Oppositional Defiant Disorder: Symptoms, Causes, And Treatments

Oppositional defiant disorder (ODD) is characterized by a recurring pattern of uncooperative, defiant, negative, irritable, and hostile behaviors toward parents, peers, teachers, and other authority figures (1).

The DSM-5 (2) groups it under the heading of Disruptive Disorders, Impulse Control and Behavior. Other disorders in this heading are Conduct Disorder (TD), Intermittent Explosive Disorder (IED), and Antisocial Personality Disorder (APD).

Although defiant attitude can be common in children, from time to time it can develop into a disorder like this. Opposing behavior can take different forms. It may happen that the girl or boy shows extreme passivity (not systematically obeying by showing passive or inactive).

On the contrary, they can also use negative verbalizations, insults, hostility or physical resistance with aggressiveness towards authority figures, whether they are their own parents, teachers or educators (3).

epidemiology

The prevalence of ODD varies depending on the nature of the population studied and the evaluation methods. Oppositional defiant disorder rates have been found between 2% and 16% (1). This disorder can appear from 3 years of age. However, it usually begins at 8 years of age, being rare that it begins after adolescence.

The normal thing is that the negative symptoms emerge in the family environment. However, over time they can occur in other environments as well, such as at school, for example. This disorder affects approximately 2 to 16 children and adolescents in 100 and is more common among young people from families with a low socioeconomic level.

Possible Causes of Oppositional Defiant Disorder

Opposing behavior can be both normal and necessary in the life cycle. It is needed to assume individuality and establish internal rules and controls (1). Oppositional symptomatology can appear as a reaction to an important life event. An accident or traumatic event are examples of this.

In addition, it can also be a defense against feelings of incapacity, incompetence, anxiety, loss of self-esteem or tendencies of submission.

Biological – physiological theory

Since aggressive behavior can be related to biochemical and hormonal factors, it is believed that these can play an important role in the appearance of oppositional behaviors.

Learning theory

This theory maintains that the negative characteristics of the disorder are attitudes that young people learn from the negative techniques used by parents and authority figures. Some of these are punishment, yelling, or even hitting.

It’s not that there are distinctive family parenting patterns; however, it has been found that many of the parents of children or adolescents with this disorder are exaggeratedly interested in power and control over their children.

In addition, it may happen that the family environment influences the appearance of these behaviors. Stubborn siblings, depressed and controlling mothers, and passive-aggressive fathers have been observed in some families. An example of the latter could be a father who ignores the education of his children, but who nevertheless criticizes any intervention by his partner.

Diagnosis of oppositional defiant disorder

To diagnose this disorder, it is normal to interview the parents first. In it, the psychologist will be able to determine how the child or adolescent’s behavior has been during their life cycle.

They will also be necessary: a direct examination with the minor or adolescent and a review by the teachers of their school. A complete medical history (including family, personal, pathological and developmental history) will be required, as well as knowing when to consult another specialist and when to refer to another level of care (1).

Treatment

Treatment for this disorder must be based on individual, family and group psychotherapy. In addition, it involves working with both the child and the parents.

Individual psychotherapy

The goal with this type of therapy should be to increase the child’s ability to:

• Solve the problems.
• Put your communication skills into practice.
• Control your anger and impulses.

Family therapy

In addition to individual psychotherapy, it is essential to take into account communication and family interaction with these types of disorders. The child’s parents or guardians will sometimes need the help of a professional to develop some skills in parenting the child or adolescent.

In conclusion, we can say that oppositional defiant disorder does not exclusively affect the child or adolescent. It also affects the family, teachers and colleagues. Its origin seems to be mainly psychosocial and may have to do with the upbringing that has been given to the child or adolescent. This disorder must be treated as soon as possible, otherwise it can evolve into a greater behavior problem, such as conduct disorder.