Is Your Child Just Disobedient or Could She Actually Have a Mental Disorder?

When a child, anywhere from toddlerhood to the teen phase, exhibits continued and frequent patterns of defiance, anger, arguing, hostility and irritability to parents or any other adults who care for them.

These may include talking back, disobedience and other forms of defiance to authority figures.

Signs and Symptoms of Oppositional Defiant Disorder

It's sometimes tricky to differentiate between a willful child going through a regular developmental stage and a child suffering from oppositional defiant disorder (ODD).

The disorder, however, usually manifests during preschool. It may also develop later but commonly does before a child hits his early teen years.

Symptoms must include at least four from the following categories to be diagnosed with ODD:

1. Angry and irritable behavior

• Is usually resentful and angry
• Is usually annoyed easily by other people or is touchy
• Has a short temper

2. Argumentative and defiant behavior

• Usually annoys others on purpose
• Frequently argues with adults
• Usually refuses to obey instructions, rules or requests from adults
• Usually faults others for his misbehaviors or missteps

3. Vindictiveness

• Has exhibited snide or hateful behavior at least two times in the last six months

Symptoms must also satisfy the following criteria:

• Behavior occurs with at least one person who is not a sibling
• Behavior disrupts home, work and school life
• Behavior is not caused by other mental health problems such as depression, another disorder, bipolar disorder or substance use disorder
• Occurs for at least six months

ODD is either: mild when symptoms manifest in one setting either at school, work, home or with friends; moderate when symptoms manifest in two settings; and severe when symptoms manifest in three or more settings.

Do note that symptoms may initially manifest in one setting, but later on may appear in others.

Causes of oppositional defiant disorder

Though the exact cause for oppositional defiant disorder is unknown, there are contributing factors linked to the development:

• Environment. A child living with a dysfunctional family and experiencing parenting problems such as abuse, neglect, inconsistent rules, rigid or severe discipline and lack of supervision.
• Biological. Brain defects or injuries can impair the functionality of neurotransmitters, which are responsible for helping nerve cells communicate.
• Genetics. Those with oppositional defiant disorder usually have family members who suffer from mental illnesses.

Risk Factors of oppositional defiant disorder

• It is more common in males
• A child who experiences neglect, abuse or lack of supervision
• A child who lives with a parent who suffers from substance use disorder or mental health. Family discords also increase the risk for oppositional defiant disorder
• A child who has problems with regulating emotions and has low tolerance for frustration

Complications 

• It may interrupt a child's daily life at home or school
• Causes low-self esteem
• A child who is easily frustrated
• Antisocial behavior
• Difficulty having and maintaining relationships
• Problems on impulse control
• Feeling of rejection because of poor social skills and behavior problems
• Poor academic performance
• Substance use disorder
• Suicide

Children with oppositional defiant disorder may also suffer from mental health problems or disorders:

• Anxiety
• Depression
• ADHD
• Learning and communication disorders
• Learning disabilities
• Conduct disorders

When to Call the Doctor

To your child, it will seem that your demands are unreasonable, especially since he won't be aware of his condition.

If you, however, believe that your child is suffering from oppositional defiant disorder and that as a parent, you find it challenging to handle the situation then reach out to a psychologist or behavioral expert.

Tests and Diagnosis of oppositional defiant disorder

A comprehensive physical and  psychological evaluation will be done.

It will include the evaluation of your child's health; presence of other mental, communication or learning disorders; frequency of your child's behavior and what settings the behaviors occur in.

Treatments and Drugs

Medications are usually prescribed when other disorders are present, especially in the case of ADHD or depression.

As for treatments, the following are given:

• Parent management training (PMT). Parents are taught more positive parenting skills to handle the situation better.
• Individual therapy. A child with oppositional defiant disorder is given tools to express and manage anger better.
• Family therapy. The goal is to equip family members with effective communication tools to improve relationships.
• Parent-child interaction therapy (PCIT). In this method, the parent and child are left to interact, while a therapist, who is behind a one-way mirror, instructs the parent on reinforcing positive behaviors through an ear piece.
• Social skills training. Here a child is taught how to socialize with peers in a more positive manner.
• Cognitive problem-solving training. A child is taught to determine triggers or thought patterns that cause behavior issues and think of solutions to reduce ODD-related issues.

Lifestyle and Home Remedies

• Praise positive behavior
• Be an example by behaving how you want your child to
• Learn to let go by picking your battles
• Be consistent with rules and reasonable consequences
• Stick to a routine for your child
• Set regular bonding activities weekly to build on positive interaction with your child
• Ensure that everyone from different settings--school or home--are also consistent with your child