Oppositional Defiant Disorder (ODD) refers to marked defiance, disobedience and aggression in a child without accompanying more serious social disorder or aggressive activity that offends the law or the rights of others.
According to epidemiological surveys, the prevalence of oppositional defiant disorder is between 2% and 16%, and the peak incidence is about 8 to 10 years old.
In the past, when discussing the comorbidity of attention deficit hyperactivity disorder (ADHD) and behavioral disorders, we often discussed ODD and conduct disorder (CD) together.
According to the diagnostic criteria of DSM-IV, ADHD, ODD and CD are jointly classified as “attention and disruptive behavior disorder”, which shows that the three are closely related to each other. However, after the birth of DSM-5, ADHD was removed from the original “Attention and Disruptive Behavior Disorders” chapter and incorporated into “Neurodevelopmental Disorders”, suggesting that the medical community’s understanding of these three diseases has gradually changed. No longer simply think of the three as a continuum of behavioral lineage issues.
With the deepening of research, more and more evidence also proves that ODD and CD may have their own independent risk factors.
Oppositional defiant disorder is mainly manifested in that children have negative attitudes and disobedience to adults’ instructions, lose their temper with adults, and even confront and challenge parents’ authority.
The confrontational behavior of young children may be expressed in a hidden way, such as many physical discomforts, confrontation with the requirements of adults in a negative way, and even selective silence as the main manifestation. With the increase of age, behavioral problems gradually become obvious, manifested as confrontation with adults such as parents and teachers, disobedience to discipline, easy to lose temper, and blame others for their own mistakes.
The diagnosis of ODD in adolescence requires identification of normal adolescent behaviors. In terms of frequency, adversarial behavior occurs 1-2 times per week in normal adolescents, but at least 5-7 times per week in children with oppositional defiant disorder.
Children with ADHD comorbid ODD not only have more obvious violation of discipline and aggressive behavior, but also may have more anxiety and depression.
In addition, the study also found that the overall IQ of children with ADHD comorbid ODD is lower than that of children with simple ADHD. Due to the existence of ADHD, children cannot effectively listen to lectures, and there is more risk of learning difficulties.
Recent studies have found that children with ODD have obvious emotional regulation problems, mainly characterized by difficulty in regulating negative emotions. This feature also exists in ADHD children, and ADHD children also have problems in emotional efficacy and other aspects, suggesting that the defect of emotional ability may also be one of the potential reasons for the comorbidity of the two.
Diagnosis points:
According to the diagnostic criteria of the International Classification of Diseases (ICD-10), the basic characteristics of ODD are a type of persistent defiant, antagonistic, hostile, provocative and destructive behaviors, which are obviously beyond the normal behavior of children of the same age in the same sociocultural background, But it does not include more serious violations of the interests of others. Such children tend to frequently and actively disregard the requirements or regulations of adults, and deliberately provoke others; children generally have poor tolerance for setbacks, lose their temper, are irritable, often resent others and get angry with others; children Blame these people for their own mistakes or difficulties.
