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Oppositional Defiant Disorder (ODD). Age-inappropriate, stubborn, hostile, and defiant behavior, including: losing temper arguing with adults active defiance or refusal to comply deliberately annoying others blaming others for mistakes or misbehavior being “touchy” or easily annoyed

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Oppositional Defiant Disorder (ODD)

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Oppositional Defiant Disorder (ODD)

  • Age-inappropriate, stubborn, hostile, and defiant behavior, including:

    • losing temper

    • arguing with adults

    • active defiance or refusal to comply

    • deliberately annoying others

    • blaming others for mistakes or misbehavior

    • being “touchy” or easily annoyed

    • anger and resentfulness

    • spitefulness or vindictiveness


Conduct Disorder (CD)

  • A repetitive and persistent pattern of violating basic rights of others and/or age-appropriate societal norms or rules, including:

    • aggression to people and animals (e.g., bullying, threatening, fighting, using a weapon)

    • destruction of property (e.g., deliberate fire setting)

    • deceitfulness or theft (e.g., “conning” others, shoplifting, breaking into others’ property)

    • serious violations of rules (e.g., running away, truancy, staying out at night withoutpermission)


Characteristics of Conduct Disorder

  • Behavioral manifestations:

    • Aggression

    • Defiance

  • Dimensions

    • Severity

    • Frequency

    • Intensity

    • breadth


Criteria for Conduct Disorder


Costs to Society

  • Large – see overhead

    • Costs for one youth over a million dollars


Etiology/Risk Factors

  • Biological – lots of ??s

    • Correlations are not well understood

  • Psychological/Personality Factors

    • Perceived hostility

    • Accepting of aggression

    • Problem solving

    • Early temperament & learning


Etiology/Risk Factors cont’

  • Parents/Socialization

    • Lack of attention and/or inconsistency

    • Peers

    • poverty

  • Environmental/Situational Factors

    • Alcohol or drug abuse

    • Access to weapons

    • crowds


Stability of Disorder

  • Discipline problems

  • Breadth of problems

  • Predictors:

    • Age of onset

    • Breadth of deviance

    • Parent characteristics


Prevalence & Gender Differences

  • Prevalence

    • 2%-6% for CD

    • 12% for ODD

  • Gender differences

    • in childhood, antisocial behavior 3-4 times more common in boys

    • differences decrease/disappear by age 15

    • boys remain more violence-prone throughout lifespan; girls use more indirect and relational forms of aggression


Developmental Course

  • Earliest sign usually difficult temperament in infancy

  • Two Pathways

    • life-course-persistent (LCP) path begins at an early age and persists into adulthood

    • adolescent-limited (AL) path begins around puberty and ends in young adulthood (more common and less serious than LCP)

  • Often negative adult outcomes, especially for those on the LCP path


Parenting Factors

  • Coercion-escalation hypothesis

  • Why punishment does not work for families in this pattern of interaction


Causes of Conduct Problems

  • Genetic Influences

    • biologically-based traits like difficult early temperament or hyperactivity-impulsivity may predispose certain children

    • adoption and twin studies support genetic contribution, especially for overt behaviors

    • different pathways reflect the interaction between genetic and environmental risk and protective factors


Treatment

  • 3 empirically supported treatments

    • Parent management training

    • Problem solving skills training

    • Multi-systemic therapy

      Parent-child interaction therapy also promising

      Limited empirical support for wilderness programs and residential treatment


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