Could you tell me what causes Oppositional Defiant Disorder? Is it inherited? How can you tell if a child has ODD?

No one knows for certain. The usual pattern is for problems to begin between ages 1-3. If you think about it, a lot of these behaviors are normal at age 2, but in ODD, they never go away. ODD does run in families. If a father is alcoholic and has been in trouble with the law, his child is almost three times as likely to have ODD (18% of kids will have ODD if the parent is alcoholic and has been in trouble with the law).

ODD is diagnosed in the same way as many other psychiatric disorders in kids. You need to examine the child, talk with him, talk to the parents, and review the medical history. Sometimes other medical tests are necessary to make sure it is not something else. You always need to check kids out for other psychiatric disorders, because it is common for kids with ODD to have other problems, too.

My Out-of-Control Child

My child has just been diagnosed with Oppositional Defiant Disorder. What is it exactly?

OPPOSITIONAL DEFIANT DISORDER is a psychiatric disorder that is characterized by two different sets of problems. These are aggressiveness and a tendency to purposefully bother and irritate others. It is often the reason that people seek treatment. When OPPOSITIONAL DEFIANT DISORDER is present with ADHD, depression, tourette's, anxiety disorders, or other neuropsychiatric disorders, it makes life with that child far more difficult. For Example, ADHD plus OPPOSITIONAL DEFIANT DISORDER is much worse than ADHD alone, often enough to make people seek treatment. The criteria for OPPOSITIONAL DEFIANT DISORDER are:

A pattern of negativistic, hostile, and defiant behavior lasting at least six months during which four or more of the following are present:

• is often angry and resentful
• is often spiteful and vindictive
• is often touchy or easily annoyed by others
• often actively defies or refuses to comply with adults' requests or rules
• often argues with adults
• often blames others for his or her mistakes or misbehavior
• often deliberately annoys people
• often loses temper

The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.

All of the criteria above include the word "often". But what exactly does that mean? Recent studies have shown that these behaviors occur to a varying degree in all kids. These researchers have found that the "often" is best solved by the following criteria:

Has occurred at all during the last three months—

• blames others for his or her mistakes or misbehavior
• is spiteful and vindictive

Occurs at least twice a week—

• actively defies or refuses to comply with adults' requests or rules
• argues with adults
• is touchy or easily annoyed by others
• loses temper

Occurs at least four times per week—

• deliberately annoys people
• is angry and resentful

If you are not careful, this disorder will destroy you long before it ruins your child. The outcome can be dismal if you do not seek some outside assistance from a professional.

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The Effect of Rage on Families

Family ties are one of the strongest contributors to individual character development. Many of us spend years trying to understand, erase, or copy the influence of our family unit. When Rage is part of a family's tradition, it spreads itself much like a virus to future generations. The wider the spread, the more difficult the Rage is to contain.

The effect of Rage in families is usually apparent in the way that members relate with one another. Our earliest experiences communicating and relating to others occurs within the family. Patterns of Rage in relationships are then taken and recreated in later relationships outside the family. Thankfully, a committed, well-designed treatment plan can repair the damage of having been raised in an hostile family system.

Rage in Relationships—

Rage is one of the most common negative patterns in relationships. Couples sometimes report that it is their Rage that makes the relationship feel alive. Rage takes root in insecure relationships where open communication is absent and the emotion of love is buried beneath years of Resentment. There is typically hopelessness in the present and doubt about the future in these relationships. The good news is that individuals committed to improving their relationships through the hard work of therapy are generally rewarded with a renewed sense of hope. Here are some tips on how to limit Rage producing interactions in your relationships:

1. Always consider individual or family therapy in instances where your Rage feels out of control and/or mysterious.
2. Ask yourself if you have legitimate assumptions about the intentions of others.
3. Before feeling attacked or hurt, make an attempt to give others the benefit of the doubt, especially if you have nothing to lose by doing so.
4. Explore your participation in relationships that repeatedly bring out the worst in you.
5. Keep the lines of communication open. When you feel Resentment building, see if you can journal your feelings and then share your thoughts with a loved one.
6. When you have Rage toward another person, start with an internal check of your own emotional state. Ask yourself why you feel the way you do.

How Do I Know If My Family or Loved One Has a Rage Problem?

Hostile individuals are, in most instances, very aware of their problems in controlling Rage. Unfortunately, too many come to accept their Rage as an unchangeable part of who they are and feel hopeless to change. If you feel that you or a loved one may have an Rage disorder, look for several of the following symptoms happening in your life on a regular basis:

1. Becoming more hostile than is appropriate in regard to mild frustration or irritation.
2. Family and/or friends approach you with the concern that you need help managing your Rage.
3. Having chronic physical symptoms such as high blood pressure, gastrointestinal, difficulties, or anxiety.
4. Having feelings of guilt or regret over something that you have said or done in a fit of Rage.
5. Repeated social conflict as a result of Rage outbursts (law suits, fights, property damage, school suspensions, etc.).

Where to Get Help for My Rage—

Fortunately, the mental health profession has been responsive to individuals seeking treatment for help with Rage. Referrals to treatment programs and services are often available and mandated for those individuals suffering moderate to severe social conflict. Many chronically hostile individuals feel shame and guilt about their Rage. There may be times when a friend or loved one may need to request help or plan an intervention for the hostile individual. In such instances, it is critical to take advantage of mental health professionals with a background in Rage management training.

What Kind of Help Will I Get for My Rage?

An effective Rage management plan can include individual or family therapies, which are some of the more common ways people attempt to deal with chronic Rage.

Individual Therapy—

Individual therapy, which explores the root of hostile feelings and behavior, is traditionally a safer, more secure option to working with the entire hostile family at once. Treatment with individuals helps facilitate a thorough focus on the most important emotions beneath the individual's Rage.

Family Therapy—

Family therapy is a powerful way of repairing the damaging effect of long-term Rage interactions. Over time, chronic Rage drives a wedge between family members, resulting in the members becoming disconnected from one another, or overly involved with one another in an unhealthy manner. Therapy would consider each member's role in the Rage interactions, versus assuming any single member is responsible for the family's Rage.

How Marriage and Family Therapy Helps Control Rage—

More often than not, chronic Rage has a lengthy, definable history. Marriage and family therapists are trained experts in identifying Rage patterns that pass from one generation to the next. Identifying these patterns helps to explore individuals' learned perceptions about the appropriateness of Rage expression and suppression. Encouraging a parent to share how emotions were expressed in his or her immediate family allows other family members to understand the family's inherited concepts about Rage.

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