Diagnosis Of Oppositional Defiant Disorder Research Articles

A Study to Assess the Effectiveness of Planned Teaching Programme on Behavioural Disorder in Children among Primary School Teachers in Selected School, Dadra & Nagar Haveli, Silvassa

BACKGROUND: Behavioural disorders of children lead to abnormality in their Personality, emotions or behavior, which is dangerous and affect to him/her, family and society. Behavioural disorders are caused by multiple factors like faulty parental attitude, inadequate family environment (broken families, low socio-economic status, lack of love and affection), mentally and physically sick or handicapped, influence of social relationship, influence of mass media, and influence of social change. Some children show symptoms that are consistent with diagnoses of Oppositional Defiant Disorder (ODD), Attention-Deficit hyperactivity Disorder (ADHD), and Learning disability. Objective: The aim of the study was to assess the effectiveness of planned teaching program on behavioural disorders among primary school teachers at Dadra & Nagar Haveli, Silvassa. Methodology: A pre-experimental one group pre-test post-test research design was adopted, through non probability purposive sampling technique, 150 samples were selected from selected primary school of Dadra and Nagar Haveli, Silvassa. Demographic Variables based on baseline Performa was used to collect demographic data and Self-administered knowledge questionnaire were used to assess the existing knowledge level of primary school teachers regarding behavioural disorder in school aged children. Planned teaching program on behavioral disorders in children was administered to primary school teachers to enhance the knowledge followed by post was conducted after 7 days. The data was analyzed and interpreted based on descriptive and inferential statistics. Result: The result of the study shows that, the overall post-test knowledge mean percentage (71.26%) is greater than pretest knowledge mean percentage (39.57%). The calculated “t” value (27.174) of the knowledge score of the primary school teachers regarding behavioural disorders of school aged children is greater than the table value at 0.05 level of significance hence the planned teaching programme is effective to improve the knowledge of school teachers. Conclusion: Thus, it can be concluded that Planned teaching programme was effective in improving the knowledge of primary school teacher regarding behavioural disorders in school aged children. Key words: Assess, Effectiveness, Knowledge of primary school teachers, Behavioural disorders, School aged children, planned teaching program.

Improving diagnostic accuracy: Comparison of nomograms and classification tree analyses for predicting the diagnosis of oppositional defiant disorder.

Unstructured clinical interviews are inaccurate tools for diagnostic decision-making. While structured diagnostic evaluations improve reliability, they are infrequently used in clinical practice. Empirical approaches are a hallmark of evidenced-based assessment and may reduce burdens of structured interviews. We explore two approaches to empirical prediction of diagnosis, the naïve nomogram, and classification tree analysis (CTA). To illustrate the clinical utility of each approach, we compared their use in a sample of 6-year-olds (N = 619) to predict structured-interview diagnoses of oppositional defiant disorder (ODD). Findings indicate the accuracy of both approaches in predicting the absence of a disorder and improved detection of ODD using CTA for subgroups of children. Both empirical prediction techniques have applicability to diagnostic decision-making in psychiatry and pediatrics. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Supplemental Material for Improving Diagnostic Accuracy: Comparison of Nomograms and Classification Tree Analyses for Predicting the Diagnosis of Oppositional Defiant Disorder

Supplemental Material for Improving Diagnostic Accuracy: Comparison of Nomograms and Classification Tree Analyses for Predicting the Diagnosis of Oppositional Defiant Disorder

A Call to Revise the Diagnosis of Oppositional Defiant Disorder—Diagnoses Are for Helping, Not Harming

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Attention-Deficit/Hyperactivity Disorder Symptoms and Externalizing Progression in the LAMS Study: A Test of Trait Impulsivity Theory

To test differential prospective prediction of growth in externalizing behavior, including oppositional defiant disorder, conduct disorder, and substance use disorders, by earlier hyperactive-impulsive (HI) vs inattentive (IN) symptoms of attention-deficit/hyperactivity disorder (ADHD). Participants in the Longitudinal Assessment of Manic Symptoms (LAMS) Study (N= 685 at study entry), including 458 boys and 227 girls ages 6-12, completed full parent report and self-report assessments every year for 8 years on the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Three sets of analyses were conducted. First, hierarchal regression (block entry) was used to test independent associations between HI symptoms and later externalizing outcomes, controlling for IN symptoms, and IN symptoms and later externalizing outcomes, controlling for HI symptoms. Second, logistic regression was used to test progression of DSM externalizing disorders. Third, tests of mediation were used to assess potentiation of externalizing progression through environmental risk mediators (eg, family environment, neighborhood violence). Consistent with hypotheses derived from trait impulsivity theories of externalizing behavior, HI symptoms of ADHD were associated independently with long-term externalizing outcomes, whereas IN symptoms were not. Between months 48 and 96, ADHD-HI/combined symptom subtype diagnoses predicted later oppositional defiant disorder diagnoses, oppositional defiant disorder diagnoses predicted later conduct disorder diagnoses, and conduct disorder diagnoses predicted later substance use disorder diagnoses. Evidence for environmental risk mediation (eg, parental monitoring, neighborhood violence) was also found. Findings support trait impulsivity models of externalizing progression, whereby ADHD-HI/combined symptoms subtypes predispose to increasingly severe externalizing behaviors, which are magnified in contexts of environmental risk.

