Introduction
Oppositional defiant disorder (ODD) is a condition that involves persistent phases of anger, refusal to comply with adults, arguing, and spitefulness. It is experienced for a period of at least six months. Other behaviors include deliberately annoying people, touchiness, and blaming others for their misconduct. For a child to be regarded as suffering from ODD, they must exhibit four out of the eight signs and symptoms of the condition (Pardini, Frick & Moffitt, 2010). Despite their behavior, children suffering from oppositional defiant disorder are not always violent. In addition, they do not destroy property or engage in theft.
The criteria for ODD are more evenly distributed between emotions and behavior than other impulsive control disorders. The condition leads to extensive impairment in academic, social, and occupational functioning (Matthys & Lochman, 2010). Oppositional defiant disorder is manifested by patterns of extreme stubbornness, desire for revenge, and confrontation.
History of Oppositional Defiant Disorder
The condition was initially described in the Manual of Mental Disorders in 1980 under DSM-iii (Aebi et al., 2010). The 1987 publication of the DSM changed OD to the current ODD. The term became the official name for defiant, argumentative, and rule breaking children. In addition, psychiatrists started viewing it as a medical condition which required precise treatment. Clinical experts noted the first symptoms often appeared during preschool age.
It was rare for them to manifest in adolescence stage. Since then, numerous field trials to describe the state have been conducted on male subjects. Most clinical experts argued on whether the diagnostic criteria employed with boys could be of significant to females (Matthys & Lochman, 2010). In addition, some clinicians questioned the need for use of gender-specific criteria and threshold.
Parents with a stubborn child were advised not to consider themselves as being overly indulgent or poor in parenting and controlling their kids behavior. The reason behind this is because the misconduct could be as a result of suffering from a medical disorder. Through various tests, it was discovered a majority of children who suffered from Oppositional Defiant Disorder at a very minor age would later be diagnosed with other conditions (Heflinger & Humphreys, 2008). They include Attention-deficit/ hyperactivity disorder (ADHD), anxiety, or depression.
Over time, coexisting conditions have been discovered to be common in children suffering from oppositional defiant disorder. However, psychiatrics do not exactly describe the degree and temperament of their coexistence. In addition, it is estimated one third of children who suffer from ODD later develop conduct disorder. In adulthood, 40% of them tend to experience antisocial personality disorder (Comer, 2014). Since its discovery in 1980, it has been reported that males are more likely to suffer from ODD compared to females.
Causes of Oppositional Defiant Behavior
The precise cause of oppositional defiant disorder is not well known. However, researchers believe the condition is caused by a combination of genetic, environmental, and genetic factors.
Genetic Factors
Numerous research findings indicate parents can pass on a number of mental disorders to their children. The conditions later manifest themselves in various ways such as through hyperactivity. They are also displayed by inattention and patterns of oppositional and conduct issues. Adoption and twin research reveal an estimated 50% of antisocial problem causes are linked to biological factors (Pardini et al., 2010). Cases of oppositional defiant disorder are often experienced in families with a history of ADHD, mood problems, and substance abuse. As a result, children from such family units are likely to suffer from ODD.
Neurobiological Factors
They are other aspects behind this condition. The elements involve injuries to the brain. Such developments are associated with a number of behavioral disorders, especially among they young. Findings from Neuroimaging studies reveal persons suffering from ODD may have slight variations in the brain area which influences impulse control, decision making, and reasoning. In addition, children with the condition are believed to have both overactive behavioral activation system (BAS) and underactive behavioral system (Fields, 2012). BAS motivates certain deeds due to lack of punishment. On its part, BIS influences anxiety.
Environmental Factors
Inconsistent discipline practices have been known to cause antisocial behavior. As a result, insecure parent and child relations have been linked to oppositional defiant disorder. In addition, researchers believe unsteadiness in the family unit can also influence the condition. Factors which lead to poor parenting and monitoring include low socio-economic status (Hamilton & Armando, 2008). As a result, children from such backgrounds patterns of persistent aggression and antisocial behaviors at a very young age.
