Oppositional Defiant Disorder Treatment
Oppositional Defiant Disorder Treatment by Anthony Kane, MD
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About a year ago I wrote an article on Oppositional Defiant Disorder discussing the condition, symptoms and treatment options. This article is an update describing what is new.
-Introduction
Oppositional defiant disorder (ODD) is a psychiatric behavior disorder that is characterized by aggressiveness and a tendency to purposefully bother and irritate others. These behaviors cause significant difficulties with family and friends and at school or work.
-Description
Oppositional defiant children show a consistent pattern of refusing to follow commands or requests by adults. These children repeatedly lose their temper, argue with adults, and refuse to comply with rules and directions. They are easily annoyed and blame others for their mistakes. Children with ODD show a pattern of stubbornness and frequently test limits, even in early childhood.These children can be manipulative and often induce discord in those around them. Commonly they turn attention away from themselves by inciting parents and other family members to fight with one and other.
-Behavioral Symptoms
Normal children occasionally have episodes of defiant behavior, particularly during ages of transition such as 2 to 3 or the teenage years where the child uses defiance in an attempt to assert himself.
Children who are tired, hungry, or upset may be defiant. Oppositional defiant behavior is a matter of degree and frequency. Children with Oppositional Defiant Disorder display difficult behavior to the extent that it can interfere with learning, school adjustment, and, sometimes, with the child’s social relationships.
Common behaviors seen in Oppositional Defiant Disorder include:
-Losing one’s temper
-Arguing with adults
-Actively defying requests
-Refusing to follow rules
-Deliberately annoying other people
-Blaming others for one’s own mistakes or misbehavior
-Being touchy, easily annoyed
-Being easily angered, resentful, spiteful, or vindictive
-Speaking harshly, or unkind when upset
-Seeking revenge
-Having frequent temper tantrums
Many parents report that their ODD children were rigid and demanding from an early age.
-Diagnosis
The diagnosis of ODD is not always straight forward and needs to be made by a psychiatrist or some other qualified mental health professional after a comprehensive evaluation.
If you feel your child may have ODD, there is a quick ODD Screening Test at http://addadhdadvances.com/ODDtest.html
-Causes
It is not clear what causes Oppositional Defiant Disorder. There are currently two theories.The developmental theory suggests that ODD is really a result of incomplete development. For some reason, ODD children never complete the developmental tasks that normal children master during the toddler years. They get stuck in the 2-3 year old defiant stage and never really grow out of it.
The learning theory suggests that Oppositional Defiant Disorder comes as a response to negative interactions. The techniques used by parents and authority figures on these children bring about the oppositional defiant behavior.
-Co-morbidity
Oppositional Defiant Disorder usually does not occur alone. 50-65% of ODD children also have:
-ADD
ADHD
-35% of these children develop some form of affective disorder
-20% have some form of mood disorder, such as
-Bipolar Disorder or anxiety
-15% develop some form of personality disorder
Many of these children have learning disorders. Any child with Oppositional Defiant Disorder must be evaluated for other disorders as well.
If your child has ODD it is imperative to find out what are the co-existing problems. This is the key to treating the condition, as we shall soon discuss.
-Prognosis
So what happens to these children?
There are four possible paths.
-Some will grow out of it. Half of the preschoolers that are labeled ODD are normal by the age of 8. However, in older ODD children, 75% will still fulfill the diagnostic criteria later in life.
-The ODD may turn into something else. 5-10% of preschoolers with ODD have their diagnosis changed from ODD to ADHD. In some children, the defiant behavior gets worse and these children eventually are diagnosed with conduct disorder at http://addadhdadvances.com/CDtest.html. This progression usually happens fairly early. If a child has ODD for 3-4 years and he hasn’t developed Conduct Disorder, then he won’t ever develop it.
-The child may continue to have ODD without any thing else. This is unusual. By the time preschoolers with ODD are 8 years old, only 5% have ODD and nothing else.
-The child develops other disorders in addition to ODD. This is very common.
-Treatment:
Medical Intervention
There have been some recent studies that have examined the effects of certain medications on Oppositional Defiant Disorder. All the research is preliminary and just suggests that certain treatments may help.
One study examined the use of Ritalin to treat children with both ADHD and ODD. This study found that 90% of the children treated with Ritalin no longer had the ODD by the end of the study. The researchers skewed the results a bit because a number of children were dropped from the study because they wouldn’t comply with the treatment regimen. Still if these children are included as treatment failures the study still showed a 75% success rate.
