Etiology of Oppositional Defiant Disorder

The word etiology means "to study the cause of a disease." Many researchers are studying the biochemical and genetic causes of psychological disorders. Even though the exact cause of oppositional defiant disorder is unknown, professionals believe that a combination of developmental, social, psychological and biological factors is involved.

• Opposition in action.

Definition

• Oppositional defiant disorder (ODD) is a children's psychiatric diagnosis that is usually diagnosed by the age of 8 but may also be identified during adolescence. It is defined by angry and hostile behaviors that exceed typical misbehavior and that are more serious than rebellious developmental stages. ODD behaviors must last for at least six months and occur more frequently than expected in children at the same age and developmental stage.

Symptoms

• The symptoms of ODD include arguing with adults or other authority figures, anger, and active defiance of requests and rules. Children with ODD are often easily upset, resentful, spiteful and vindictive. They frequently blame others for their mistakes. Their behavior is so persistent and difficult that it causes dissension in the family, affects the children's ability to maintain friendships, and spreads to school where they begin to argue with teachers and resort to physical aggression.

Developmental Causes

• The developmental theory suggests that children with ODD did not successfully complete the emotional and psychological milestones of development. As they get older and are faced with more difficult expectations, their coping mechanisms may be at the level of a two year old.

Biological Causes

• The search for biological causes has gained momentum in recent years. In 2007 the American Academy of Child and Adolescent Psychiatrists (AACAP) reported that "methodologically sound controlled clinical trials are lacking." But by April 2008 a study published in BMC Psychiatry found an association between chemicals in the brain and ODD as well as a genetic link. Researchers from the University of Southern California published their study in the February 2009 issue of the Journal of Abnormal Child Psychology, stating that they found genetic influences strong enough to justify further research.

Psychological Causes

• Information provided by AACAP states that brain imaging studies have shown "subtle differences in the part of the brain responsible for reasoning, judgment and impulse control." Psychological studies have shown that children with ODD have trouble identifying social cues from peers, and this causes them to misinterpret interactions. They often see hostile intent where none exists. The child's inherent temperament may play a role as it defines the ability to manage stressors such as socialization.

Environmental Causes

• Information from the University of Virginia Health System states that negative behaviors may be learned, reflecting the child's environment. AACAP agrees, stating that "lack of structure or parental supervision, inconsistent discipline practices, and exposure to abuse or community violence have also been identified as factors which may contribute to the development of ODD."

Treatment

• Treatment for ODD focuses on therapy and training. Medications may be used to treat an underlying condition such as ADHD or to help with symptoms such as aggression and anxiety, but medications are not the primary treatment. Different types of therapy that are effective include parent training, individual and family therapy, cognitive behavioral therapy, and social skills training. Successful treatment relies on parents, caretakers, and family members being committed to the time and effort because treatment lasts at least months and possibly years.