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ODD (Oppositional Defiant Disorder)


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  #1  
September 15th, 2010, 05:47 PM
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Oppositional defiant disorder (ODD): Symptoms - MayoClinic.com

Those are the symptoms as described by mayoclinic. Do you this this disorder is a crock of **** (aka: these kids are just big brats) or would you say this is something real that needs medication or other sorts of treatment?
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  #2  
September 15th, 2010, 05:51 PM
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It's way beyond big brats. One of the major problems with ODD is that the children often struggle with lack of empathy. This disorder transfers to a Conduct Disorder diagnosis up to half the time, and can then translate into psycopathy, Antisocial Personality, and others.

Behavior is one thing. Intention is another. Acting out due to trauma, abuse or general neglect and lack of education about emotions makes sense. Acting out purely "because I felt like it", causing mayhem for fun and having no emotional tie to the harm it causes is much more intense and problematic.
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  #4  
September 15th, 2010, 05:52 PM
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This "disorder" could describe almost every child at some point. I could definitely see this get out of hand and kids going on medication for this rather than just learning how to behave.
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  #6  
September 15th, 2010, 05:57 PM
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Quote:
Originally Posted by Lash View Post
It's way beyond big brats. One of the major problems with ODD is that the children often struggle with lack of empathy. This disorder transfers to a Conduct Disorder diagnosis up to half the time, and can then translate into psycopathy, Antisocial Personality, and others.

Behavior is one thing. Intention is another. Acting out due to trauma, abuse or general neglect and lack of education about emotions makes sense. Acting out purely "because I felt like it", causing mayhem for fun and having no emotional tie to the harm it causes is much more intense and problematic.

I definitely think that there are special situations where this "could" be a true disorder. I can also see parents jumping to conclusions and having their children go on meds when its not necessary. Perfect example is ADD/ADHD. Parent's are quick to say their kid has ADD/ADHD if their child acts up in any way.
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  #7  
September 15th, 2010, 05:57 PM
Lash's Avatar Platinum Supermommy
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You can't really medicate ODD. It's not a disorder that really responds to medication. It can be used, especially when the child also has ADHD or Bipolar, but often the medication is treating THAT disorder, and not ODD.

You can attempt antipsychotics and mood stabilizers, but often this disorder is not hindered drastically by medication- when ODD is NOT comorbid, the chance of medication working is under 15%.

ODD diagnosis are not handed down lightly. This is not your typical ADHD type diagnosis that most people believe is given to every child on the planet at some point or another. ODD is in a much more sensitive classification of child disorders and is treated as such.
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  #8  
September 15th, 2010, 05:59 PM
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Quote:
Originally Posted by Lash View Post
You can't really medicate ODD. It's not a disorder that really responds to medication. It can be used, especially when the child also has ADHD or Bipolar, but often the medication is treating THAT disorder, and not ODD.

You can attempt antipsychotics and mood stabilizers, but often this disorder is not hindered drastically by medication- when ODD is NOT comorbid, the chance of medication working is under 15%.

Ok, I misunderstood, I figured it was like ADD with something like Ridlin.

Quote:
Originally Posted by Lash View Post

ODD diagnosis are not handed down lightly. This is not your typical ADHD type diagnosis that most people believe is given to every child on the planet at some point or another. ODD is in a much more sensitive classification of child disorders and is treated as such.

If that is the case, then that is great.
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  #9  
September 15th, 2010, 06:00 PM
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The symptoms (at least how they were described in that link) remind me of DH, lol. They just seem really general and vague like they could fit most kids at some point. Lash, I liked your post though, I didn't think about intent and how that plays a major role in this disorder. I just chalked it up to kids being brats and parents wanting to slap a name on it.
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  #10  
September 15th, 2010, 06:02 PM
Lash's Avatar Platinum Supermommy
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Quote:
Originally Posted by RTMOM View Post
I definitely think that there are special situations where this "could" be a true disorder. I can also see parents jumping to conclusions and having their children go on meds when its not necessary. Perfect example is ADD/ADHD. Parent's are quick to say their kid has ADD/ADHD if their child acts up in any way.
Parents can say all they want. They can diagnose all they want through google. I can't imagine very many docs or psychiatrists on the planet that will hand meds to this child easily. A child with ODD will be on a much much heavier medication than ADHD meds. We're talking classes like atypical antipsychotics, Lithium, Depakote, Methylphenidate. These meds require intense observation, constant blood levels, and hypervigilance as to how the medications can interact with the child.

