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Oppositional Defiant Disorders

NIH - Medical Encyclopedia Oppositional Defiant Disorder

"Oppositional defiant disorder is a pattern of disobedient, hostile, and defiant behavior toward authority figures. To fit this diagnosis, the pattern must persist for at least 6 months and must go beyond the bounds of normal childhood misbehavior.

Symptoms: • Arguing with adults • Loss of temper • Angry and resentful of others • Actively defies adults' requests • Spiteful or vindictive behavior • Blames others for own mistakes • Is touchy or easily annoyed • Few or no friends or loss of previous friends • Constant trouble in school ...

Possible Complications: In a significant proportion of cases, the adult condition of conduct disorder can be traced back to the presence of oppositional defiant disorder in childhood ...

Prevention: Consistency in rules and fair consequences should be practiced in the child's home. Punishments should not be overly harsh or inconsistently applied. Appropriate behaviors should be modeled by the adults in the household. Abuse and neglect increase the chances that this condition will occur. "

Highlighted Articles

Oppositional defiant disorder. (Aust Fam Physician. 2008) “DISCUSSION: Many of the behaviours required to meet this diagnosis are not uncommon in the preschool child or adolescent. However, in children with ODD the behaviours are persistent, cause significant distress to the family system, and impact on the child's social and educational functioning. Oppositional defiant disorder usually presents in the preschool years, although it may become evident during adolescence. There is strong evidence that early intervention to increase positive factors in family relationships and to increase both the parents' and child's skill levels can assist in the prevention of more serious disorders and mental health issues.”

Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: results from the National Comorbidity Survey Replication. (J Child Psychol Psychiatry. 2007) "Results: Lifetime prevalence of ODD is estimated to be 10.2% (males = 11.2%; females = 9.2%). Of those with lifetime ODD, 92.4% meet criteria for at least one other lifetime DSM-IV disorder, including: mood (45.8%), anxiety (62.3%), impulse-control (68.2%), and substance use (47.2%) disorders. ODD is temporally primary in the vast majority of cases for most comorbid disorders. Both active and remitted ODD significantly predict subsequent onset of secondary disorders even after controlling for comorbid conduct disorder (CD). Early onset (before age 8) and comorbidity predict slow speed of recovery of ODD. Conclusions: ODD is a common child- and adolescent-onset disorder associated with substantial risk of secondary mood, anxiety, impulse-control, and substance use disorders. These results support the study of ODD as a distinct disorder."

Conduct Disorders

NIH - Medical Encyclopedia Conduct Disorder

"Conduct disorder, a disorder of childhood and adolescence, involves chronic behavior problems, such as defiant, impulsive, or antisocial behavior; drug use; or criminal activity.

Causes: Conduct disorder has been associated with family conflicts, child abuse, poverty, genetic defects, and parental drug addiction or alcoholism. The diagnosis is more common among boys and is estimated to be as high as 10%. However, because many of the qualities necessary to make the diagnosis (such as "defiance" and "rule breaking") can be subjective, it is hard to know how common the disorder really is. For accurate diagnosis, the behavior must be far more extreme than simple adolescent rebellion or boyish exuberance. Conduct disorder is often associated with attention-deficit disorder, and the two together carry a major risk for alcohol and/or other drug dependence. Children with conduct disorder tend to be impulsive, difficult to control, and unconcerned about the feelings of others ...

Symptoms: Cruel or aggressive behavior toward people and animals • Destruction of property, including fire setting • Lying, truancy, running away • Vandalism, theft • Heavy drinking and/or heavy illicit drug use • Breaking rules without apparent reason • Antisocial behaviors, such as bullying and fighting ...

Possible Complications: Children with conduct disorder may go on to develop personality disorders as adults, particularly antisocial personality disorder. As their behaviors worsen, these individuals may also develop significant drug and legal problems.

When to Contact a Medical Professional: See your health care provider if your child seems to be overly aggressive, is bullying others, is being victimized, or continually gets in trouble. Early treatment may help."

Highlighted Articles

A 30-Year Prospective Follow-up Study of Hyperactive Boys With Conduct Problems: Adult Criminality. (J Am Acad Child Adolesc Psychiatry. 2007)

"CONCLUSIONS: Hyperactive/ADHD boys with conduct problems are at increased risk for adult criminality. Hyperactive boys without childhood conduct problems are not at increased risk for later criminality. An intensive 3-year MMT treatment of 6- to 12-year-old hyperactive boys is insufficient to prevent later adult criminality."

From conduct disorder to severe mental illness: associations with aggressive behaviour, crime and victimization. (Psychol Med. 2007)

"CONCLUSIONS: Men and women with severe mental illness who have a history of CD by mid-adolescence are at increased risk for aggressive behaviour and violent crime. These patients are easily identifiable and may benefit from learning-based treatments aimed at reducing antisocial behaviour. Longitudinal, prospective investigations are needed to understand why CD is more common among people with than without schizophrenia."

