ODD

Question 1

Outline the onset of ODD

Answer 1

• typically before the child turns 8
• rarely diagnosed in older children/adults
• more common in males
• symptoms stable between 5 and 10 years, then slowly decline

Question 2

ODD symptoms are often identified around…. and often precede….

Answer 2

preschool age

symptoms of conduct disorder

Question 3

Broadly speaking, ODD includes…

Answer 3

a persistent pattern of angry/irritable mood, defiant behavior and vindictiveness

Question 4

Risk-based links between ODD and CD

Answer 4

ODD is a strong risk factor for development of CD in boys

ODD is not a risk factor for CD in girls

MAJORITY of kids with ODD do not go on to develop CD, despite the high rates of other comorbidities

Question 5

ODD and comorbidities?

Answer 5

92.4% of those with ODD had at least 1 other mental disorder

Impulse control disorders
Anxiety disorders
Mood disorders
Subs Use disorders

Question 6

What is the global prevalence of ODD?

Answer 6

10.2% average
(11.2 and 9.2 in boys and girls)

Question 7

Although there is big research gap on ODD is SA,

Answer 7

local rates may exceed international ones due to South Africa’s low SES, family dynamics etc

Question 8

While ODD diagnoses may help children get treatment, it can also…

Answer 8

Have harmful social consequences

• stigmatization and being outcasts (parents and children)
• harsher punishments
• assumed future criminality
• biases from teachers
• low expectations -> confirmation bias

*youths of color also tend to be diagnosed more easily with ODD than white youths

Question 9

Diagnoses of ODD and CD may perpetuate:

Answer 9

• structural racism
• poor academic achievement
• increased risk of juvenile and justice involvement
• disciplinary disparities

Question 10

Outline 3 biological etiological factors for ODD?

Answer 10

Genetics (50-62% variance)

Temperament (high persistence, low harm avoidance, negative affect)

Prenatal factors (mother smoking and mood disturbances)

Question 11

Outline the 3 environmental etiological factors for ODD?

Answer 11

• maladaptive parental behavior (long term negative emotion and environment
• adverse childhood exps (abuse, divorce etc)
• SES (lower ed, disordered family, harsher parenting)

Question 12

Outline the social etiological factors for ODD

Answer 12

• family dysfunction (low levels of cohesion, rigid structures, low adaptability)
• inconsistent parenting (low parental warmth, minimal involvement, negative reinforcement)

Question 13

Outline the psychological etiological factors for ODD

Answer 13

• Callous-unemotional behavior (lack of guilt/empathy, blunted effect)

LEADS TO:

• Emotional dysregulation, and future externalizing behavior

Question 14

What is another risk factors for ODD?

Answer 14

Having and ADHD diagnosis (affects social functioning and behavior, could predispose one to ODD)

Question 15

What are the diagnostic criteria for ODD?

Answer 15

Three main categories:
1. Angry/irritable mood
2. Argumentative/defiant behavior
3. Vindictiveness

• A pattern of one of the three lasting at least 6 months (evidenced by symptoms) exhibited in interactions with individuals OTHER than their sibling

*symptoms should not be explained by other disorder, substance use, culture or circumstance. And should cause distress to the individual or others in context

Question 16

What are the differences in diagnostic criteria or older and younger kids?

Answer 16

Younger than 5:
- behavior should occur on most days for at least 6 months

Older than 5:
- behavior should occur at least once per week for at least 6 months

Question 17

There are 3 severity levels of ODD. What are they?

Answer 17

Mild: symptoms confined to one setting

Moderate: symptoms present in at least 2 settings

Severe: symptoms are present in 3 or more setting

Question 18

Give two examples of ODD screening tools

Answer 18

• The Child Behavior Checklist
• The Behavior Assessment for Children (BASC-2)

Question 19

What are some considerations surrounding ODD treatment
(4 points)

Answer 19

• ought to be multimodal (multiple role players)
• varies depending on child’s age, heath, severity
• treatment is influenced by parent-treatment compatibility
• early intervention is NB (prevents future problems; CD and antisocial behaviors etc

Question 20

What are the 6 types of treatment for ODD?

Answer 20

• Psychosocial interventions
• Individual and family therapy
• School-based interventions
• Pharmacology (reserved for comorbidities an severe behavioral issues)
• Lifestyle and home remedies
• Problem-solving and coping skills

Question 21

Outline psychosocial interventions for ODD

Answer 21

Family intervention
- primary treatment, parents trained in child management, interventions for behavioral change

Behavioral Parent training -
- parents taught contingency plans

CBT (parents) and C-CBT
- Children taught impulse and anger control.
- Enhance communication and coping skills

Regulation-Focused Psychotherapy for Children (RFP-C)
- focuses on emotional regulation rather then externalized behaviors (like most other treatments)
- targets defense mechanisms against unpleasant feeling states

Question 22

What are some of the factors that complicate ODD diagnosis?

Answer 22

• a child’s developmental period
• a child’s environmental factors

Question 23

Three of the controversies surrounding ODD are….

Answer 23

• racial bias in diagnosis
• is ODD real? Or simply a combination of comorbidities and behavioral problems
• difference between ODD and CD/ ODD as a precursor to CD? Not clear

Question 24

What are 4 South African factors that contribute to the development of ODD?

Answer 24

• harsh discipline/abuse
• family disruptions
• poverty
• delinquent peer groups