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:
- 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
- Deliberately engaged in fire setting with the intention to cause damage
- Deliberately destroys other’s property
- 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)
- Often stays out at night despite parental objections
- Runs away from home
- Often truant from school
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