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Health - Environment and Learning

Bullying

NEWS:

Bullying at School Linked to Bullying at Home “It was also the case that significantly more boys than girls told us that they bullied their sibling -- who was most likely to be younger than them. It's likely that this form of sibling bullying is all about maintaining a position of dominance. "However, for girls, bullying is mainly related to a poor quality of sibling relationship and not to birth order. In fact, high levels of conflict and low levels of empathy were significantly related to sibling bullying and sibling victimization." A significant link between bullying and victimisation patterns at home and at school was found. Children who bullied siblings were likely to bully their peers, while victims at home were likely to also be victimized at school. “

Bullying Doubles Risk for Psychosomatic Ills in Kids “Psychosomatic complaints included headache, stomachache, backache, abdominal pain, dizziness, sleeping problems, poor appetite, bedwetting, skin problems, vomiting, feeling tired, or feeling tense. … However, Dr. Weihs is more cautious than the authors about what conclusions to draw from that association. ''The term psychosomatic makes the assumption that the bullying caused the somatic complaints of these children — even though the data do not support this conclusion. It would be more appropriate to describe these symptoms as somatic complaints or somatic symptoms, until the causal association is demonstrated in prospective studies," Dr. Weihs told Medscape Psychiatry. "It is likely that bullying has adverse health effects that are physiologically compromising to children, such as elevated stress hormones and the associated increase in risk of hypertension and heart disease," Dr. Weihs added. "This should also be mentioned as a needed area for future research." Meanwhile, she agrees with Dr. Gini that children with apparently psychosomatic symptoms should be questioned about bullying, "If bullying is present, an intervention to stop the child from being victimized should be undertaken," Dr. Weihs said.”

Bullying may make kids psychotic “People who are bullied as children have twice the risk of having delusions, hallucinations or other psychotic symptoms as pre-teens as those who have not been bullied, British researchers said on Monday. They said bullying -- especially when it is severe or chronic -- can have serious consequences for some children, and may even act as a trigger for people who are genetically predisposed to schizophrenia. "Chronic or severe peer victimization has nontrivial, adverse, long-term consequences," Andrea Schreier of the University of Warwick in Coventry, England, and colleagues wrote in the Archives of General Psychiatry. Several studies have shown that traumatic events in childhood such as physical or sexual abuse are linked with the development of psychosis in adulthood. And people who display psychotic symptoms in childhood are more prone to develop schizophrenia as adults.”

Bullying victimization in youths and mental health problems: 'Much ado about nothing'? (Psychol Med. 2009)

Bullying, once a silent battle, now a crime

Girls Twice As Likely As Boys To Remain Victims Of Bullying, Study Finds “Girls targeted by bullies at primary school are two and a half times more likely to remain victims than boys, according to research from the University of Warwick and University of Hertfordshire. Researchers found girls being directly victimised by bullies (being beaten and suffering physical or verbal threats) at six years old were significantly more likely to still be a direct victim at age ten. … Professor Wolke said: “These findings indicate that even at an early age some victims of bullying remain victims over a long period of time. The development and implementation of intervention programmes that help victims to escape further victimization in primary school are called for.” He added that the findings suggested school professionals, health practitioners and parents should be aware of children showing signs of both physical and emotional health problems, as these appeared to be important risk factors for becoming and remaining a victim.”

Cyber Bullying Affects One in 10 Students “Bullying still makes life miserable for plenty of students, only these days some aggressors apparently operate electronically. A new study shows that many children in grades 6 through 10 have either bullied classmates or been bullied by them, sometimes online or through cell phones. “

Schools Failing When It Comes To Bullying, Violence Prevention

New Tactics To Tackle Bystander’s Role In Bullying

What can we do about cyber-bullying?

ARTICLES:

JOURNAL ARTICLES:

A cross-national profile of bullying and victimization among adolescents in 40 countries. (Int J Public Health. 2009)

Being Bullied: Associated Factors in Children and Adolescents 8 to 18 Years Old in 11 European Countries (PEDIATRICS 2009) “RESULTS. The percentage of children being bullied was 20.6% for the entire sample, ranging from 10.5% in Hungary to 29.6% in the United Kingdom. In almost all countries the factors most strongly associated with being bullied were younger age, having probable mental health problems, having a low score on the Kidscreen-52 moods and emotions dimensions, and poor social support. Using the grand mean for all countries as the reference category, there was an above-average likelihood of children or adolescents reporting that they had been victims of bullying in 5 countries (Austria, Netherlands, Spain, Switzerland, and the United Kingdom), and a below-average likelihood in 3 countries (France, Greece, Hungary).”

Childhood Bullying Behavior and Later Psychiatric Hospital and Psychopharmacologic Treatment (Arch Gen Psychiatry. 2009)

Income inequality and school bullying: multilevel study of adolescents in 37 countries. (J Adolesc Health. 2009)

School bullying among adolescents in the United States: physical, verbal, relational, and cyber. (J Adolesc Health. 2009)

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