This is not some money making scheme for the docs. These cases are not easy for anyone. I'll compare it to a med doctor: These cases are more like treating an aggressive cancer than the common cold. It's not as easy as "here's an antibiotic, call us in a few days if it doesn't work" like a cold. This is a case of intense testing, scrutiny, heavy doses of medications, long term treatment

Just like with Personality Disorders in Adults, ODD is more of a way of viewing the world than an imbalance in hormones like we see in Axis 1 disorders like Anxiety and Depression. We're talking problems with the way the brain formed in utero

Quote:
Conduct disorder and ADHD have both been associated with psychopathy; which may be explained by disruption to dorsolateral prefrontal cortex. This area is associated with executive function, which is affected in all three disorders
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  #11  
September 15th, 2010, 06:10 PM
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Quote:
A comprehensive evaluation of the child should ideally include interviews with the child and parents, a full social and medical history, review of educational records, a cognitive evaluation, and a psychiatric exam.

One or more clinical inventories or scales may be used to assess the child for Conduct disorder or Oppositional Defiant Disorder including the Youth Self-Report, the Overt Aggression Scale (OAS), Behavioral Assessment System for Children (BASC), Child Behavior Checklist (CBCL), the Nisonger Child Behavior Rating Form (N-CBRF), Clinical Global Impressions scale (CGI), and Diagnostic Interview Schedule for Children (DISC). The tests are verbal and/or written and are administered in both hospital and outpatient settings.

Follow-up studies of conduct-disordered children have shown a high incidence of antisocial personality disorder, affective illnesses, and chronic criminal behavior in adulthood. However, proper treatment of coexisting disorders, early identification and intervention, and long-term support may improve the outlook significantly.
No Doc wants to see this disorder walking in their door.
Quote:
Throughout all ages, medication may be a useful component of treatment to help address specific symptoms or to treat co-existing conditions (e.g., depression, ADHD, or anxiety disorders), although there is no single medication which specifically treats ODD. There is also limited research data on the safety and efficacy of medications in the treatment of ODD.
Brain makeup of ODD
Quote:
Brain imaging studies have also suggested that children with ODD may have subtle differences in the part of the brain responsible for reasoning, judgment and impulse control. Psychological studies have also demonstrated that children who display aggressive behavior have trouble accurately identifying and interpreting social cues from peers. Specifically, aggressive children tend to see hostile intent in neutral situations. They also generate fewer solutions to problems and expect to be rewarded for their aggressive responses
If you think a bratty spoiled child is the same as a child with ODD, then I urge you to go spend time in a Juvenile Detention Center or Psych hospital. These children are dumped in our hospitals in record numbers because parents "are at our wits ends". They rotate in and out of our doors merely so parents can have a few days of respite.

I recently worked with an adult full blown Sociopath. Working with the military provides the advantage of treating a disorder I might not ever otherwise treat, unless I worked in forensic psychology. The military is chock full of fantastic wonderful healthy people, but the environment also often attracts some sick people as well, including those that want to use the excuse of war and "patriotism" to inflict harm, torture others and exert power.

If you ever possibly think that ODD, Conduct Disorder and the other disorders like Sociopath or Psychopath do not exist, I urge you to spend 10 mins in one of these rooms with one of these patients. I'd make a believer out of you yet.
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  #12  
September 15th, 2010, 06:15 PM
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Lash, this is why you should be the host.



I have never heard of this disorder before, thanks for the information.
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  #13  
September 15th, 2010, 06:24 PM
KrazE's Avatar ShutTheFrontDoor
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AKA Teenagers?

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  #14  
September 15th, 2010, 06:30 PM
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Quote:
Originally Posted by KrazE View Post
AKA Teenagers?

Who can kill and have no shred of sorrow or empathy. THOSE kinds of Teenagers. Children of the Corn kind of teenagers.

