In children and adolescents, ODD is a pattern of angry and irritable mood, argumentative and defiant behavior, and possibly vindictiveness beyond what is considered typical and that is present for a minimum of six months. Aggressive and destructive behavior is not present, but rather a disregard for rules and an intentional power struggle when structure is enforced. Symptoms are usually seen in more than one environment, but can be most present in a specific setting such as home or school.
Symptoms of ODD:
- Actively refuses to comply with the group or authority figure’s requests or rules
- Performs acts to purposely annoy people
- Is angry and resentful of others
- Argues frequently
- Blames others for their actions and mistakes
- Loses temper easily and frequently
- Is spiteful and possibly seeks revenge when perceived to be wronged
- Easily annoyed or emotionally sensitive
- Behaviors interfere with ability to perform at school, make friends, keep a job, or coexist in a family or home environment
What Causes ODD?
While the specific cause of ODD is unknown at this time, it is believed that a combination of biological, environmental, and genetic factors that contribute to the development of the disorder. Genetics may create a natural disposition or temperament that lessens a person’s ability to cope with distress in appropriate ways. Whereas environment can include problems with parenting such as lack of supervision, inconsistent or inappropriate discipline, or abuse and neglect.
Therapy is the most effective treatment for ODD, and often involves the child/adolescent, parents, and other school or social supports. Parent involvement in behavior management is vital to success in treatment. The primary areas of focus in treatment are parent training, family therapy, and individual therapy utilizing CBT for the child. Parenting training is utilized to assist a parent in setting up the structure that a child with ODD needs to learn and adapt to expected societal and behavioral norms. This will lessen frustration for both child and parent, reducing the amount of conflict and allowing positive and appropriate behavior to be rewarded. Family therapy focuses on the interactions between child and parent, improving the quality of interactions and reducing negative interactions that lead to resentment and increase rebellious behavior. Individual therapy my primarily use Cognitive Behavioral Therapy, or CBT, but will also incorporate other areas of focus, including social skills training. Individual therapy should focus on assisting the child in identifying maladaptive thought patterns that lead to behavior problems and change them to be more functional. It is also important to assist the child in healthily and appropriately expressing their emotions to reduce acting out and improve their ability to get their emotional needs met without the acting out behaviors.