There have been two studies examining the effect of Strattera on children with both ADHD and ODD. One study showed that Strattera helped with ODD, one study showed it did not help.There was a large Canadian study that showed that Risperdal helped with aggressive behavior in children with below normal intelligence. It did not matter if the child had ADHD or not. There was study showing that 80% of children with explosive behavior improved when given the mood stabilizer, divalproex.There was another pilot study examining the use of Omega-3 oils and vitamin E in ODD children. Both helped the ODD behavior to some degree.
-Treatment:
Psychological Intervention
Parent management training is still viewed as the main treatment for Oppositional Defiant Disorder. Our program, How to Improve Your Child’s Behavior, located at http://addadhdadvances.com/betterbehavior.html which is available online, or some other parent training program is still considered essential if you want to help your child.
Also, the younger your child is when you enroll in such a program, the better the results.
-Conclusion:
Advice to Parents
Currently, there is still far too little research on this very common disorder.Medically, the most important consideration is to treat other disorders that come along with ODD. Considering that Ritalin may help alleviate the problem in 75-90% of ODD children who have ADHD, and considering that most children with ODD also have some degree of ADHD, I feel that it is very worth your while to try your ODD child on Ritalin unless you know for sure that he does not have ADHD.
The other treatments may also be worth a try depending upon the nature of your child. I feel that using Omega-3 supplements and a vitamin E supplement should be tried in all children. This is because most children are deficient in these nutrients. Even if it does not help with the ODD, it should make your child healthier.
Parent training is still the most effective means of dealing with Oppositional Defiant Disorder. The two main drawbacks of most of these programs are the expense and the availability. Some practitioners charge $100 or more per visit and considering the program will take several months costs add up.
Insurance usually will not pay for such programs. Many parents complain to me that they can not afford the program that their child so desperately needs. In addition, these programs are not available everywhere. Over the years, numerous parents have told me that where they live there are no programs for Oppositional Defiant Children. I created How to Improve Your Child’s Behavior to address these two problems. It allows parents to help their children regardless of where they live and at a cost that is less than one office visit. Even though it was an experiment to try to administer such a program online and to date no one else is doing this, over the past two years How to Improve Your Child’s Behavior has proven time and again to help parents gain control of their defiant children.
Get more information on Oppositional Defiant Disorder- ODD Help at http://addadhdadvances.com/betterbehavior.html
It is tough to live with children who have ODD. However, if you make sure that your child has his other problems addressed and you improve your parenting skills by enrolling in a parent training program, you can do a great deal to improve your child’s condition and his future.
Anthony Kane, MDADD ADHD Advances http://addadhdadvances.com
About The Author: Anthony Kane, MD is a physician and international lecturer. Get help for your ADD/ADHD child, including child behavior advice, information on the latest ADHD treatment, and help with Oppositional Defiant Disorder at http://addadhdadvances.com .
What is an adjustment disorder?
What is an adjustment disorder?
An adjustment disorder is defined as an emotional or behavioral reaction to an identifiable stressful event or change in a person’s life that is considered maladaptive or somehow not an expected healthy response to the event or change. The reaction must occur within three months of the identified stressful event or change happening. The identifiable stressful event or change in the life of a child or adolescent may be a family move, parental divorce or separation, the loss of a pet, birth of a brother or sister, to name a few.
What causes adjustment disorders?
Adjustment disorders are a reaction to stress. There is not a single direct cause between the stressful event and the reaction. Children and adolescents vary in their temperament, past experiences, vulnerability, and coping skills. Their developmental stage and the capacity of their support system to meet their specific needs related to the stress are factors that may contribute to their reaction to a particular stress. Stressors also vary in duration, intensity, and effect. No evidence is available to suggest a specific biological factor that causes adjustment disorders.
Who is affected by adjustment disorders?
Adjustment disorders are quite common in children and adolescents. They occur equally in males and females. While adjustment disorders occur in all cultures, the stressors and the signs may vary based on cultural influences. Adjustment disorders occur at all ages, however, it is believed that characteristics of the disorder are different in children and adolescents than they are in adults. Differences are noted in the symptoms experienced, severity and duration of symptoms, and in the outcome. Adolescent symptoms of adjustment disorders are more behavioral such as acting out, while adults experience more depressive symptoms.
What are the symptoms of an adjustment disorder?
