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Thursday, July 31, 2014
Bipolar Disorder (Children and Adolescents)
Handling A Child with Oppositional Defiant Disorder
I would like some information on a smoewhat new disorder called Oppositional Defiant Disorder(ODD). My daughter has been recently diagnosed with it and also has been diagnosed ADHD since age five and has been on various medications. She is now on a new drug named Abilify for helping with outbursts and anger control. She is so very defiant and disrespectful.
What next? Yes counseling. Been there done that too. Help.
Thank you for your question regarding the diagnosis and treatment of Oppositional Defiant Disorder, or ODD as it is most commonly called. ODD is a pattern of hostile, aggressive and defiant behaviors. The Diagnostic & Statistical Manual of Mental Disorders - Edition 4 (DSM-IV), which is used for making psychiatric diagnoses and is the so-called bible of the profession, lists the following 8 symptoms of ODD:
- frequent loss of temper
- arguing with adults
- refusing to comply with adults' commands
- deliberately annoying people
- blaming others for own mistakes
- easily annoyed by others
- frequently angry and resentful
- frequently spiteful
If a child has four of these symptoms for 6 months or more and these behvaiors cause problems in the child's environments (i.e., home, school or with friends) then a diagnosis is made. However, it is extremely important for a mental health professional to assess for other diagnoses that look like ODD because this will affect the type of treatment that will work (e.g., mood disorders such as depression or bipolar disorder once known as manic depression).
Regarding treatments for ODD, the most effective psychological treatment for ODD is behavioral modification or parent training, as it is sometimes called. Another effective treatment is Collaborative Problem-Solving as described in Dr. Ross Greene's book "The Explosive Child." To find out who is able to provide these treatments in your area I would suggest contacting your local National Alliance for the Mentally Ill (NAMI) chapter, university psychology clinic, or Children's Hospital. ANother option would be to access the National Alliance for the Mentally Ill webstite below.
I hope this information is helpful to you and your child.
Best of luck.
Nicholas Lofthouse, PhD
Clinical Assistant Professor of Psychiatry
College of Medicine
The Ohio State University