Disruptive Behavior Therapy Paper

My rationale for writing this paper is to know what oppositional defiant disorder (ODD) is and its effect on age, gender, and concurring behaviors (comorbidity) like attention deficit hyperactivity disorder (ADHD) and conduct disorder (CD). How these conditions are affected in getting the proper diagnosis and treatment for ODD. Loeber, Burke, and Pardini reported in clinical groups among children, ODD is listed as one of the most commonly known behavioral disorders (as cited in Kazdin, 1995). Stringaris and Goodman (2009) found ODD is apparently very important among adolescents because of its strong connection with a large assortment of fully developed mental health disorders such as (as cited by Kim-Cohen et all., 2003,

“Maybe we all have darkness inside of us and some of us are better at dealing with it than others.” ― Jasmine Warga. Many people often view a disruptive child as a misbehaving child that is acting up for attention. A few of those times, many people generally will not stop and think for a second that maybe the child that is yelling and throwing a fit may be suffering from a mental illness. These types of conditions that some of these kids have may be hard for them to control their behavior.

Due to the lack of self-control and the increased impulsivity of these individuals there is a higher level of reported defiance. 65% of children with ADHD diagnosis have issues with defiance, non-compliance and other authority related conflicts. Many people with this disorder experience uncontrollable verbal hostility, short tempers, and troubles with expressive language. Because of the lack of filters to tell the brain that these actions should be avoided, these children receive poor rapport from peers. They are also often misunderstood. Many times teachers learn to expect the behavior but punish it rather than redirect it. These children may learn to use this disorder as an excuse to not succeed. There are some people who believe that this labeling is needed and helpful.

A rating scale was completed by a Parker Elementary school teacher, Mrs. Smith for 8 year old Andrea. The Disruptive Behavior Rating Scale (DBRS) consisted of 50 questions with responses with zero representing rarely/hardly ever, one representing occasionally, two representing frequently, and three representing most of the time. The scale utilized is used by clinical professionals for diagnostic purposes of four different areas for behavior concerns these include: distractible, oppositional, impulsive-hyperactivity, and antisocial conduct. The rating scale was completed on 1/31/1992.

I will be able to take kaylen to the park if I am able to decrease the amount of symptoms per day.

One of the greatest concerns of psychotropic drug use in children and adolescents is that this type of medication is overprescribed. According to a report by the Food and Drug Administration, as of September 2009, “more than 500,000 children and adolescents in America are now taking antipsychotic drugs.” (Wilson, 2010) 500,000 is definitely a large number, but considering the fact that approximately one in ten children in the United States suffer from various mental illnesses, this number is actually quite low. The main reason people believe this medication is overprescribed is because many parents are simply looking for an easy way to quell their child’s hyperactivity. “’Families sometimes feel the need for a quick fix,’ Dr. Gleason said. ‘That’s often the prescription pad. But I’m concerned that when a child sees someone who prescribes but doesn’t do therapy, they’re closing the door that can make longer-lasting change.’” (Wilson, 2010)

Oppositional defiant disorder (ODD) is one of a group of behavioral disorders in the disruptive behavior disorders category. Children who have these disorders tend to be disruptive with a pattern of disobedient, hostile, and defiant behavior toward authority figures. These children often rebel, are stubborn, argue with adults, and refuse to obey. They have angry outbursts, have a hard time controlling their temper, and display a constant pattern of aggressive behaviors. ODD is one of the more common mental health disorders found in children and adolescents (AACAP, 2009). It is also associated with an increased risk for other forms of psychopathology, including other disruptive behavior disorders as well as mood or anxiety problems (Martel,

Evidence indicates that genetic factors may play a role in development of disruptive behavior disorders (Hansell & Damour, 2005). A biological structure of an infant’s brain has preposition genes and chemical responses to develop into an adult (Perry, 2002). Disorders in lifespan development are not biologically set to occur (Dombeck, 2010). Issues’ dealing with environment, education, and way of life has made changes in developments, childhood behavior keeps a child on a continuum between normal and abnormal behavior (Hansell & Damour, 2005). Several disorders currently exist in the Diagnostic and Statistical Manual (DSM-IV-TR) because studies on children, adolescent, and young adult disorders evolved from DSM-II (Hansell & Damour, 2005).

