Oppositional Defiant Disorder Assessment


Children in school age who are characterized with stubbornness,opposition, and anger are another group of students who can be easily diagnosedby parents and teachers because they feel frustrated by the difficulty of thesestudents. These students strongly refuse to respond to requests, usually losetheir temper, argue with teachers, parents, and peers, and usually blame othersfor their problems. In fact, the demands of the teacher or parent to perform anunpleasant task (such as cleaning the room or doing homework) are the cause ofthese aggressive behaviors.

The prevalence of youth who have been diagnosed with defiantoppositional disorder (ODD) ranges between 2-16 %.The highest rates are foundamong males during childhood, however; in adolescence, female rates are similarto those of males. There is a high percentage of children with defiantoppositional disorder will eventually exhibit conduct or behavior disorder.There is evidence that the features of stubbornness are more prevalent in maleswho exhibit rough characteristics in kindergarten.

Oppositional defiant disorder is prevalent among young childrenand adolescents. The diagnosis of oppositional defiant disorder requires thatthese behaviors are repeated much more than other children of the same age ordevelopmental level. These behaviors strongly debilitate performance in homeand school. The specific features of oppositional defiant disorder include apattern of persistent negative behavior and behavior of opposition, with theexistence of symptoms of stubbornness, losing temper repeatedly, arguing withadults, deliberately disturbing others, blaming others, discomfort, anger,revenge, and disobedience which is considered as the most disturbing behaviorfor adults who work or live with these students. Disobedience refers to thebehaviors to behaviors that include failure to meet adult requests in a timelymanner (10-15 seconds), failure to accomplish the tasks required, and failureto follow the rules previously adopted. Oppositional behaviors refer tobehaviors that include failure refer to behaviors that include verbal orphysical rejection of the response.

Diagnostic criteria of oppositional defiant disorder 313.81(F91.3) inDSM5

A pattern of angry/irritable mood, argumentative/defiantbehavior, or vindictiveness lasting at least 6 months as evidenced by at leastfour symptoms from any of the following categories, and exhibited duringinteraction with at least one individual who is not a sibling.

Angry/Irritable Mood

1. Often loses temper.

2. Is often touchy or easilyannoyed.

3. Is often angry and resentful.

Argumentative/Defiant Behavior

1. Often argues with authorityfigures or, for children and adolescents, with adults.

2. Often actively defies or refusesto comply with requests from authority figures or with rules.

3. Often deliberately annoysothers.

4. Often blames others for his orher mistakes or misbehavior.

Vindictiveness

1. Has been spiteful or vindictiveat least twice within the past 6 months.

2. The disturbance in behavior isassociated with distress in the individual or others in his other immediatesocial context (e.g., family, peer group, work colleagues), or it impactsnegatively on social, educational, occupational, or other important areas offunctioning.

3. The behaviors do not occurexclusively during the course of a psychotic, substance use, depressive, orbipolar disorder. Also, the criteria are not met for disruptive mooddysregulation disorder.

Stubbornness behavior differs from ADHD behavior, in thatstubborn children are characterized by opposition, violence, and they arguewith adults. The achievement of children who exhibit symptoms of ADHD is weakin school due to attention, movement and impulse behaviors. Althoughoppositional defiant disorder and ADHD are two different disorders, up to 35%to 45% of children and adolescents with ADHD meet the criteria of bothdisorders. Children who suffer from stubbornness and attention problems will ofcourse exhibit physical violence of course, bigger problems with theirrelations with peers, less academic achievement, and they will represent greatchallenge for their teachers within the classroom. Usually adolescents withoppositional defiant disorders suffer from severe family problems, slow homeworkachievement, and repeated disciplinary referrals at school.