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“Labels” and Oppositional Defiant Disorder ODD Laurie Christensen What does your label say about you? almost 21 % of children ages 9 to 17 in the United States have a diagnosable mental or addictive disorder associated with at least minimum impairment (this chart shows 30.9%) What does your label say about you? Shaffer et al., 1996 psychiatric disorder with moderate impairment 11.5% anxiety disorders 7.2 % (up to 35% in one study) depression 4.2 % disruptive behavior disorders 6 % (ADHD was 7-16% in one study) substance use disorder 2 % Causes for disqualification from military service (2005) • Learning and attention deficit hyperactivity disorder (Eligible if individual can demonstrate passing academic performance without the use of accommodations or medications in the previous 12 months) • psychotic disorders (schizophrenia, paranoid disorder, or other unspecified psychosis) • mood disorders (major depression, bipolar disorder, or depressive disorder) • anxiety disorders (panic disorder, agoraphobia, social phobia, simple phobias, obsessive-compulsive disorder, acute reactions to stress, and posttraumatic disorder) • adjustment disorder Causes for disqualification from military service (2005) cont’d • suicidal behavior (gesture or attempts or a history of self-mutilation) • conduct or behavioral disorders • personality disorders (immaturity, instability, personality inadequacy, impulsiveness, or dependency) • dissociative disorders (hysteria and depersonalization) • somatoform disorder (hypochondriasis or chronic pain disorder) • receptive or expressive language disorder that interferes with the production of speech or ability to repeat commands • psychosexual conditions (transsexualism, exhibitionism, transvestism, voyeurism or other paraphilias) Why does it matter?? The researchers concluded that mental disorders are the most important source of medical and occupational morbidity among active-duty U.S. military personnel. A history of treatment for a mental condition depends solely on selfreport. Although recruits undergo a medical evaluation, there is no formal psychiatric assessment. To avoid labels…… It is the common practice of psychiatrists to give general labels to juveniles that are troubled. One of the most common WRITTEN diagnosis is Oppositional Defiant Disorder What is it? Oppositional defiant disorder is a pattern of : • disobedient • hostile • defiant behavior toward authority figures 3 characteristics of the child who has ODD are: Aggression defiance constant need to irritate others (any creatures like this in YOUR family?!?!?) Symptoms • • • • • • • • • Actively does not follow adults' requests Angry and resentful of others Argues with adults Blames others for own mistakes Has few or no friends or has lost friends Is in constant trouble in school Loses temper Spiteful or seeks revenge Touchy or easily annoyed (To fit this diagnosis, the pattern must last for at least 6 months and must be more than normal childhood misbehavior) Possible contributing causes: (inherited and environmental) • A child's natural disposition • Limitations or developmental delays in a child's ability to process thoughts and feelings • Lack of supervision • Inconsistent or harsh discipline • Abuse or neglect • Having a parent with a history of ADHD, oppositional defiant disorder, conduct problems or substance abuse • Lack of positive parental involvement • Having parents with a severely troubled marriage or financial problems • Family instability (divorce, multiple moves, or changing schools or child care providers frequently) Treatment • • • • Individual and family therapy manage anger express feelings more healthfully improve communication and relationships help family members learn how to work together Parent-child interaction therapy (PCIT) • therapists coach parents while they interact with their children Treatment Cognitive problem solving training • identify and change the patterns that are leading to behavior problems • work together to come up with solutions that work for both of you Social skills training • learn how to interact more positively and effectively with peers Treatment Parent training • Give effective timeouts • Avoid power struggles –Pick your battles! • Remain calm and unemotional in the face of opposition • Model the behavior you want your child to have • Set your child up for success by assigning tasks and reward a well-done job by recognizing and praising good behaviors and positive characteristics Parent Training • Offer acceptable choices (this gives a certain amount of control) • Establish a specific daily schedule and stick to a routine that involves being together • Set limits, enforce reasonable consequences (must be consistently reinforced!!) Most importantly…. • show consistent, unconditional love and acceptance of your child — even during difficult and disruptive situations • Don't be too hard on yourself • This process can be tough for even the most patient parents • Helping your child through tough times without a label can benefit them their entire life Sources • https://health.google.com/health/ref/Oppositional+d efiant+disorder • http://www.nap.edu/openbook.php?record_id=1151 1&page=136# • http://www.mayoclinic.com/health/oppositionaldefiant-disorder/DS00630/DSECTION=lifestyleand-home-remedies • http://specialed.about.com/od/behavioremotional/a/ odd.htm