In all adjustment disorders, the reaction to the stressor seems to be in excess of a normal reaction, or the reaction significantly interferes with social or occupational (educational) functioning. There are six subtypes of adjustment disorder that are based on the type of the major symptoms experienced. The following are the most common symptoms of each of the subtypes of adjustment disorder. However, each child may experience symptoms differently. Symptoms may include:
adjustment disorder with depressed mood
depressed mood
tearfulness
feelings of hopelessness
adjustment disorder with anxiety
nervousness
worry
jitteriness
fear of separation from major attachment figures
adjustment disorder with anxiety and depressed mood
A combination of symptoms from both of the above subtypes (depressed mood and anxiety) is present.
adjustment disorder with disturbance of conduct
violation of the rights of others
violation of societal norms and rules (truancy, destruction of property, reckless driving, fighting)
adjustment disorder with mixed disturbance of emotions and conduct
A combination of symptoms from all of the above subtypes are present (depressed mood, anxiety, and conduct).
adjustment disorder unspecified
Reactions to stressful events that do not fit in one of the above subtypes are present. Reactions may include behaviors such as social withdrawal or inhibitions to normally expected activities (i.e., school or work).
The symptoms of adjustment disorders may resemble other medical problems or psychiatric conditions. Always consult your child’s (adolescent’s) physician for a diagnosis.
How are adjustment disorders diagnosed?
A child and adolescent psychiatrist or a qualified mental health professional usually makes the diagnosis of an adjustment disorder in children and adolescents following a comprehensive psychiatric evaluation and interview with the child or adolescent and the parents. A detailed personal history of development, life events, emotions, behaviors, and the identified stressful event is obtained during the interview.
Treatment for adjustment disorders:
Specific treatment for adjustment disorders will be determined by your child’s (adolescent’s) physician based on:
your child’s (adolescent’s) age, overall health, and medical history
extent of your child’s (adolescent’s) symptoms
subtype of the adjustment disorder
your child’s (adolescent’s) tolerance for specific medications, procedures, or therapies
expectations for the course of the stressful event
your opinion or preference
Treatment may include:
individual psychotherapy using cognitive-behavioral approaches
Cognitive-behavioral approaches are used to improve age-appropriate problem solving skills, communication skills, impulse control, anger management skills, and stress management skills.
family therapy
Family therapy is often focused on making needed changes within the family system such as improving communication skills and family interactions, as well as increasing family support among family members.
peer group therapy
Peer group therapy is often focused on developing and using social skills and interpersonal skills.
medication
While medications have very limited value in the treatment of adjustment disorders, medication may be considered on a short term basis if a specific symptom is severe and known to be responsive to medication.
Prevention of adjustment disorders:
Preventive measures to reduce the incidence of adjustment disorders in children are not known at this time. However, early detection and intervention can reduce the severity of symptoms, enhance the child’s normal growth and development, and improve the quality of life experienced by children or adolescents with adjustment disorders.
Leading Psychiatrists are calling Arthur a ‘walking miracle’-After 15 years in mental institutions, absorbing inhumane shock treatments, abusing alcohol, he’s now being called worldwide’ The Zig Ziglar of Mental Illness ‘Read about his amazing comeback and what #1 best-selling author Mike Litman has called The Most Inspirational Book of 2002′ Out of Darkness – One Man’s Journey From The Depths Of Mental Illness to Pure Joy
They are calling Arthur Buchanan’s methods of recovering from mental illness REVOLUTIONARY! (MEDICAL COLLEGE OF MICHIGAN) ‘Arthur Buchanan has given us a revolutionary blue print for recovery in these uncertain times, when Mental Illness at a all time high in the United States of America, yet if you follow this young mans methods, we assure you of positive results and I QUOTE ‘If these methods are followed precisely, their is no way you can’t see positive results with whatever illness you have’ Dr. Herbert Palos Detroit, Michigan’
Listen to Arthur Buchanan on the Mike Litman Show!
http://freesuccessaudios.com/Artlive.mp3 THIS LINK WORKS, LISTEN TODAY!
With Much Love,
Arthur Buchanan
President/CEO
Out of Darkness & Into the Light
43 Oakwood Ave. Suite 1012
Huron Ohio, 44839
www.out-of-darkness.com
567-219-0994 (cell)
What is an adjustment disorder?
What is conduct disorder (CD)?
What is conduct disorder (CD)?
Conduct disorder is a behavior disorder, sometimes diagnosed in childhood, that is characterized by antisocial behaviors which violate the rights of others and age-appropriate social standards and rules. Antisocial behaviors may include irresponsibility, delinquent behaviors (such as truancy or running away), violating the rights of others (such as theft), and/or physical aggression toward others (such as assault or rape). These behaviors sometimes occur together, however, one or several may occur without the other(s).
What causes conduct disorder?