Psychometric and machine learning approaches for diagnostic assessment and tests of individual classification.

Assessments are commonly used to make a decision about an individual, such as grade placement, treatment assignment, job selection, or to inform a diagnosis. A psychometric approach to classify respondents based on the assessment would aggregate items into a score, and then each respondent's score is compared to a cut score. In contrast, a machine learning approach to classify respondents would build a model to predict the probability of belonging to a specific class from assessment items, and then respondents are classified based on their predicted probability of belonging to that class. It remains unclear whether psychometric and machine learning methods have comparable classification accuracy or if 1 method is preferable in all or some situations. In the context of diagnostic assessment, this study used Monte Carlo simulation methods to compare the classification accuracy of psychometric and machine learning methods as a function of the diagnosis-test correlation, prevalence, sample size, and the structure of the diagnostic assessment. Results suggest that machine learning models using logistic regression or random forest could have comparable classification accuracy to the psychometric methods using estimated item response theory scores. Therefore, machine learning models could provide a viable alternative for classification when psychometric methods are not feasible. Methods are illustrated with an empirical example predicting an oppositional defiant disorder diagnosis from a behavior disorders scale in children of age seven. Strengths and limitations for each of the methods are examined, and the overlap between the field of machine learning and psychometrics is discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Efficacy of Risperidone on the Treatment of Very-Early Onset Skin Picking Disorder

Skin picking disorder (SPD) has frequently been reported to start before the age of 10; but “very-early onset” type was not defined before in the literature. Also research on the treatment of SPD in childhood is limited. We presented a “very-early onset” SPD case whose symptoms have started on the age of 4 and escalated with her comorbid oppositional defiant disorder diagnosis. Patient was successfully treated with low dose (0.25 mg/day) risperidone and proper psychoeducational interventions. Identifying SPD in very early childhood is hard cause; criterion of SPD might not capture all the specific features which very young children manifest and clinicians might overlook their complaints. Efficacy of risperidone might reflect a shared psychopathological etiology between impulse control and SPD, and lead future research on treatment of SPD with atypical anti-psychotics.

Il caso di Viola "insolente e sbruffoncella": un percorso psicoterapeutico multimodale tra lavoro con la bambina e intervento sulla genitorialità

Il caso clinico presentato è quello di Viola, una bambina di 7 anni con difficoltà comportamentali. Sebbene le manifestazioni non siano severe, non soddisfano, infatti, la diagnosi di disturbo oppositivo-provocatorio, interferiscono sul clima familiare e compromettono il funzionamento scolastico. Vi è un secondo aspetto, inizialmente non esplicitato dai genitori in chiave patologica, che riguarda l'enuresi notturna; tale problematica limita le possibilità di esplorazione del mondo extra-familiare ed è proprio quando emerge la possibilità di fare esperienze con i coetanei, che diventa necessario inserirla tra gli obiettivi terapeutici. In ottica cognitivo-evolutiva e costruttivista, in fase di valutazione è prioritario comprendere il significato interno del sintomo e svelarne la funzione relazionale. Nel caso di Viola è emerso come i comportamenti provocatori fossero il tentativo di controllare in maniera coercitiva gli adulti di riferimento e l'enuresi può essere visto come il sintomo per assicurarsi la prossimità del genitore. Il lavoro clinico è stato favorito da un'ottima collaborazione da parte della coppia genitoriale e buona parte della terapia si è focalizzata su di loro. Grazie alla ricostruzione degli ABC comportamentali in seduta e alla graduale aggiunta di sfumature cognitive ed emotive, i genitori hanno potuto cogliere la funzione relazionale del sintomo e avvicinarsi al mondo emotivo della figlia. L'intervento con la bambina, svolto in parallelo, è stato indirizzato ad una migliore gestione delle proprie emozioni e un lavoro di mentalizzazione in terza persona, finalizzato ad una crescente consapevolezza degli stati mentali altrui.

