Por Josephine Elia, MD, Nemours/A.I. duPont Hospital for Children
Avaliação/revisão completa abr 2021
Oppositional Defiant Disorder (ODD) is a recurrent pattern of negative, defiant, and disobedient behavior often directed toward authority figures. Children with oppositional defiant disorder are stubborn, difficult, disobedient, and irritable without being physically aggressive and without actually violating the rights of others. ODD is sometimes considered a milder form of conduct disorder. However, the two disorders have distinct differences. Children with conduct disorder seem to lack a conscience, and unlike children with oppositional defiant disorder, they repeatedly violate the rights of others, sometimes without any sign of irritation. Many preschoolers and early teens occasionally exhibit oppositional behaviors, but oppositional defiant disorder is diagnosed only if the behaviors persist for six months or more and are serious enough to interfere with social or academic performance.
CAUSES:
The causes are unknown. It is more likely to be more common in children from families whose adults fight loudly. This disorder indicates the presence of underlying problems that may require further investigation and treatment.
SYMPTOMS:
Symptoms usually begin between preschool and high school. Characteristic behaviors of these children include:
· Arguing with adults · Losing your temper easily and frequently · Actively defy rules and instructions · Deliberately pestering others · Blaming others for your own mistakes · Becoming angry, resentful, and easily upset
Be cruel and vindictive These children know the difference between right and wrong and feel guilty when they do something seriously objectionable. Many of them lack social skills.
DIAGNOSIS:
· Symptoms and behavior A doctor diagnoses oppositional defiant disorder based on the child's symptoms and behavior, which must have been present for at least six months and be serious enough to interfere with the child's ability to function. When oppositional defiant disorder is suspected, doctors carefully screen children for signs of depression, such as disturbed sleep or appetite, or anxiety. Depression and anxiety disorders in children can cause some of the same symptoms as oppositional defiant disorder. For example, sometimes the main symptom of depression is irritability, and extreme anxiety can cause a child with an anxiety disorder to disobey and behave rebelliously. A doctor must differentiate these disorders from oppositional defiant disorder, usually on the basis of other symptoms that the disorders cause. The clinician also needs to differentiate oppositional defiant disorder from untreated attention deficit hyperactivity disorder (ADHD), which also causes similar symptoms. These symptoms tend to lessen when ADHD is treated properly. TREATMENT: · Behavior control techniques · Possibly group therapy Problems that may be contributing to the symptoms (for example, family dysfunction or ADHD) should be treated if possible. The best treatment for oppositional defiant disorder is through behavior management techniques, which include a consistent disciplinary approach and adequate reinforcement of the desired behavior (with rewards). Parents and teachers can be instructed in these techniques by the child's counselor or therapist. Children can benefit from group therapy, which helps them improve their social skills. Sometimes drugs used to treat depressive or anxiety disorders help. Even without treatment, most children gradually get better over time.
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