The conditions that contribute to the development of conduct disorder are considered to be multifactorial, with many factors (multifactorial) contributing to the cause. Neuropsychological testing has shown that children and adolescents with conduct disorders seem to have an impairment in the frontal lobe of the brain that interferes with their ability to plan, avoid harm, and learn from negative experiences. Childhood temperament is considered to have a genetic basis. Children or adolescents who are considered to have a difficult temperament are more likely to develop behavior problems. Children or adolescents from disadvantaged, dysfunctional, and disorganized home environments are more likely to develop conduct disorders. Social problems and peer group rejection have been found to contribute to delinquency. Low socioeconomic status has been associated with conduct disorders. Children and adolescents exhibiting delinquent and aggressive behaviors have distinctive cognitive and psychological profiles when compared to children with other Mental Health Disorders problems and control groups. All of the possible contributing factors influence how children and adolescents interact with other people.
Who is affected by conduct disorder?
Approximately 6 percent of children ages nine to 17 years old have conduct disorders. The disorder is more common in boys than in girls. Children and adolescents with conduct disorders often have other psychiatric problems as well that may be a contributing factor to the development of the conduct disorder. The prevalence of conduct disorders has increased over recent decades. Aggressive behavior is the reason for one-third to one-half of the referrals made to child and adolescent Mental Health Disorders services.
What are the symptoms of conduct disorder?
Most symptoms seen in children with conduct disorder also occur at times in children without this disorder. However, in children with conduct disorder, these symptoms occur more frequently and interfere with learning, school adjustment, and, sometimes, with the child’s relationships with others.
The following are the most common symptoms of conduct disorder. However, each child may experience symptoms differently. The four main groups of behaviors include the following:
aggressive conduct
Aggressive conduct causes or threatens physical harm to others and may include the following:
intimidating behavior
bullying
physical fights
cruelty to others or animals
use of a weapon(s)
forcing someone into sexual activity, rape, molestation
destructive conduct
Destructive conduct may include the following:
vandalism; intentional destruction to property
arson
deceitfulness
Deceitful behavior may include the following:
lying
theft
shoplifting
delinquency
violation of rules
Violation of ordinary rules of conduct or age-appropriate norms may include the following:
truancy (failure to attend school)
running away
pranks
mischief
very early sexual activity
The symptoms of conduct disorder may resemble other medical conditions or behavioral problems. Always consult your child’s (adolescent’s) physician for a diagnosis.
How is conduct disorder diagnosed?
A child psychiatrist or a qualified mental health professional usually diagnoses conduct disorders in children and adolescents. A detailed history of the child’s behavior from parents and teachers, observations of the child’s behavior, and, sometimes, psychological testing contribute to the diagnosis. Parents who note symptoms of conduct disorder in their child or teen can help by seeking an evaluation and treatment early. Early treatment can often prevent future problems. Further, conduct disorder often coexists with other mental health disorders, including mood disorders, anxiety disorders, post-traumatic stress disorder, substance abuse, attention-deficit/hyperactivity disorder, and learning disorders, increasing the need for early diagnosis and treatment. Always consult your child’s (adolescent’s) physician for more information.
Treatment for conduct disorder:
Specific treatment for children with conduct disorders will be determined by your child’s (adolescent’s) physician based on:
your child’s (adolescent’s) age, overall health, and medical history
extent of your child’s (adolescent’s) symptoms
your child’s (adolescent’s) tolerance for specific medications, procedures, or therapies
expectations for the course of the condition
your opinion or preference
Treatment may include:
cognitive-behavioral approaches
The goal of cognitive-behavioral therapy is to improve problem solving skills, communication skills, impulse control, and anger management skills.
family therapy
Family therapy is often focused on making changes within the family system, such as improving communication skills and family interactions.
peer group therapy
Peer group therapy is often focused on developing social skills and interpersonal skills.
medication
While not considered effective in treating conduct disorder, medication may be used if other symptoms or disorders are present and responsive to medication.
Prevention of conduct disorder in childhood:
Some experts believe that a developmental sequence of experiences occurs in the development of conduct disorder. This sequence may start with ineffective parenting practices, followed by academic failure, and poor peer interactions. These experiences then often lead to depressed mood and involvement in a deviant peer group.
Other experts, however, believe that many factors, including child abuse, genetic susceptibility, history of academic failure, brain damage, and/or a traumatic experience influence the expression of conduct disorder. Early detection and intervention into negative family and social experiences may be helpful in disrupting the development of the sequence of experiences that lead to more disruptive and aggressive behaviors.