One closely related disorder to conduct disorder is oppositional defiant disorder. This is a disorder usually seen in children younger than 10 years. It is characterized by a pattern of frequent uncooperative hostile behavior towards authority figures. It is manifested by frequent temper tantrums, excessive arguing, active defiance, deliberate attempts to annoy others, blaming others, frequent anger and resentment, mean and hateful talking, and revenge seeking(6). While these symptoms are part of normal development of two and three year olds they become part of a diagnosable disorder when they interfere with the normal development of the child. This disorder is often a precursor to conduct disorder especially the childhood-onset type(4).

Disruptive Behavior Disorders. Oppositional defiant disorder (ODD), conduct disorder (CD), and attention deficit hyperactivity disorder (ADHD) form a cluster of childhood disorders considered to be “disruptive behavior disorders” (American Psychiatric Association, 2004). Although most violent adolescents have more than one mental disorder and they may have internalizing disorders, for example depression or substance abuse, there appear to be increasingly higher rates of physical aggression found in these adolescents who experience disruptive behavior disorders than for those with other mental disorders. The fact that violent juvenile offenders are more likely to have these diagnoses is not surprising, because impulsive and/or aggressive behaviors are part of their diagnostic criteria. Additionally, there is relatively high co-morbidity with substance abuse disorders, which are also associated with juvenile violence (Moeller, 2001). Individuals with conduct disorder have the following features but this list is not inclusive for example they may have little empathy and little concern for the feelings, wishes, and wellbeing of others, respond with aggression, may be callous and lack appropriate feelings of guilt re remorse, self-esteem may be low despite a projected

The sample for this study was a longitudinal study of 177boys. These boys were gathered having disruptive behavior disorders. The participants were 7 to 12 years of age. The sample was composed of white(70%) and african-americans(30%). The procedures for this experiment were to conduct an annual assessment between 1987 and 1994. It was conducted with the boy and his parents. The test given to the participants in the interviews was a parallel version of the National Institute of Mental Health Diagnostic Interview Schedule for Children(DISC.) The test was also modified to include all DSM III-R symptoms. The diagnostic procedure used 2 clinicians who independently reviewed reports of the participants symptoms. Through this study it yielded that 24.4% had ADHD, 36.6%had ODD, 12.2% had OAD, 12.2% had MDE, 10.5% had SAD, 4.1% had DYS, 2.9%, had ENU, and 1.2% had ENC. These disorders were recorded after and during the 7 year period.

According to Action (2007) children with oppositional defiant disorder and attention deficit disorder exhibit more aggression and are more likely to do poor academically. Barkoukis, Dombeck & Reiss (2008) believe that conduct disorder and oppositional defiant disorder share symptoms. Children exhibit similar behaviors such as being irritable and lacking social skills. The only difference between the two disorders is that conduct disorder exhibits more destructive behaviors whereas ODD does not. ODD is not as severe as conduct disorder. Conduct disorder does not have the emotional component, such as being angry and irritable that ODD carries with it (APA, 2013). Although intermittent explosive disorder is associated with a lot of anger, the disorder also displays an aggressive side that is not a part of how ODD is defined (APA, 2013). Typically with ADHD a child has an inability to sit still for a very long period of time. In order for ODD to be comorbid with ADHD the child’s need to not do what is told by an authority figure should not be in the context of how the child keeps their attention or having the child remain still (APA, 2013). Boys typically display features of

Overt conduct disorder violate social rules and includes a wide variety of antisocial behaviors such as aggression, theft, vandalism, firesetting, lying, truancy, and running away. It interferes with everyday functioning at home and school. Students with overt conduct disorder “perform harmful behaviors at a much higher rate and at a much later age than normally developing student” (Kauffman 2005).

Although ADHD is associated with reduced school performance and academic attainment. Irrespective of the above, the youth has a history of conduct related behaviors since childhood, such as defiance of authority figures, acts of theft and aggression, and suspensions at school, which would support a diagnosis of Conduct Disorder Childhood Onset Type.

The symptoms of impulsivity are often the most disruptive and can cause children with Attention Deficit Hyperactivity Disorder to have a hard time in social situations. They often can’t wait their turn, often interrupt conversations or intrude on others games, act without thinking and say the wrong thing at the wrong time. In addition, an inability to keep powerful emotions in check can result in angry outburst or temper tantrums.