Narcissistic traits as predictors of emotional problems in children with oppositional defiant disorder: A longitudinal study

BackgroundChildren's self-views encompass two independent dimensions: self-esteem and narcissism, which recently have received growing attention from researchers and clinicians. The current study sought to test whether these dimensions might predict the developmental course of children with Oppositional Defiant Disorder diagnosis. MethodThe sample (N = 64, M age = 10.1 years, 57 boys) included children with Oppositional Defiant Disorder diagnosis. We examined longitudinal relationships between self-views (both self-esteem and narcissism) and parent-reported internalizing and externalizing behavioral problems. ResultsThe study spanned two time-points, spaced 12 months apart. None of the predictors were longitudinally associated with the levels of externalizing behavioral problems in children. However, narcissism predicted the levels of children's internalizing problems at the follow-up, whereas self-esteem did not. LimitationsThe relatively small sample and the lack of assessing causality limit the generalizability of the findings. Results need to be replicated in larger samples. ConclusionsThese findings illustrate the value of taking into account children's narcissistic traits in clinical assessment. By broadening knowledge of narcissistic traits in clinical samples of children, we hope to inform assessment procedures in standard clinical practice, as well as the development of tailored interventions to curb the emergence of later negative outcomes related to childhood narcissism, such as internalizing problems.

Individualised stepwise adaptive treatment for 3\u20136-year-old preschool children impaired by attention-deficit/hyperactivity disorder (ESCApreschool): study protocol of an adaptive intervention study including two randomised controlled trials within the consortium ESCAlife

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a psychosocially impairing and cost-intensive mental disorder, with first symptoms occurring in early childhood. It can usually be diagnosed reliably at preschool age. Early detection of children with ADHD symptoms and an early, age-appropriate treatment are needed in order to reduce symptoms, prevent secondary problems and enable a better school start. Despite existing ADHD treatment research and guideline recommendations for the treatment of ADHD in preschool children, there is still a need to optimise individualised treatment strategies in order to improve outcomes. Therefore, the ESCApreschool study (Evidence-Based, Stepped Care of ADHD in Preschool Children aged 3 years and 0 months to 6 years and 11 months of age (3;0 to 6;11 years) addresses the treatment of 3–6-year-old preschool children with elevated ADHD symptoms within a large multicentre trial. The study aims to investigate the efficacy of an individualised stepwise-intensifying treatment programme.MethodsThe target sample size of ESCApreschool is 200 children (boys and girls) aged 3;0 to 6;11 years with an ADHD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) or a diagnosis of oppositional defiant disorder (ODD) plus additional substantial ADHD symptoms. The first step of the adaptive, stepped care design used in ESCApreschool consists of a telephone-assisted self-help (TASH) intervention for parents. Participants are randomised to either the TASH group or a waiting control group. The treatment in step 2 depends on the outcome of step 1: TASH responders without significant residual ADHD/ODD symptoms receive booster sessions of TASH. Partial or non-responders of step 1 are randomised again to either parent management and preschool teacher training or treatment as usual.DiscussionThe ESCApreschool trial aims to improve knowledge about individualised treatment strategies for preschool children with ADHD following an adaptive stepped care approach, and to provide a scientific basis for individualised medicine for preschool children with ADHD in routine clinical care.Trial registrationThe trial was registered at the German Clinical Trials Register (DRKS) as a Current Controlled Trial under DRKS00008971 on 1 October 2015. This manuscript is based on protocol version 3 (14 October 2016).

Variability in emotion regulation in paediatric obsessive-compulsive disorder: Associations with symptom presentation and response to treatment

This study explored whether variability in emotion regulation was associated with several clinical correlates of OCD and an attenuated response to treatment. Participants in this study were 137 youth (and their parents) aged 7–17 years with a primary diagnosis of OCD. Parents completed study questionnaires and children received intensive CBT with exposure and response prevention treatment. A median split of responses to the baseline Emotional Control (EC) index of the BRIEF, resulted in two groups of children – those with relatively greater and poorer EC. The results indicated that children in the relatively poorer EC group had significantly greater OCD severity, more family accommodation, internalising and externalising symptoms. They were also more likely to have a comorbid diagnosis of oppositional defiant disorder or social phobia. Additionally, children with relatively greater EC were more likely to have attained response or remission of their symptoms immediately following treatment. Similarly, at three months following treatment there were fewer responders to treatment among the lower EC group relative to the higher EC group; however, there was no significant difference for treatment remission between groups. Therefore, EC may be an indicator for a more severe presentation of OCD and a poorer response to treatment.

Pathologizing Latinas

Scholars of the welfare system have explored the racialized criminalization of mothers of color who are punished by the foster care system, through control of their children, when they are unable to meet the ideals of middle-class motherhood but have yet to fully articulate a language to understand the ways in which this criminalization and punishment extends to youth once they are placed in the foster care system. Using ethnographic interviews with agents of the care system, I explore the ways in which the system pathologizes Latinas’ quotidian acts of resistance and survival like their use of silences through the behavioral diagnosis of Oppositional Defiant Disorder (ODD). I argue that California’s foster care system is an arm of the transcarceral continuum, marking girls of color and their strategies of resistance as pathological, thereby criminalizing them through the diagnosis of behavioral disorders.