Treatment of Oppositional Defiant Behavior
There are various treatment options for this condition. The interventions are aimed at children and their parents. In most cases, a combination of medications and other interventions is used. The treatment measures include
Parental Training
A mental health expert trained to deal with ODD can be consulted to help the parent develop proper parenting skills. Researchers stress they should be more positive and less frustrating to both the parent and the child. In addition, the child suffering from ODD can also take part in the training (Fields, 2012). The reason behind this is so as to enable family develop shared procedures on appropriate how to deal with misconduct problems.
Individual and Family Therapy
Counseling is another intervention used to treat the disorder. It helps the child in anger management and self-expression. Family psychotherapy improves parent-child relation (Aebi et al., 2010). Through this, better communication is developed. Various techniques can be employed to help manage the behavior. They include denying the child some privileges, for example, access to electronic games every time he or she fails to control high temper. In addition, the parent can reduce punishment in instances where the child manages regain calmness after initiating an argument.
Training in Cognitive Problem Solving
The therapy is conducted with the main purpose being to help the ODD child identify and change thinking patterns responsible for misconduct. In this procedure, both the parent and kid are required to work closely together (Comer, 2014). The reason behind this is so as to formulate better solutions which are beneficial to all of them. Parents are also advised to reward positive behavior. Praise enables the child to continue acting in a good manner.
Benefits of Treatment
The treatment procedures have various positive impacts on the clients. It is beneficial to the child and the parent. The child learns how to control his or her thinking and manage anger. In addition, interaction with peers improves significantly (Pardini et al., 2010). The parents are helped to develop better ways of reinforcing good behavior. They also adopt skills which will enable them to show more love to their children. As a result, those suffering from ODD feel more protected and safe.
Prevention of Oppositional Defiant behavior
Research findings reveal programs for preschool children help reduce oppositional defiant behavior. For elementary school age group, the best prevention measure is engaging parents in management ways to control the condition (Comer, 2014). There are various plans at this level. One of them is Triple P. The measures are self-directed and help manage severe children misconduct mannerisms through various ways. They enhance the capabilities of the parents to deal with the child. Other effective school-based programs are those which focus on peer groups, bullying, and antisocial behavior.
ODD can also be prevented by early detection of unordinary behavioral patterns. Most medical experts believe results from a certain sequence of events and experiences. The first step is often poor parenting. The child then fails to comply with rules set by the seniors and engages in poor interaction with the peers. As the experiences continue, the misconducts develop into a severe problem.
Early detection and intervention of a dysfunctional family and unordinary behavior involves employing effective and consistent parenting skills (Fields, 2012). In addition, proper communication, anger management, and conflict resolution techniques are vital for preventing oppositional defiant behavior. The intervention greatly helps the child to undergo normal growth as the others. As a result, their quality of life is improved.
Children suspected to be suffering from ODD can be referred to medical professional with extensive knowledge and skill on the condition. The move helps to prevent the condition from developing to more severe stages. A physician can guide a parent multiple avenues to visit. In addition, the expert on detection on the disorder can act as the familys advocate (Matthys & Lochman, 2010). Through this, he or she can connect the child to institutions which provide educational services for ODD children and their parents.
Cross-Cultural Issues Pertaining to ODD
The worldwide predominance of Oppositional defiant and conduct disorder is presented to evaluate the major criteria employed in research to analyze the legality of psychiatric disorders across different cultures (Hamilton & Armando, 2008). Numerous studies indicate cultural backgrounds influence the interpretation of behavioral disorders.
As a result, Diagnostic Statistical Manual, Fourth Edition (DSM-IV), American Psychiatric Association (APA), and International Statistical Classification of Diseases and Related Health Problems, 10th edition (ICD-10) have implemented diagnostic procedures which can be applied across all cultures. DSV-IV stresses all ODD diagnosis should be used when the child manifests clear symptoms. It should not be applied by looking at factors within the immediate social context.
Children from ethnic minority groups and poor family backgrounds have the highest risk of suffering from Oppositional defiant disorder (Comer, 2014). The reason behind this is because they are likely to be exposed to negative environments and poor infant nutrition. In addition, they may experience inconsistent parenting patterns and stressful circumstances.
