Is anyone raising a teen diagnosed with oppositional defiant disorder?

[Anonymous]

Anonymous wrote:Oppositional-defiant disorder (ODD) refers to a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures.

So... all teenagers have this, then? ODD is a complicated way of saying "being a teenager"?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Remember when autism was caused by Refrigerator Moms? And then there was the schizophrenogenic mother

totally different. ODD is inherently defined by relationships to other people, and many supposedly ODD kids are fine in settings away from family or as adults when they mature (or get away from family). Autism and schizophrenia are pervasive, objective disorders that are not subjectively related to other people.

and many kids with ODD do better WITH family than away from them while at school, camp, etc.
It's not always rebellion against bad parents like you presume

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Remember when autism was caused by Refrigerator Moms? And then there was the schizophrenogenic mother

totally different. ODD is inherently defined by relationships to other people, and many supposedly ODD kids are fine in settings away from family or as adults when they mature (or get away from family). Autism and schizophrenia are pervasive, objective disorders that are not subjectively related to other people.

and many kids with ODD do better WITH family than away from them while at school, camp, etc.
It's not always rebellion against bad parents like you presume

So it's rebellion against a bad school environment. If the "disorder" is defined by how you relate to an environment, ONLY shows up in one environment, it's paramount to also look at that environment. How is that not obvious?

[Anonymous]

Anonymous wrote:ARGH. Different environments pose different challenges. In some situations or environments, the kid's lagging skills (in emotion regulation, in negotiating transitions, in shifting cognitive frameworks, etc.) become more apparent than in others. That's why "opposition" can present in some situations and not in others.

FWIW, the DSM5 discussion of ODD rates the severity of the disorder in relation to HOW MANY different environments it presents: "mild" ODD is confiened to one setting, while "severe" ODD presents in multiple settings--ie, pervasively.

Right, and I think the DSM definition is bogus. If the issue is that you have lagging skills in emotional regulation and transitions, then sounds more like an expression of ADHD. ODD is a garbage diagnosis (often). It's literally the description of a symptom, not a disorder. It may be more useful for a child who cannot comply in ANY setting and is at risk of jail or expulsion, but even then, I'll bet you $1,000,000 there is underlying trauma, abuse, or neurological issues. This is very similar to the supposed diagnosis of children as psychopaths.

My child, for example, had horrible behavior problems as a preschooler stemming from anxiety, lagging motor skills, and ADHD inattentive. Diagnosing him as ODD would have been as stupid as diagnosing someone who faints from heart disease as having Fainting Syndrome.

[Anonymous]

Anonymous wrote:What if a child is only oppositional around other adults - not parents? PP, you seem to have issues with your own parents. Don't project your family's problems onto everyone else.
I agree with those who've said it's control and anxiety based. When kids know they're loved and supported at home no matter what, their behavior is better at home. At school, where the teacher and classmates are virtual strangers, they have no assurance that they are a valued member of the community and have to work hard to fit in. That causes anxiety, ergo ODD.

If it's control and anxiety based, then DIAGNOSE ANXIETY. Not something made up like ODD.

[Anonymous]

Here's a good take from a practicing MD:

"I think ODD behaviors almost always arise from other diagnoses or social situations. Failure to consider this criterion leads to significant over diagnosis of ODD, which is too often cited as the most common co-occurring condition along side ADHD."

http://www.focus-md.com/dont-diagnose-oppositional-defiant-disorder-part-1-4/

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Remember when autism was caused by Refrigerator Moms? And then there was the schizophrenogenic mother

totally different. ODD is inherently defined by relationships to other people, and many supposedly ODD kids are fine in settings away from family or as adults when they mature (or get away from family). Autism and schizophrenia are pervasive, objective disorders that are not subjectively related to other people.

and many kids with ODD do better WITH family than away from them while at school, camp, etc.
It's not always rebellion against bad parents like you presume

So it's rebellion against a bad school environment. If the "disorder" is defined by how you relate to an environment, ONLY shows up in one environment, it's paramount to also look at that environment. How is that not obvious?

It's often rebellion against a school environment that fails to provide appropriate accomodations or special ed support for kids with autism and/or ADHD. Kids are placed in large classes with 1 teacher who has no special ed training, little patience, and pressure from admin to raise standardized test scores, and Johnny acts out. He gets labeled the "problem student", other students start to shun him, and behavior worsens to ODD level.
This is what happens when kids don't get the special ed help they need.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Remember when autism was caused by Refrigerator Moms? And then there was the schizophrenogenic mother

totally different. ODD is inherently defined by relationships to other people, and many supposedly ODD kids are fine in settings away from family or as adults when they mature (or get away from family). Autism and schizophrenia are pervasive, objective disorders that are not subjectively related to other people.

and many kids with ODD do better WITH family than away from them while at school, camp, etc.
It's not always rebellion against bad parents like you presume

So it's rebellion against a bad school environment. If the "disorder" is defined by how you relate to an environment, ONLY shows up in one environment, it's paramount to also look at that environment. How is that not obvious?

