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Oppositional Defiant Disorder (ODD) In Children: Causes, Symptoms, Complications And Treatments

Oppositional defiant disorder (ODD) is one of the common disruptive behavioural disorders in children that involves problems related to the self-control of behaviours and emotions. Other similar childhood behavioural disorders include attention deficit hyperactivity disorder (ADHD), intermittent explosive disorder (IED) and conduct disorder (CD).

Children who have ODD are often aggressive and uncooperative towards their parents, peers or any authority figures and often cause them challenges due to their behaviours. They are often labelled as problematic children and judged that may negatively impact their growth and development. The findings related to gender differences in ODD is inconsistent. [1]

In this article, we will discuss details about oppositional defiant disorder and its causes, symptoms, treatments and other details. Take a look.


Causes Of Oppositional Defiant Disorder

The exact cause of ODD is still unknown, however, there are many genetic, psychosocial and environmental factors that may lead to the development of aggressive behaviours in children.

When children face hard times in learning from people with whom they are emotionally attached (such as parents), behavioural issues start developing in them. The negative behaviours and approaches of parents are mirrored by children, which then become the characteristics of children behaviour, resulting in ODD.

However, children with loving parents can also develop ODD which is why, its exact causes are still not established.

1. Genetics

Studies say that the heritability of ODD is around 50-61 per cent. The ODD gene received from parents can cause problems in the regulation of serotonin and dopamine in children and may initiate in them aggressive symptoms. It includes factors like: [2]

  • Parent with ADHD, ODD, bipolar disorders and other mental health conditions.
  • Parents with drinking or substance use habits.
  • Maternal smoking during pregnancy or exposure to toxins.
  • Poor nutrition.
  • Imbalance in chemicals of the brain.
  • 2. Environmental factors

    It includes negative parenting behaviours like harsh punishments, maltreatment from the elderly, inconsistent discipline and peer rejection. These factors are positively associated with ODD among children. The severity of ODD may increase if these environmental factors are supported by genetic factors. [3]

    3. Psychosocial Factors

    It includes factors like maltreatment and necklaces, single parenthood, low social class, disharmony in the family, poverty, poor discipline, neighbourhood and untrustworthy relationships. [4] Good parenting and trust in relationships can decrease the severity of this factor to a great extent.

    Symptoms Of Oppositional Defiant Disorder

    Some of the behaviours noticed in children with ODD include:

    • Persistent angry or irritable mood.
    • Argumentative behaviour, often with parents.
    • Vindictive towards others.
    • Impulsive behaviour.
    • Poor tolerance
    • High emotional reactivity.
    • Easily annoyable.
    • High temper problems.
    • Not obeying elders.
    • Blaming others for their own mistakes.
    • Negativity in their mind.
    • Verbal aggression.
    • Note: These symptoms are often persistent in children with ODD and lasts for at least six months.


Risk Factors For Oppositional Defiant Disorder

Children with ODD are often diagnosed with pre-existing mental health conditions like:

  • Attention deficit hyperactivity disorder (ADHD)
  • Conduct disorder (CD)
  • Anxiety and depression
  • Learning disorders
  • Other cognitive and developmental disabilities.
  • The aforementioned factors can increase the risk of ODD in children. Also, the age of onset, current disorder, duration of symptoms, place, events, situations, childhood trauma also helps determine the severity of ODD due to these risk factors.

    Complications Of Oppositional Defiant Disorder

    According to a study, ODD in boys is linked to an increased risk of conduct disorder, while in girls, ODD often lead to a continuation of ODD, anxiety and depression. [5]

    Other complications of ODD in both boys and girls include:

    • Antisocial behaviour
    • Drug abuse
    • Poor performance, both at school and work.
    • Suicidal thoughts

Diagnosis Of Oppositional Defiant Disorder

According to the American Academy of Child and Adolescent Psychiatry, medical experts should interview the child and his/her caregiver, parents or teachers to understand the behaviour of the child and categorise them for proper diagnosis. [6]

Also, ODD is not easily diagnosable as its symptoms may coincide with other mental health conditions, therefore, open communication among parents and the child should be elaborately carried out to justify the symptoms for proper diagnosis and receive the correct treatment.

Treatments Of Oppositional Defiant Disorder

Treatment methods for ODD often include ways to reduce the frequency or intensity of ODD in children. Some of the treatment methods for ODD include:

  • Parent-management training: This includes educating the parents on how to positively manage their child's aggressive nature and teach them discipline and positive interactions.
  • Family therapy: It includes making changes in the entire family to support their child with ODD and make improvements in their interactions and communication skill.
  • School-based interventions: It includes creating a positive environment at school such as by removing the stigma related to mental health and proper cooperation by teachers in the classroom. [7]
  • Medications: To treat the underlying anxiety, depression and ADHD.

Is Oppositional Defiant Disorder Preventive?

Medical experts say that early diagnosis, school interventions and individual therapy can help prevent ODD in children. Head Start programs in school such as resolving conflict and management of anger can help prevent ODD to a great extent later in life.

Also, social skills training, talk therapy, building peer relationships and vocational therapy can help adolescents and children. Not to forget, parent management training is also an essential part of managing and preventing ODD in children.

To Conclude

The severity of ODD differs from child to child. Though it is mainly noticed in school-going children as the symptoms start occurring at this age, adolescents and adults can also have the condition.

Being a parent, the best way to deal with ODD in their child is to first accept the condition and then consult a medical expert to understand how to deal with it in a positive way, and not in a punishable way.

Is it impossible to treat the oppositional defiant disorder (ODD)?

Experts say that this statement is not entirely true. Though genetics play a vital part in determining the ODD in children, it can be reduced by 60 per cent by good parenting, peer support and school-based interventions. Also, if the condition is early diagnosed and treated well at an early age, the risk may reduce to even lower.

Is ODD a result of bad parenting?

Bad parenting is one of the strong risk factors for the oppositional defiant disorder (ODD), however, alone, it may not increase the risk of the condition. When bad parenting is combined with other factors like genetics, environmental and psychosocial, the risk of oppositional defiant disorder may get double.

Is oppositional defiant disorder and conduct disorder the same?

Though both ODD and CD falls under destructive behavioural disorders in children, they are not the same. While ODD is mostly identified in children, the CD is highly prevalent in adults. Also, ODD does not involve physical or violent harm to others, while CD may include sexual violence and animal hurting.

Story first published: Tuesday, September 21, 2021, 8:30 [IST]