Disorders
Oppositional Defiant Disorder
One major contributing factor to a child's misbehavior is thought to be a diagnosis known as ODD or oppositional defiant disorder. Oppositional defiant disorder is a pattern of disobedient, hostile, and defiant behavior towards authority figures. The pattern must persist for at least six months and must go beyond the bounds of normal childhood misbehavior.
Causes, incidence, and risk factors
Oppositional defiant disorder is more prevalent in boys than girls. Some studies have found that as much as 20% of the school age population are affected, but most experts believe this figure is over-inflated due to changing cultural definitions of normal childhood behavior, and other possible racial, cultural, and gender biases.
Oppositional Defiant Disorder typically begins around the 8th of age. The cause of this disorder is unknown, and may be caused by a combination of biology, parenting, and or environmental factors.
ODD Symptoms
· Arguing with adults
· Loss of temper
· Angry and resentful of others
· Actively defies adults' requests
· Spiteful or vindictive behavior
· Blames others for their own mistakes
· Very touchy or easily annoyed
· Few or no friends or loss of previous friends
· Constant trouble in school
Signs and tests
The pattern of Oppositional Defiant Disorder behaviors must be distinguished from what is commonly observed in other children. With similar age and developmental level, and results in significant social or academic problems.
Evaluation by a psychiatrist or psychologist may be recommended. In children and adolescents, depression and attention-deficit /hyperactivity disorder (ADHD) may cause similar disturbances in behavior, and should be considered as alternate or additional diagnoses.
Treatment
The best treatment for the child with Oppositonal Defiant Disorder is individual psychotherapy. The parents should also learn behavioral management skills. Medication may be helpful if the behaviors occur in the course of another condition (such as depression, childhood psychosis, or ADHD).
Punitive treatments like boot camps and "behavioral modification" schools which restrict contact with parents and place the child amongst other disturbed children can do more harm than good.
Expectations (prognosis)
The outcome varies. Some children respond well to treatment.
Complications
In a significant proportion of cases, the adult condition of conduct disorder can be traced back to the presence of oppositional defiant disorder in childhood.
Calling your health care provider
Call your health care provider if you have concerns about your child's development or behavior.
Prevention
Consistency in rules and fair consequences should be practiced in a child's home. Punishments should not be overly harsh or inconsistently applied.
Appropriate behaviors should be modeled by the adults in the household. Abuse and neglect increase the chances that Oppositional Defiant Disorder will occur in your child.
Conduct Disorder
Conduct disorder, which is a disorder of childhood and adolescence, involves longstanding behavior problems, such as defiant, impulsive, antisocial behavior, drug use, and or criminal activity.
Causes, incidence, and risk factors
Conduct disorder has been associated with family conflicts, child abuse, poverty, genetic defects, and parental drug addiction or alcoholism. The diagnosis is more common among boys and is estimated to be as high as 10%.
However, because many of the qualities necessary to make the diagnosis (such as "defiance" and "rule breaking") can be subjective, it is hard to know how common the disorder really is. For accurate diagnosis, the behavior must be far more extreme than simple adolescent rebellion or boyish exuberance.
Conduct disorder is often associated with attention-deficit disorder, and the two together carry a major risk for alcohol and/or other drug dependence.
Children with conduct disorder tend to be impulsive, difficult to control, and unconcerned about the feelings of others. They often lie and break rules without apparent reasons and engage in antisocial behavior like bullying and fighting.
Symptoms
· Cruel or aggressive behavior towards people and animals
· Destruction of property, including fire setting
· Lying, truancy, running away
· Vandalism, theft
· Heavy drinking and/or heavy illicit drug use
Signs and tests
Some of the common signs of conduct disorder are bullying, fighting and staying out at night without concern for curfew or other limits. These children often make no effort to hide their aggressive behaviors and have difficulty making close friends. The diagnosis is made on the basis of a history of these kinds of behaviors.
Treatment
Successful treatment of Conduct Disorder requires close involvement of the child's family. Parents can learn techniques to help manage their child's problem behavior. In cases of abuse, the child may need to be removed from the family and placed in a less chaotic environment. Treatment, such as medications or talk therapy may be used for depression and attention-deficit disorder, which commonly accompany conduct disorder.
Many "behavioral modification" schools, "wilderness programs", and "boot camps" are sold to parents as solutions for conduct disorder. These may use a form of "attack therapy" or "confrontation" that can actually be harmful. There is no research that supports these such techniques. Research suggests that treating children at home, along with their families, is more effective.
If you are considering an inpatient program, be sure to thoroughly investigate it. There have been serious injuries and deaths associated with some of them, and in many states they are not regulated.
Expectations (prognosis)
Those children who have severe or frequent symptoms tend to have the poorest prognosis. Expectations are also worse for individuals who have other illnesses, such as mood and drug abuse disorders.
Complications
Children with conduct disorder may go on to develop personality disorders as adults, particularly antisocial personality disorder. As their behaviors worsen, these individuals may also develop significant drug and legal problems.
Calling your health care provider
See your health care provider if your child seems to be overly aggressive, is bullying others, is being victimized, or continually gets in trouble. Early treatment may help.
Prevention
The sooner the treatment for conduct disorder is started, the more likely the child will learn adaptive behaviors and prevent some of the potential complications.
The information on Conduct Disorder and Oppositional Defiant Disorder is provided by MEDLINE plus and the National Library of Medicine site located at: (http://www.nlm.nih.gov)