Oppositional Defiant Disorder Health Article

Diagnosis

While psychological testing may be needed, the doctor must examine and talk with the child, talk with the parents, and review the medical history. Oppositional defiant disorder rarely travels alone. Children with attention/deficit hyperactive disorder will also have oppositional defiant disorder 50% of the time. Children with depression/anxiety will have oppositional defiant disorder 10–29% of the time. Because all of the features of this disorder are usually present in conduct disorder, oppositional defiant disorder is not diagnosed if the criteria are met for conduct disorder.

A diagnosis of oppositional defiant disorder should be considered only if the behaviors occur more frequently and have more serious consequences than is typically observed in other children of a similar developmental stage. Further, the behavior must lead to significant impairment in social, school, or work functioning.

Treatment

Treatment of oppositional defiant disorder usually consists of group, individual and/or family therapy, and education. Of these, individual therapy is the most common. Therapy can provide a consistent daily schedule, support, consistent rules, discipline, and limits. It can also help train patients to get along with others and modify behaviors. Therapy can occur in residential, day treatment, or medical settings. Additionally, having a healthy role model as an example is important for the patient.

Parent management training focuses on teaching the parents specific and more effective techniques for handling the child's opposition and defiance. Research has shown that parent management training is more effective than family therapy.

Whether involved in therapy or working on this disorder at home, the patient must work with his or her parents' guidance to make the fullest possible recovery. According to the New York Hospital/Cornell Medical Center, the patients must:

• use self timeouts
• identify what increases anxiety
• talk about feelings instead of acting on them
• find and use ways to calm themselves
• frequently remind themselves of their goals
• get involved in tasks and physical activities that provide a healthy outlet for energy
• learn how to talk with others
• develop a predictable, consistent, daily schedule of activity
• develop ways to obtain pleasure and feel good
• learn how to get along with other people
• find ways to limit stimulation
• learn to admit mistakes in a matter-of-fact way

Stimulant medication is used only when oppositional defiant disorder coexists with attention deficit/hyperactivity disorder. Currently no research is currently available on the use of other psychiatric medications in the treatment of oppositional defiant disorder.