2004). Physical Injury and Disease Barker (2004) stressed that disease, damage or dysfunction to the brain may affect a person’s propensity for aggressive behavior. Rutherford and Nickerson (2010) tackled that ODD also commonly occur with children who have mood disorders such as bipolar disorder and depression. Bipolar disorder is illustrated by Rutherford and Nickerson (2010) as a disorder with extreme mood swings from elation to despair, though some individuals possess small highs and much more extreme lows. Rutherford and Nickerson (2010) added that a person with bipolar disorder can be impulsive and reckless during the highs as evidenced by spending beyond their limits and entertaining delusions of grandeur; during their lows they may become downhearted and even catatonic or feel that they are in the depths of despair and death is the only way to escape their miserable state. Depression is another disorder that often goes hand-in-hand with ODD (Rutherford & Nickerson, 2010, p. 52). Children with this disorder can experience overwhelming sadness after a loss from time to time. Temperament Children’s temperament varies and about ten percent (10%) of children have difficult temperaments that make a particular child difficult to deal with compared to others (Barker, 2004). Problems that ODD causes the patient ODD is expected to interfere with school performance and the interpersonal relationships of the child resulting in poor grades and few friends (Heller & Gitterman, 2011, p. 314). Furthermore, poor self-esteem, melancholy, disappointment, temper outburst and substance use is probable. Heller and Gitterman (2011) also emphasized that ODD symptoms have also been shown to lead to an increased risk of substance use conditions and risk of developing conduct conditions if remain untreated as the child ages (p. 314). Healing Rutherford and Nickerson (2010) emphasized that OCC cannot be cured per se, it can be effectively controlled to the point that the child’s behavior is well within the norm for his or her age group (p. 56). Moreover, treatment has been proven effective in a variety of programs. Medication According to Rutherford and Nickerson (2010), medication for behavioral problems can suppress symptoms (p. 56). Furthermore, they emphasized that it is important not to skip a dosage because the efficiency of the medication cannot suppress the disruptive behaviors once the medication is out of the bloodstream. There is no single medication for ODD; however, the clinician who evaluates the child may give medications to repress the disruptive behaviors that a child particularly exhibits (Rutherford & Nickerson, 2010). If a child shows aggressive behaviors, drugs that suppress aggression like olanzapine, quetiapine and risperidone may be helpful. Likewise, lithium carbonate and carbamazepine may also be useful. Furthermore, if the child’s belligerence is depicted as rage or lack of impulse control, anticonvulsants can be prescribed such as carbamazepine and divalproex. On the contrary, if a child manifests depression, it is often cured with antidepressants like bupropion, imipramine, nortriptyline and fluoxetine, which is specifically approved for use in children (Rutherford & Nickerson, 2010). If a child with ODD has ADHD also, Ritalin may be administered as directed by the child’s physician. Parenting Styles In all likelihood, in order to best help the child and his or her parent create a more peaceful and loving home, it would also be vital if the parent attends some of the therapy sessions to aid their child in altering his or her environment thus, aiding in the reduction of ODD behaviors (Rutherford & Nickerson, 2010). Parents can employ the use of a system of rewards for positive behavior wherein it starts with praising the child even for the small stuff that he or she does right (Rutherford & Nickerson, 2010). Consequently, this style trains the child to think through the consequences of insolent behavior so that he or she could be able to minimize punishment. Self-Helping Although behavioral approaches are effective in reducing overt aggressive behavior, children with ODD often have high levels of anger; therefore, the direct treatment of high anger arousal, an antecedent of impulsive and explosive behavior is an important strategy in managing such (Quay & Hogan, 1999, p. 447). Children with ODD can also be taught with social skills to promote prosocial behaviors (Quay & Hogan, 1999, p. 448). It aids children in acquiring social skills necessary to avoid interpersonal rejection and gain acceptance by adults and peers who often identify disruptive children as undesirable classmates and playmates (Quay & Hogan, 1999, p. 448). Problems Later in Life Rutherford and Nickerson (2010) highlighted that if ODD is not treated; behaviors may worsen and may progress to Conduct Disorder as emphasized also by Burke and Loeber (2010) in their study. Children later in life may damage the homes they live in, have frequent run-ins with the law, and put themselves as well as their family in physical danger. Moreover, they may even attempt to commit suicide. References Ayd, F.J. (2000). Lexicon of Psychiatry, Neurology and the Neurosciences, 268-725. Barker, P. (2004). Basic Child Psychiatry, 44-46. Burke, J., & Loeber, R. (2010). Oppositional defiant disorder and the explanation of the comorbidity between behavioral disorders and depression. Clinical Psychology: Science and Practice, V17 N4, 319-326 Burke, J., Waldman, I., & Lahey, B. (2010, September 20). Predictive validity of childhood oppositional defiant disorder and conduct disorder: implications for the DSM-V. Journal of Abnormal Psychology. Advance online publication. Doi: 10.1037/a0019708 Heller, N.R., & Gitterman, A. (2011). Mental Health and Social Problems: a Social Work Perspective, 314. Kotarsky, D.V. (2008). Family Communication in Adolescents Diagnosed with Comorbid Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder, 1-134. Lanza, H., & Drabick, D. (6 Aug 2010). Family routine moderates the relation between child impulsivity and oppositional defiant disorder symptoms. Journal of Abnormal Child Psychology, 39, 83-94. Ollendick, T.H., & Schroeder, C.S. (2003). Encyclopedia of Clinical Child and Pediatric Psychology, 429. Quay, H.C., & Hogan, A.E. (1999). Handbook of Disruptive Behavior Disorders, 447-448. Rapoport, J.L., & Ismond, D.R. (1996). DSM-IV Training Guide for Diagnosis of Childhood Disorders, 153-155. Rutherford, J.J., & Nickerson, K. (2010). The Everything Parent’s Guide to the Defiant Child: Reassuring Advice to Help Your Child Manage Explosive Emotions and Gain Self-Control, 47-59.  Weiner, I.B., & Craighead, W.E. (2010). The Corsini Encyclopedia of Psychology, 3, 1129-1131. Read More