ODD is "more mild" than any of the other diagnoses, but it's not to be taken lightly either. It can be caused by situational and environmental factors like growing up in poverty, surrounded by gangs and violence. In our culture and society, joining a game to beat up others, steal money to get by and creating and participating in a subculture of fear is abnormal and judged. But children join these groups to survive all the time. Those children typically will also grow out of that behavior if put into a new environment, given some kind of social and emotional support and offered a chance at life. Half the time though, ODD doesn't work that way. It doesn't change no matter the intervention.

Diagnosis goes far beyond a set of symptoms. Behavior always has intention. Intention to numb myself from other humans because everyone I know leaves, gets shot or goes to jail is much different from lack of empathy and inability to connect to others. Believing cops are bad because your neighborhood is riddled with racial violence and divide is much different from hating all authority "just cuz"

Understanding intention is KEY to understanding psychology and therapy.
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  #15  
September 15th, 2010, 06:52 PM
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I have heard of this before but I just chalked it up to parents not wanting to deal with their kids. After reading what Lash posted, it has changed my mind. Very well said Lash, kudos.
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  #16  
September 15th, 2010, 06:59 PM
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I usually just lurk here these days, but I did want to comment on this thread. If you ever see a child with ODD (a REAL case of ODD), there would be no confusing him/her with a "bratty child." My first run in with ODD was in a 3rd grade child. I have to say (not trying to be mean or insensitive), that child was scary. You looked in his eyes and there was nothing. He had ZERO conscience or awareness of consequences. That sad part was that at the time, this was a rarely diagnosed disorder in a small rural community, so this child was in a regular classroom without even an aide! We had to keep our eyes on him ALL THE TIME! The second you turned around, he would be out to seriously harm one of the other students.

Last year the other 4th grade teachers in my school (different school) were beside themselves with a student who had a ODD diagnosis. He was in my class. I completely blame our (now fired) worthless head of Learning Support for the misdiagnosis. This child did not have ODD... wasn't even close! I cringe to see those letters tossed around a LS room, because true ODD children are scary individuals and should be the focus of any extra help available. That's just my two cents!
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Last edited by *Jaime*; September 15th, 2010 at 07:01 PM.
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  #17  
September 15th, 2010, 07:29 PM
Lash's Avatar Platinum Supermommy
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Quote:
Originally Posted by *Jaime* View Post
I usually just lurk here these days, but I did want to comment on this thread. If you ever see a child with ODD (a REAL case of ODD), there would be no confusing him/her with a "bratty child." My first run in with ODD was in a 3rd grade child. I have to say (not trying to be mean or insensitive), that child was scary. You looked in his eyes and there was nothing. He had ZERO conscience or awareness of consequences. That sad part was that at the time, this was a rarely diagnosed disorder in a small rural community, so this child was in a regular classroom without even an aide! We had to keep our eyes on him ALL THE TIME! The second you turned around, he would be out to seriously harm one of the other students.

Last year the other 4th grade teachers in my school (different school) were beside themselves with a student who had a ODD diagnosis. He was in my class. I completely blame our (now fired) worthless head of Learning Support for the misdiagnosis. This child did not have ODD... wasn't even close! I cringe to see those letters tossed around a LS room, because true ODD children are scary individuals and should be the focus of any extra help available. That's just my two cents!

Great post. I've seen that "empty look" and you can't put that in a diagnostic manual, because it's so intangible, but you know it when you see it!!
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  #18  
September 15th, 2010, 07:47 PM
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I had no idea this even existed. Thanks for the lesson.
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  #19  
September 15th, 2010, 08:29 PM
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I just wanted to add my limited 2 cents too. I spent my pre kiddo career working with dual diagnosed developmentally disabled adults starting many many years ago in a locked behavioral unit in an institutional setting. I also have seen the blank stare and even after many years of working there could still send a chill up my spine.

I did have limited experience with children, mainly coverage when another director had a vacation or needed a break/time off, in community based settings, after the push for de-institutionalization happened in MA back in the mid 90's
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  #20  
September 16th, 2010, 12:10 AM
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I was going to say this sounds a lot like Tony's son, but Lash's explanation made me see how he isn't anywhere near that bad. He is bad though, good kid, but has some problems he hasn't fully worked out, and the next step is medication (counseling was tried before). But Tony really doesn't want him on meds, but ay yi yi, I love the kid but sometimes he really is very hard to handle
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