OPPOSITIONAL DEFIANT DISORDER

OPPOSITIONAL DEFIANT DISORDER - OPPOSITIONAL DEFIANT...

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OPPOSITIONAL DEFIANT DISORDER DSM-IV 313.81 Oppositional defiant disorder 312.9 Disruptive behavior disorder NOS A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, in which the child  loses temper, argues with adults, often actively defies or refuses adult requests or rules, blames others,  deliberately does annoying things, and swears or uses obscene language. This behavior creates significant  impairment in academic/social functioning but does not meet the criteria for conduct disorder. (Disruptive  behavior disorder NOS reflects clinical features that constitute the subthreshold for both oppositional  defiant and conduct disorders.) ETIOLOGICAL THEORIES Psychodynamics The oppositional youth is fixed in the separation-individuation stage of development. The youth insists  on autonomy by negative adaptive maneuvers in which he or she continually provokes adults or peers. As  the youth develops internal controls, he or she will eventually grow out of these behaviors. Genetic/Biological Similar to the predisposition for conduct disorder, heredity contributes to individual temperament,  frustration, tolerance, and the tendency to seek risks or disobey authority. The disorder may be gender- linked, as the incidence is higher in boys than in girls. Family Dynamics Familial and cultural norms may prohibit the degree of individual differentiation among the family  members.   Attempts   to   maintain   conformity   are   met   by   negativism,   disobedience,   and   quarrelsome  defiance.   Parenting   skills   are   ineffective   and/or   inconsistent   with   reactive   and   emotionally   charged  interchanges   between   parent   and   child.   Some   parents   interpret   average   or   increased   levels   of  developmental oppositionalism as hostility and as the child’s deliberate effort to be in control. If power and  control are issues for parents, or if they exercise authority for their own needs, a power struggle can be  established between the parents and the child that sets the stage for the development of oppositional defiant  disorder. A relationship between life events and the development of anxiety disorders has been identified. This  theory suggests that disruptive behavior is learned as a means for a child to gain adult attention. Anxiety  generated by a dysfunctional family system, marital problems, etc., could also contribute to symptoms of  this   disorder.   Parents   become   frustrated   with   the   child’s   poor   response   to   limit-setting.   Parenting  intervention become oversensitive or the reverse, with no external structure provided. CLIENT ASSESSMENT DATA BASE
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OPPOSITIONAL DEFIANT DISORDER - OPPOSITIONAL DEFIANT...

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