Leading Psychiatrists are calling Arthur a ‘walking miracle’-After 15 years in mental institutions, absorbing inhumane shock treatments, abusing alcohol, he’s now being called worldwide’ The Zig Ziglar of Mental Illness ‘Read about his amazing comeback and what #1 best-selling author Mike Litman has called The Most Inspirational Book of 2002′ Out of Darkness – One Man’s Journey From The Depths Of Mental Illness to Pure Joy
They are calling Arthur Buchanan’s methods of recovering from mental illness REVOLUTIONARY! (MEDICAL COLLEGE OF MICHIGAN) ‘Arthur Buchanan has given us a revolutionary blue print for recovery in these uncertain times, when Mental Illness at a all time high in the United States of America, yet if you follow this young mans methods, we assure you of positive results and I QUOTE ‘If these methods are followed precisely, their is no way you can’t see positive results with whatever illness you have’ Dr. Herbert Palos Detroit, Michigan’
Listen to Arthur Buchanan on the Mike Litman Show!
http://freesuccessaudios.com/Artlive.mp3 THIS LINK WORKS, LISTEN TODAY!
With Much Love,
Arthur Buchanan
President/CEO
Out of Darkness & Into the Light
43 Oakwood Ave. Suite 1012
Huron Ohio, 44839
www.out-of-darkness.com
567-219-0994 (cell)
What is conduct disorder (CD)?
About Severe Depression
Severe depression is different from the common depression. Common depression only effect people’s work and study, which will not endanger their life. Severe depression may bring more serious resaults.
Symptom. People who are extremely depressed and who may be thinking about hurting themselves or about suicide need help as soon as possible. When depression is this severe, it is a very real medical emergency, and an adult must be notified. Most communities have suicide hotlines where people can get guidance and support in an emergency.
Solving way.Although it’s important to be supportive, trying to cheer up a friend or reasoning with him or her probably won’t work to help depression or suicidal feelings go away. Depression can be so strong that it outweighs a person’s ability to respond to reason. Even if your friend has asked you to promise not to tell, severe depression is a situation where telling can save a life. The most important thing a depressed person can do is to get help. If you or a friend feels unsafe or out of control, and need to get help immediately, you can tell a trusted adult, call 911, or go to the emergency room.
Depression doesn’t mean a person is “crazy.” Depression (and the suffering that goes with it) is a real and recognized medical problem. Just as things can go wrong in all other organs of the body, things can go wrong in the most important organ of all: the brain. Luckily, most teens who get help for their depression go on to enjoy life and feel better about themselves.
Click to find more about Depression Relief Guide
About Severe Depression
Parenting Teenagers Teens And Depression
One minute your teenager will be laughing and joking along with you and the next he is in a fit of rage, yelling or crying with no warning or apparent cause. Mood swings are normal with all teenagers, but how do you know when mood swings turn into depression?
Teenagers have so much to deal with in today’s society that depression can come easily. If left untreated, it can become a much more serious issue. With pressure at school, family situations, and the necessity of making serious life choices at a young age, depression may make such a sudden impact even the teenager may not know that he or she is suffering with this disorder.
Depression in teenagers is often overlooked, and is rarely treated or even diagnosed. Many parents tend to view their teenager’s bad mood as just another teenage trait.
Teenage Mood Swings vs. Depression
Most teenagers suffering with depression will almost constantly be upset, not just with their parents, but also with siblings and even friends. Their grades may drop and their social life may cease suddenly and unexpectedly. Your teenager may make excuses to stay in his room and not participate in social activities, and even when forced to participate, may do so with little or no enthusiasm.
Sometimes, this disorder may actually be a chemical imbalance and uncontrollable with just words and care from the parent. Medications and therapy may be required for your teenager to regain their mental health back. Depression is such a serious disorder that can lead up to even more serious situations like school or home violence, self injury, even suicide.
What parents can do
If your teenager seems unhappy or upset for a long period of time, try to have a talk with him. Begin the conversation casually by mentioning that you can see that something is troubling him. Don’t be discouraged by your teen’s likely response that you cannot help or there’s noting you can do. Point out that sometimes just talking about a situation will help to find a solution or to see it from a different perspective.
If your teenager will not talk to you about her problems speak with her school guidance counselor. He or she might be able to give you helpful information about what is troubling your teen. The guidance counselor might also be able to help you assess if it would be beneficial to your teenager to see a professional therapist or to attend a group counseling session.
Should you decide that therapy is necessary, do not force your teen to attend any of these sessions. Instead, ask him to attend if only to see that his particular problem might not be as unique as he thinks. Your teenager might experience great relief in realizing that he is simply going through natural developmental stages and that it is normal to feel overwhelmed by the pressures of school, family and peers.
Instead of breaking under the stress and thinking he is not capable of handling his daily life, your teenager will approach obstacles more open minded and ready to discuss with you or his therapist.
Parenting Teenagers ? Teens And Depression