Conduct/Defiance Disorders

What is Oppositional Defiant Disorder?

All children are oppositional at times. They may argue, talk back, disobey, and defy parents, teachers, and other adults. Oppositional behavior is often a normal part of development for two to three-year-olds and early adolescents. However, openly uncooperative and hostile behavior becomes a serious concern when it is so frequent and consistent that it stands out when compared with other children of the same age and developmental level and when it affects the child’s social, family, and academic life.

In children with Oppositional Defiant Disorder (ODD), there is an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the youngster’s day to day functioning. Symptoms of ODD may include:

Frequent temper tantrums
Excessive arguing with adults
Active defiance and refusal to comply with adult requests and rules
Deliberate attempts to annoy or upset people
Blaming others for his or her mistakes or misbehavior
Often being touchy or easily annoyed by others
Excessive arguing with adults
Frequent anger and resentment
Mean and hateful talking when upset
Seeking revenge

The symptoms are usually seen in multiple settings, but may be more noticeable at home or at school. Five to fifteen percent of all school-age children have ODD. The causes of ODD are unknown, but many parents report that their child with ODD was more rigid and demanding than the child’s siblings from an early age. Biological and environmental factors may have a role.
Some children with ODD may go on to develop conduct disorder.

What is Conduct Disorder?

“Conduct disorder” is a complicated group of behavioral and emotional problems in youngsters. Children and adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way. They are often viewed by other children, adults and social agencies as “bad” or delinquent, rather than mentally ill.
Children or adolescents with conduct disorder may exhibit some of the following behaviors:

Aggression to people and animals

Bullies, threatens or intimidates others
Often initiates physical fights
Bipolar disorder – at least one episode of a depressed or irritable mood and at least one period of a manic (persistently elevated) mood.
Is physically cruel to people or animals
Steals from a victim while confronting them (e.g. assault)
Forces someone into sexual activity

Destruction of Property

Deliberately engaged in fire setting with the intention to cause damage
Deliberately destroys other’s property

Deceitfulness, lying, or stealing

Has broken into someone else’s building, house, or car
Lies to obtain goods, or favors or to avoid obligations
Steals items without confronting a victim (e.g. shoplifting, but without breaking and entering)

Serious violations of rules

Often stays out at night despite parental objections
Runs away from home
Often truant from school

What causes ODD and CD?

More research needs to be done into the causes of both ODD and CD. However, a genetic vulnerability, especially combined with environmental “triggers” (family histories of disruptive behavior disorder, antisocial personality disorder, mood disorders, or substance abuse; permissive, neglectful, harsh or inconsistent parenting; and poverty) seem to be causes for some children. With CD, studies have also shown that both identical twins are more likely to have conduct disorder than fraternal twins. Adoption studies have shown that the risk increases when both adoptive and biological parents have conduct disorder (antisocial personality disorder in adults). And some studies have indicated that impairment in frontal lobe and low serotonin levels may also be factors in causing CD.

Determining if your child has ODD or CD

A child presenting with ODD or CD symptoms should have a comprehensive evaluation. It is important to look for other disorders which may be present; such as, attention-deficit hyperactive disorder (ADHD), learning disabilities, mood disorders (depression, bipolar disorder) and anxiety disorders. It may be difficult to improve the symptoms of ODD or CD without treating the coexisting disorder.

Assessment and diagnosis of conduct/defiance disorders should be done by a mental health professional, preferably one who is trained in children’s mental health. Any diagnosis must be made in consultation with the child’s family. The assessment process should include observation of the child, discussion with the child and family, the use of standardized instruments or structured diagnostic interviews, and history-taking ,including a complete medical and family / social history. When assessing and diagnosing any childhood emotional or behavioral disorder, the mental health professional should consider the social and economic context in which a child’s behavior occurs.

Accurate assessment and appropriate, individualized treatment will assure that all children are able to traverse the developmental stages of childhood and adolescence and make a successful adaptation to adulthood.

Texas Panhandle Centers staff are trained in the treatment of children with disruptive behavior and can provide guidance to guardians, schools or organizations working with children. For more information on mental health services available for children and adolescents, click on the links below:

TPC Chrildren’s Services | TPC STAR Program