It's often rebellion against a school environment that fails to provide appropriate accomodations or special ed support for kids with autism and/or ADHD. Kids are placed in large classes with 1 teacher who has no special ed training, little patience, and pressure from admin to raise standardized test scores, and Johnny acts out. He gets labeled the "problem student", other students start to shun him, and behavior worsens to ODD level.
This is what happens when kids don't get the special ed help they need.

That's not a description of an actual freestandin diagnosis ...

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:PPs who think ODD is the result of bad parenting have no clue what they're talking about. I bet they think these kids just need a good spanking. Morons.

No, but the parents clearly need parenting classes. The ODD did not rise up in a vacuum. It represents a culmination of conditions that facilitated its development and one MAJOR condition is inconsistent parenting and poor disciplining.

In furtherance of consideration of poor choices, note the context of this discussion. OP has received a diagnosis of ODD for the child. Instead of pursuing discussions with the diagnostician or trained and licensed therapists, OP has turned to this anonymous forum and is asking for help. Hhhhmm. Interesting approach. And OP wonders how it all got this way. Gee, good question.

As someone who DOES work with high risk kids who have received diagnoses of ODD my recommendation is to immediately begin working with licensed therapists, individual and family, and then to do what those therapists suggest during sessions.

I'd be willing to bet that you are a "therapist" looking to help these families empty their wallets by offering them parenting classes. ODD can be exacerbated by bad parenting, of course, but it is absolutely NOT caused by it. It's genetic. Some kids get it and some don't within the same family.

I don't know how to say this other than very bluntly. You are wrong. ODD is not genetic and to say it is really demonstrates that you have absolutely no idea what you are talking about.

You are correct. ODD is NOT genetic and is often a misdiagnosis for a brain-based (yes that is a thing) condition such as a mood disorder which is not always clearly recognizable at the start of the illness. Our DC was initially for a short time, misdiagnosed with ODD, but it turned out to be bipolar disorder and anxiety (also genetic) instead of ODD. I knew that it was something else because the ODD diagnosis did not add up based on upbringing and stable childhood.

[Anonymous]

Anonymous wrote:

Anonymous wrote:ARGH. Different environments pose different challenges. In some situations or environments, the kid's lagging skills (in emotion regulation, in negotiating transitions, in shifting cognitive frameworks, etc.) become more apparent than in others. That's why "opposition" can present in some situations and not in others.

FWIW, the DSM5 discussion of ODD rates the severity of the disorder in relation to HOW MANY different environments it presents: "mild" ODD is confiened to one setting, while "severe" ODD presents in multiple settings--ie, pervasively.

Right, and I think the DSM definition is bogus. If the issue is that you have lagging skills in emotional regulation and transitions, then sounds more like an expression of ADHD. ODD is a garbage diagnosis (often). It's literally the description of a symptom, not a disorder. It may be more useful for a child who cannot comply in ANY setting and is at risk of jail or expulsion, but even then, I'll bet you $1,000,000 there is underlying trauma, abuse, or neurological issues. This is very similar to the supposed diagnosis of children as psychopaths.

My child, for example, had horrible behavior problems as a preschooler stemming from anxiety, lagging motor skills, and ADHD inattentive. Diagnosing him as ODD would have been as stupid as diagnosing someone who faints from heart disease as having Fainting Syndrome.

I don't disagree with your overall point, but the bolded is pretty farfetched.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:ARGH. Different environments pose different challenges. In some situations or environments, the kid's lagging skills (in emotion regulation, in negotiating transitions, in shifting cognitive frameworks, etc.) become more apparent than in others. That's why "opposition" can present in some situations and not in others.

FWIW, the DSM5 discussion of ODD rates the severity of the disorder in relation to HOW MANY different environments it presents: "mild" ODD is confiened to one setting, while "severe" ODD presents in multiple settings--ie, pervasively.

Right, and I think the DSM definition is bogus. If the issue is that you have lagging skills in emotional regulation and transitions, then sounds more like an expression of ADHD. ODD is a garbage diagnosis (often). It's literally the description of a symptom, not a disorder. It may be more useful for a child who cannot comply in ANY setting and is at risk of jail or expulsion, but even then, I'll bet you $1,000,000 there is underlying trauma, abuse, or neurological issues. This is very similar to the supposed diagnosis of children as psychopaths.

My child, for example, had horrible behavior problems as a preschooler stemming from anxiety, lagging motor skills, and ADHD inattentive. Diagnosing him as ODD would have been as stupid as diagnosing someone who faints from heart disease as having Fainting Syndrome.

