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Oppositional Defiant Disorder (ODD) is characterized by a recurrent pattern of uncooperative, defiant, negative, irritating, and hostile behavior toward parents, peers, teachers, and other authority figures (1).
The DSM-5 (2) groups it under the heading Disruptive Disorders, Impulse Control, and Behavioral Disorders. Other disorders under this title are Dyssocial Conduct Disorder (CD), Intermittent Explosive Disorder (ITE), and Antisocial Personality Disorder (APD).
Although the defiant attitude is common in children, in some cases it can develop into a disorder like this. Oppositional behavior can take different forms. It may happen that the girl or boy demonstrates extreme passivity (not systematically obeying because he is passive or inactive).
On the contrary, they can also use negative verbalizations, insults, hostility or physical resistance aggressively towards authority figures, whether they are parents, teachers or educators (3).
Epidemiology
The prevalence of ODD varies depending on the nature of the population studied and the methods of assessment. Incidence rates of oppositional defiant disorder are between 2% and 16% (1). This disorder can appear from the age of 3 years onwards. However, it usually starts at 8 years of age, and it rarely starts after adolescence.
It is normal for negative symptoms to arise in the family environment. However, over time, they can also occur in other environments, such as at school, for example. This disorder affects about 2 to 16 children and adolescents in every 100, and is more common among young people from low-income families.
Possible Causes of Oppositional Defiant Disorder
Oppositional behavior may be normal and necessary in the lifecycle. It is necessary to assume an individuality and establish internal rules and controls (1). Oppositional symptoms may 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 inadequacy, incompetence, anxiety, loss of self-esteem, or tendencies to submit.
Biological-Physiological Theory
Since aggressive behavior may be related to biochemical and hormonal factors, it is believed that these may play an important role in the emergence of oppositional behavior.
learning theory
This theory claims that the negative characteristics of the disorder are attitudes that young people learn from the negative attitudes used by parents and authority figures. Some of them are punishment, yelling or even hitting children.
It is not that there are specific family patterns of parenting, but it has been found that many parents of children or adolescents with this disorder are overly interested in power and control over their children.
Furthermore, the family environment can influence the appearance of these behaviors. Stubborn siblings, depressed and controlling mothers, and passive-aggressive fathers were observed in some families. An example of the latter could be a father who ignores his children’s education, but who nevertheless criticizes any intervention by his partner.
Diagnosis of Oppositional Defiant Disorder
To diagnose this disorder, it is normal to interview parents first. In this conversation, the psychologist will be able to determine how the child or adolescent’s behavior has been throughout their life cycle.
A face-to-face conversation with the minor or teenager and an assessment from your school’s teachers will also be necessary . A complete medical history (including family, personal, pathological, and developmental history) will be asked to determine whether to see another specialist and when to refer to another level of care (1).
Treatment of Oppositional Defiant Disorder
Treatment for this disorder should be based on individual, family and group psychotherapy. Furthermore, it involves working with both the child and the parents.
individual psychotherapy
The goal of this type of therapy should be to increase the child’s ability to:
- Solving the problems.
- Put your communication skills into practice.
- Control your anger and your impulses.
family therapy
In addition to individual psychotherapy, it is essential to take into account the communication and interaction of the family in these types of disorders. Parents or guardians may need the help of a professional to develop some skills in the education of children or adolescents.
In conclusion, we can say that oppositional defiant disorder does not exclusively affect children or adolescents. It also affects family, teachers and peers. Its origin seems to be mainly psychosocial and may have to do with the education that was given to the child or adolescent. This disorder must be treated as soon as possible; otherwise, it can develop into a larger behavioral problem, such as antisocial personality disorder.