Research reveals positive environments reduce the likely hood of suffering from ODD (Heflinger & Humphreys, 2008). One longitudinal study of the condition was conducted in Puerto Rica. Findings from children living in San Juan and Bronx indicated close family attachments and strict monitoring practiced by Puerto Ricans culture resulted to reduced cases of both CD and ODD.
Prevalence rates of the condition are also affected by practices observed within different cultures. In Chinese, the people often repress rage, aggression, and strong sentiments (Aebi et al., 2010). The cultural practice can make it a challenge for parents in such setting to determine if the behavior is caused by oppositional defiant disorder. As a result, it takes more effort to control and prevent the condition. Research by Child Behavior Checklist (CBCL) on children syndromes in I6 diverse parts of the globe showed Asian countries highly internalize syndromes compared to Western (Aebi et al., 2010).
Biblical Worldview of ODD
The entire medical community believes there is no clear reason behind the cause of certain behavioral disorder. In addition the experts argue some conditions cannot be prevented or cured. Christians stress that certain chemical imbalances and disorders which people suffer from result from the sinful nature of man (Mohr, 2011). God created humans in His own image and likeness. He also told humanity they are responsible for their own actions. He further added all people are sinners and the deeds will results to various consequences.
Most Christians argue God stressed on the need to be saved and train children in the right way. From the teachings, most Christians believe the greatest answer to dealing with behavioral problems can only be found in the bible. Christians need to study the bible more critically to discover the solutions of not only ODD but other related disorders (Mohr, 2011).
The scriptures talk about people’s disobedience towards their parents (2 Timothy 3:2 New International Version). In this era, the children are similar to those suffering from oppositional defiant disorder. Despite the condition being linked to sin, some Christians believe not all bad events are of failure to abide by the scriptures (Matthys & Lochman, 2010). The reason behind this is because there are righteous persons who believed in God and still fell ill such as Job.
Generally, the main cause of oppositional disorder in Christian worldview is the sinful nature of man. The best treatment and prevention measures lie within the scriptures. The reason behind this is because the Bible is superior to any other thing in the world. God’s word is the only real source of help to humanity (Mohr, 2011). In addition, to overcome ODD and other disorders, people need to turn to God and initiate a conversation through prayers and belief in healing.
Conclusion
All children tend to be oppositional at times when growing up. However not all cases are linked to Oppositional defiant disorder. To consider the child to be suffering from the condition, there should be clear evidence of manifestation of the major symptoms. To curb manage the behavioral disorder proper measures are required. Parents and children should face the problem collaboratively.
In addition, parents should not always blame themselves. The reason behind this is because it is evident the problem can result from biological factors and not entirely poor parenting. To manage the problem more effectively in the future, various measures need to be taken. More studies focusing on the child, parent, and family as a whole needs to be conducted. People should be enlightened more about the problem. Through this, it will be possible to detect the condition early and manage it.
References
Aebi, M., Muller, U., Asherson, P., Banaschewski, T., Buitelaar, J., Ebstein, R.,…Steinhausen, H. (2010). Predictability of oppositional defiant disorder and symptom dimensions in children and adolescents with ADHD combined type. Psychological Medicine, 40(12), 2089-2100.
Comer, R. (2014). Fundamentals of abnormal psychology (7th ed.). New York: Worth Publishers.
Fields, B. (2012). Getting the balance right: The challenge of balancing praise and correction for early school years children who exhibit oppositional and defiant behavior. Australasian Journal of Early Childhood, 37(4), 24.
Hamilton, S., & Armando, J. (2008). Oppositional defiant disorder. American Family Physician, 78(7), 861-866.
Heflinger, C., & Humphreys, K. (2008). Identification and treatment of children with oppositional defiant disorder: A case study of one state’s public service system. Psychological Services, 5, 139-152.
Matthys, W., & Lochman, J. (2010). Oppositional defiant disorder and conduct disorder in childhood. Chichester, West Sussex, UK: Wiley-Blackwell.
Mohr, S. (2011). Integration of spirituality and religion in the care of patients with severe mental disorders. Religions, 2(4), 549-565.
Pardini, D., Frick, P., & Moffitt, T. (2010). Building an evidence base for DSM-5 conceptualization of oppositional defiant disorder and conduct disorder: Introduction to the special section. Journal of Abnormal Psychology, 119, 683-688.