Oppositional Oppositional Defiant Defiant

Disorder Disorder (ODD)(ODD)

Dabney ByrdDabney ByrdAnna KimballAnna Kimball

University of North FloridaUniversity of North FloridaJune 4, 2005 June 4, 2005

OccupationalOccupational Defiant Disorder (ODD)… Defiant Disorder (ODD)…

According to the DSM-IV-TR, children According to the DSM-IV-TR, children with occupational defiant disorder with occupational defiant disorder display an age-inappropriate pattern of display an age-inappropriate pattern of stubborn hostile, and defiant behaviors stubborn hostile, and defiant behaviors that is persistent and might be exhibited that is persistent and might be exhibited as early as preschool or kindergarten. as early as preschool or kindergarten.

At least four percent ofAt least four percent of children and adolescence children and adolescence are diagnosed with ODD.are diagnosed with ODD.

History of ODDHistory of ODD

Relatively new disorderRelatively new disorder First confirmed as a psychiatric First confirmed as a psychiatric

disorder in the DSM in 1980 as disorder in the DSM in 1980 as Oppositional Disorder.Oppositional Disorder.

Was changed in the DSM-III-R in Was changed in the DSM-III-R in 1987 to Oppositional Defiant 1987 to Oppositional Defiant Disorder.Disorder.

Diagnosis of ODDDiagnosis of ODD

Doctors, psychiatrists, psychologists, Doctors, psychiatrists, psychologists, anyone who has a certified mental anyone who has a certified mental

health license, or a licensed counseling health license, or a licensed counseling social worker. social worker.

Children must meet four of the eight Children must meet four of the eight behaviors over the course of six behaviors over the course of six months in the DSM check list.months in the DSM check list.

Severity of the symptoms and the age Severity of the symptoms and the age of the client or student is an important of the client or student is an important part of the diagnostic criteria.part of the diagnostic criteria.

Diagnosis of ODD cont.Diagnosis of ODD cont.

Limitations: Internal psychiatric Limitations: Internal psychiatric dysfunction ordysfunction or

a reaction to a negative a reaction to a negative environment. environment.

Males are diagnosed at higher rates Males are diagnosed at higher rates than females.than females.

Other factors to Other factors to consider…consider…

Developmental AgeDevelopmental Age

Academic EvaluationAcademic Evaluation

Total Environment:Total Environment: FamilyFamily NeighborhoodNeighborhood Economic status Economic status

Case Study- Mental Case Study- Mental Health Health

Thirteen year old girl, frequent Thirteen year old girl, frequent suspensions from school, failing grades, suspensions from school, failing grades, using drugs, sexual experimentation, using drugs, sexual experimentation, running away from home, arguing and running away from home, arguing and cussing with parents.cussing with parents.

Mother says, “She is out of control, I am Mother says, “She is out of control, I am at my wit’s end, I do not know what to at my wit’s end, I do not know what to do?”do?”

Girl says, “I do not have a problem if they Girl says, “I do not have a problem if they (parents) would just get off my back.”(parents) would just get off my back.”

Case study- School Case study- School CounselorCounselor

Third grade student, inattentive to teacher, Third grade student, inattentive to teacher, when called upon to transition to a new task when called upon to transition to a new task would argue and eventually end in a would argue and eventually end in a screaming tantrum.screaming tantrum.

Mother says, “I have severe problems with Mother says, “I have severe problems with him at home, it has gotten to the point that I him at home, it has gotten to the point that I can no longer take him out in public.”can no longer take him out in public.”

Student says, “ He acts like that in public Student says, “ He acts like that in public because his mom buys his little brother more because his mom buys his little brother more things then she buys him. He disobeys his things then she buys him. He disobeys his teacher because he does not like her.” teacher because he does not like her.”

Suggestions for behavior Suggestions for behavior modification.modification.

Reality TherapyReality Therapy Behavior reward systemBehavior reward system Stop lightStop light Parent conferencesParent conferences Referral to a counseling agencyReferral to a counseling agency

Full Service SchoolFull Service School Behavior InterventionistBehavior Interventionist Northwestern Behavioral Counseling Northwestern Behavioral Counseling

AgencyAgency

BibliographyBibliographyErk, R. (2004). Erk, R. (2004). Counseling Treatment for Children and Counseling Treatment for Children and

Adolescents with DSM-IV-TR Disorders.Adolescents with DSM-IV-TR Disorders. Upper Saddle River, Upper Saddle River, New Jersey: Pearson Education, Inc.New Jersey: Pearson Education, Inc.

Hanna, F., Hanna, C., & Keys, S. (1999). Fifty strategies for Hanna, F., Hanna, C., & Keys, S. (1999). Fifty strategies for counseling defiant, aggressive adolescents: reaching, counseling defiant, aggressive adolescents: reaching, accepting, and relating.accepting, and relating. Journal of Counseling and Journal of Counseling and Development, 77Development, 77(4), 395-404.(4), 395-404.

Northey, W., Wells, K., Silverman, W., & Bailey, C. (2003). Northey, W., Wells, K., Silverman, W., & Bailey, C. (2003). Childhood Behavioral and Emotional disorders. Childhood Behavioral and Emotional disorders. Journal of Journal of Marital and Family Therapy, 20Marital and Family Therapy, 20(4), 523-541.(4), 523-541.

Wakefield, J., Pottick, K., & Kirk, S. (2002). Should the DSM-IV Wakefield, J., Pottick, K., & Kirk, S. (2002). Should the DSM-IV diagnostic criteria for conduct disorder social context. diagnostic criteria for conduct disorder social context. The The American journal of Psychiatry, 159American journal of Psychiatry, 159(3), 380-387.(3), 380-387.

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