Hello willry-ga!
It?s always difficult to hear these stories and not feel sorry for
those that are suffering. I hope that the information here is useful
to you and that you can share any helpful things here with your
acquaintances.
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WHAT IS OPPOSITIONAL DEFIANT DISORDER (ODD)?
ODD appears in the ?Diagnostic and Statistical Manual of Mental
Disorders? (DSM-IV), published by the American Psychiatric
Association. As a ?defined? illness, there are strict criteria for
diagnosis. Below is a list of those criteria.
?A. A pattern of negativistic, hostile, and defiant behavior lasting
at least 6 months, during which four (or more) of the following are
present:
* often loses temper
* often argues with adults
* often actively defies or refuses to comply with adults' requests or rules
* often deliberately annoys people
* often blames others for his or her mistakes or misbehavior
* is often touchy or easily annoyed by others
* is often angry and resentful
* is often spiteful or vindictive
Note: Consider a criterion met only if the behavior occurs more
frequently than is typically observed in individuals of comparable age
and developmental level.
B. The disturbance in behavior causes clinically significant
impairment in social, academic, or occupational functioning.
C. The behaviors do not occur exclusively during the course of a
Psychotic or Mood Disorder.
D. Criteria are not met for Conduct Disorder, and, if the individual
is age 18 years or older, criteria are not met for Antisocial
Personality Disorder.
Other diagnoses to consider include: Conduct Disorder; Mood Disorders;
Psychotic Disorders; Attention-Deficit/Hyperactivity Disorder; Mental
Retardation; impaired language comprehension; typical feature of
certain developmental stages.?
http://www.mentalhealth.com/dis1/p21-ch05.html
For the European criteria see the following link. In general, they are
very similar to the DSM-IV criteria, with some exceptions. The
European description includes this paragraph:
?The key distinction from other types of conduct disorder is the
absence of behaviour that violates the law and the basic rights of
others, such as theft, cruelty, bullying, assault, and
destructiveness. The definite presence of any of the above would
exclude the diagnosis. However, oppositional defiant behaviour, as
outlined in the paragraph above, is often found in other types of
conduct disorder.?
http://www.mentalhealth.com/icd/p22-ch05.html
Here is a fact sheet from the American Academy of Child and Adolescent
Psychiatry that explains features of and approaches to ODD.
http://www.aacap.org/publications/factsfam/72.htm
Here is an emedicine.com article about ODD.
http://www.emedicine.com/ped/topic2791.htm
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IS ODD REAL?
While there will always be a subset of individuals who deny the
existence of ANY mental disorder, ODD is definitely a well-documented
condition. There are many sites that list similar statistics regarding
its prevalence, and it is a well-defined condition within the DSM-IV
in the U.S.
According to the Robert Wood Johnson Foundation, ODD affects between 2
and 16 percent of all adolescents.
http://www.rwjuh.edu/health_information/adult_mentalhealth_odd.html
A similar statistic is reported here:
http://www.mountcarmelhealth.com/healthinfo/Adult/mentalhealth/odd.shtml
Here is another site with similar statistics, stating about 10% of
children under 12 are affected:
http://www.mental-health-matters.com/articles/article.php?artID=775
In the U.K, it appears that ODD affects somewhere between 10 and 15
percent of all adolescents.
http://www.ukhealthcare.uky.edu/content/content.asp?pageid=P00757
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ARE THERE CURES?
WHAT ARE THE TREATMENTS?
Children with ODD usually experience one of four eventual outcomes. They are:
(1) Grow out of it. About half of preschoolers with ODD are ?normal? by age 8.
(2) ODD becomes ?something else.? Anywhere from 5-10% of preschoolers
have their diagnosis changed to ADHD. Some develop Conduct Disorder in
addition to ODD, but this will usually happen within the first 3-4
years after initial diagnosis with ODD.
(3) ODD persists with no additional diagnosis. Only 5% of preschoolers
do not develop a second diagnosis by age 8.
(4) Other disorders are ?added? to the diagnosis of ODD. This is very common.
http://addadhdadvances.com/ODD.html
Much of the treatment of ODD focuses in on counseling, stress
management, and skills training rather than medications:
?Treatment of ODD may include: Parent Training Programs to help manage
the child's behavior, Individual Psychotherapy to develop more
effective anger management, Family Psychotherapy to improve
communication, Cognitive-Behavioral Therapy to assist problem solving
and decrease negativity, and Social Skills Training to increase
flexibility and improve frustration tolerance with peers.?
http://www.aacap.org/publications/factsfam/72.htm
There are relatively few studies on the use of medication in the
treatment of ODD. Stimulant medications (Ritalin or Strattera, for
example) have been used with modest success in children exhibiting
both ODD and ADHD. Support groups can also be a valuable tool for
parents of children with ODD.
?The central focus of therapy with oppositional defiant disorder is
usually behavioral, implemented through parent training. . . .
[Parents] learn specific behavioral techniques, which help increase
the likelihood of maintaining control in the relationship with the
child. Gradual shaping of the child's behavior toward more
age-appropriate behaviors is accomplished through the implementation
of a behavioral monitoring and reward program.?
http://mentalhelp.net/poc/view_doc.php?type=doc&id=630&cn=37
Here is the abstract of a recent study about the use of Dialectical
Behavioral Therapy (DBT) in the treatment of ODD. It looks promising.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16579964&query_hl=3&itool=pubmed_docsum
For more on DBT see:
http://www.priory.com/dbt.htm
As far as medications are concerned, according to one article:
?Stimulant medication is used only when oppositional defiant disorder
coexists with attention deficit/hyperactivity disorder. Currently, no
research is currently available on the use of other psychiatric
medications in the treatment of oppositional defiant disorder.?
All of the abstracts I have found on Pubmed indicate the same thing:
therapy and counseling are the best and nearly only treatment that
works in pure ODD.
http://www.healthatoz.com/healthatoz/Atoz/ency/oppositional_defiant_disorder.jsp
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AN ARGUMENT AGAINST MEDICINE
After considering all that I found about counseling and therapy in
treating ODD, it?s not hard to argue against the use of medications.
What is apparent is that it is quite common to have a diagnosis in
addition to ODD. If this individual is now off of, or contemplating
going off of medications, based on the above articles, I would assume
there is another diagnosis besides ODD. A very common second diagnosis
is ADHD. This is, of course, guesswork to some extent. I would need a
specific diagnosis to provide the best research possible. Here is an
article that discusses nutrition, especially protein and omega-3 fatty
acids as a means to treat ADHD:
http://www.mental-health-matters.com/articles/article.php?artID=435
Here is a child psychiatrist with thoughts on alternative treatments
for ADHD, including using computers to assist therapy:
http://www.adhdhelp.org/
This is a collection of information and links regarding the various
treatments for ADHD, medicines and otherwise:
http://www.healing-arts.org/children/ADHD/treatments.htm
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Again, I hope that there is something I?ve found that can help.
Sometimes just having more information is all it takes to calm one?s
mind or find a way to cope with a difficult situation. If you have
need of any clarification please let me know how I can help. Google
Answers is a great place to come for information, and there are a
number of excellent researchers available here. I hope your first
experience here will bring you back again sometime in the future.
Welcome!
Sincerely,
Boquinha-ga
Search strategy:
Online search
Pubmed.com search (?oppositional defiant disorder? treatment;
?oppositional defiant disorder? medication)
Search terms:
Oppositional defiant disorder
Cure oppositional defiant disorder
Treatment ?oppositional defiant disorder?
Medications ?oppositional defiant disorder?
DBT
Alternative treatment adhd |