I don't disagree with your overall point, but the bolded is pretty farfetched.

You don't think ADHD can cause problems with emotional regulation and transitions??

[Anonymous]

Anonymous wrote:Collaborative Problem Solving

http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=2004-21587-026

Effectiveness of Collaborative Problem Solving in Affectively Dysregulated Children With Oppositional-Defiant Disorder: Initial Findings.

By Greene, Ross W.; Ablon, J. Stuart; Goring, Jennifer C.; Raezer-Blakely, Lauren; Markey, Jennifer; Monuteaux, Michael C.; Henin, Aude; Edwards, Gwenyth; Rabbitt, Sarah
Journal of Consulting and Clinical Psychology, Vol 72(6), Dec 2004, 1157-1164.

Abstract

Oppositional-defiant disorder (ODD) refers to a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures. Research has shown that children with ODD and comorbid mood disorders may be at particular risk for long-term adverse outcomes, including conduct disorder. In this study, the authors examined the effectiveness of a cognitive-behavioral model of intervention--called collaborative problem solving (CPS)--in comparison with parent training (PT) in 47 affectively dysregulated children with ODD. Results indicate that CPS produced significant improvements across multiple domains of functioning at posttreatment and at 4-month follow-up. These improvements were in all instances equivalent, and in many instances superior, to the improvements produced by PT. Implications of these findings for further research on and treatment selection in children with ODD are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

see http://www.thinkkids.org/learn/research

Here's the full text of the study

http://www.livesinthebalance.org/sites/default/files/Greene%20JCCP%202004.pdf

[Anonymous]

https://www.ncbi.nlm.nih.gov/pubmed/22375727

Attention-deficit/hyperactivity disorder with oppositional defiant disorder in Swedish children - an open study of collaborative problem solving.

Abstract
AIM:
To evaluate collaborative problem solving (CPS) in Swedish 6-13-year-old children with attention-deficit/hyperactivity disorder and oppositional defiant disorder (ODD).

METHODS:
Seventeen families completed 6-10 sessions of CPS training. Primary outcome measures were SNAP-IV [attention-deficit/hyperactivity disorder (ADHD) and ODD scores] and Clinical Global Impression-Improvement (CGI-I) scores at baseline, post-intervention and 6 months later. Secondary outcome measures were the Conners' 10-item scale and the Family Burden of Illness Module (FBIM).

RESULTS:
All 17 participants completed the intervention. The whole group had significant reductions in SNAP-IV ODD, ADHD, total Conners' and FBIM scores, both at post-intervention and at 6-month follow-up. Eight of the children, although significantly improved on ODD scores and the Conners' emotional lability subscale at post-intervention, had almost no improvement in hyperactivity/impulsivity. Post-intervention, this group received stimulant medication for their ADHD. CGI-I scores of much improved or very much improved were reached by 53% (9/17) of all at post-intervention, and by 81% (13/16) at 6-month follow-up.

CONCLUSION:
Collaborative problem solving significantly reduced ODD, ADHD and emotional lability symptoms. A subgroup improved in their ADHD symptoms only after adding stimulant medication.

[Anonymous]

http://www.thinkkids.org/wp-content/uploads/2013/01/CPS-Outcomes-7-2013.pdf

In the last decade, Collaborative Problem Solving (CPS) has become a popular approach to managing the challenging behaviors of children and adolescents, and has established a growing evidence base for reducing oppositional behavior and related outcomes. In contrast with standard behavioral methods that provide incentives for meeting adult expectations, CPS focuses on identifying and treating lagging cognitive skills that interfere with children’s ability to meet these expectations. Since the majority of CPS outcomes have been evaluated in clinical and educational settings as part of internal quality-improvement efforts, only a small proportion of these findings has been published in peer reviewed academic journals. Here, we describe the CPS approach and provide a summary of all known published and unpublished findings related to its implementation in outpatient, inpatient, residential, juvenile justice, and educational settings. Finally,we provide specific recommendations for future research on the model.

[Anonymous]

Anonymous wrote:And if the parenting is so bad such that the child is diagnosed with ODD, how do you suppose that suddenly they will be good enough to master your espoused approach? It doesn't work that way. The child made his or her way into an ODD diagnosis because of environmental factors such as poor parenting. ODD is not a biologic condition, it is behavioral, and behavior is shaped by parents.

It can work that way, thank heavens. Parents who have a child who is extremely oppositional are not (necessarily) bad at parenting, and very likely are doing a great job with their non ODD children. But it takes exceptional parenting skills to parent a child with symptoms of ODD. They don't "suddenly" become good at it -- it takes training, and learning specific skills.