Oppositional Defiant Disorder (Child Health Nursing-2).pptx

1. ODD
(Oppositional Defiant Disorder)

2. Definition
• It is defined as a recurrent pattern of
negativistic, defiant, disobedient, and
hostile behavior towards authority figures.

3. • Oppositional and negativistic behavior, in
moderation, is developmentally normal in
early childhood and adolescence.
• ODD can begin as early as 3 years of
age, it typically is noted by 8 years of age
and usually not later than early
adolescence.

4. Co-morbidities
• Any of the following may be present:
 ADHD
 Learning disabilities
 Substance abuse
 PTSD
 Anxiety disorders
 Depression
 Psychosis

5. Etiology
• Genetics
• Psychological factors: neglect, abuse, poor
parenting, and exposure to violence
• Environmental factors: poverty, high-crime
neighborhood, high-employment

6. Clinical features
Some typical behaviors of child with ODD are:
• Easily irritated or annoyed.
• Frequent temper tantrums
• Argue frequently with adults
• Refuse to obey rules
• Low self-esteem
• Low frustration threshold
• Tries to annoy others
• Resentful
• Blaming others for their own mistakes and misbehavior

7. • Symptoms often start at home, sometimes
extending outside.
• Most visible with familiar adults/peers, not
always seen in clinic.
• Child may justify behavior as a reaction to
perceived unfairness.

8. Course and prognosis
• Depends on symptom severity and child’s ability to
adapt to authority.
• About 25% no longer meet criteria over time.
• Persistent symptoms increase risk of mood, conduct,
or substance use disorders.
• Better outcomes in intact, supportive families who
adjust demands and reduce attention to
argumentative behavior.
• Prognosis also influenced by family functioning and
presence of co-morbid conditions.

9. Diagnosis

10. Assessment tools available to assist
the clinician in identifying ODD
• The Child Behaviour Checklist
• Conners Child Behaviour Checklist
• The Behaviour Assessment for Children (BASC - 2)
• Strength and Difficulties Questionnaire (SDQ)
• The Child and Adolescent Psychiatric Assessment
• The Development and Well-Being Assessment
(DAWBA)
• The Disruptive Behaviour Diagnostic Observation
Schedule

11. Management
 Treatment of oppositional defiant
disorder is multimodal and should involve
the patient, family, school, and community.
 Identifying and treating comorbidities (like
ADHD, depression, and anxiety) and
modifiable risk factors (such as bullying
and learning difficulties) should be done

12. Treatment modalities include
• Cognitive behavioral therapy (CBT)
• Parent Management Training (PMT)
• Parent child interaction therapy (PCIT)
• Individual and family therapy
• Problem solving training
• Peer group therapy
• pharmacotherapy

13. THANK YOU