Questioning Fetal Alcohol Syndrome: a Case Report of Multiple Etiological Factors

A 14-year-old, Caucasian, right-handed male presented for neuropsychological evaluation for diagnostic clarification due to attention-deficit/hyperactivity disorder, bipolar I disorder, and oppositional defiant disorder diagnoses and to rule-out fetal alcohol syndrome (FAS) due to aggression, impulsivity, difficulties with authority, and history of legal issues. Patient was born at 29 weeks gestation without complications. Patient’s adoptive mother reported delays in walking, as well as regression in talking, with suspected prenatal alcohol exposure, neglect, and abuse in first 2 years of life prior to being adopted. Patient is currently in detention setting due to recent homicidal ideation toward family member. Neuropsychological and psychological tests were administered to assess for FAS and clarify previous diagnoses, for which psychostimulant and antipsychotic medications have proven ineffective. Results suggest minimal intellectual impairment beyond low general processing speed abilities, minor academic achievement concerns in only sentence comprehension, executive dysfunction specifically in inhibition, inefficient learning with early plateau, and externalizing behaviors. Adaptive functioning difficulties are limited to self-direction and safety. No evidence of brain atrophy, delayed physical development, or facial dysmorphia in childhood but significant behavioral concerns suggestive of FASDs. A wide range of etiological factors with unconfirmed prenatal alcohol exposure, such as neglect, trauma, and poor school attendance, suggests that FAS may be diagnostically restrictive as it pertains to the broad spectrum of prenatal alcohol effects and common comorbidities. FAS criteria may be revisited as it relates to confirmed alcohol exposure when history does not permit.

Clinical Practice Guidelines for the management of conduct disorder.

Clinical Practice Guidelines for the management of conduct disorder.

Confirmatory factor analysis of the behavior rating inventory of executive function in a neuro-pediatric sample and its application to mental disorders

ABSTRACTThe construct validity of the 9-scale version of the Behavior Rating Inventory of Executive Function (BRIEF) parent form was examined in a clinical sample of children and adolescents with neurological and neurodevelopmental disorders (N = 281). Confirmatory factor analysis supported a three-factor model separating the inhibitory behavioral control dimension from the emotional control and metacognitive problem-solving dimensions. The Metacognitive factor was also related to a diagnosis of attention deficit/hyperactivity disorder (ADHD) after controlling for age, gender, IQ, adaptive functioning, and a conventional behavioral rating scale, which included inattention-hyperactivity symptoms. The Emotional Regulation factor was related to a diagnosis of oppositional defiant disorder. Correlational analyses indicated that child comorbid emotional and behavioral problems may exacerbate parental BRIEF reporting. Accordingly, when assessing executive function among children with neurological and neurodevelopmental disorders, the BRIEF should be complemented with assessments of mental health problems.

Symptoms of Oppositional Defiant in Students: The Predicting Role of Emotion Regulation, Schema, and Vandalism

Background: Numerous studies demonstrated that emotional dysregulation and early maladaptive schemas are the defining core of oppositional defiant disorder. Many studies also found a strong correlation between the diagnosis of oppositional defiant disorder and vandalism. Objectives: The current study aimed to investigate the relationship between Symptoms of Oppositional Defiant and emotion regulation, schema, and vandalism in male high school students in Dezfoul, the Southwest of Iran. Patients and Methods: A sample of high school students (n = 320) with a mean age of 16.34 (SD = 0.66) years completed Oppositional Defiant Behavior Inventory pilot version (ODBI), Difficulties in Emotion-Regulation Scale (DERS), Young Schema Questionnaire-Short Form (YSQ-SF), and Questionnair of Vandalism (QV). Data were analyzed using the Pearson correlation coefficient and multivariate regression analysis. Results: The results showed a significant positive correlation between emotion regulation, schema, and vandalism with Symptoms of Oppositional Defiant. Regression analysis revealed that 12% variance of Symptoms of Oppositional Defiant can be predicted by emotion dysregulation, schema, and vandalism. Moreover, emotion dysregulation was the most effective predicting variable of oppositional defiant disorder (P < 0.001). Conclusions: The findings of the current study were in accordance with those of the previous studies, and generally showed a significant association between emotion regulation, schema, and vandalism with oppositional defiant disorder. Study implications and limitations were considered.

Friendly Faces: Characteristics of Children and Adolescents With Repeat Visits to a Specialized Child Psychiatric Emergency Program.

Pediatric mental health emergency department (ED) visits continue to rise with 19% to 62% of youth presenting to the ED ultimately returning for a mental health-related complaint. To better understand the needs of children returning to the ED, this study examines the clinical, demographic, and environmental factors associated with revisits to a dedicated child psychiatric ED. Clinical factors, home environment, and mental health service utilization of 885 children presenting to a dedicated child psychiatric ED over a 1-year period were abstracted by retrospective chart review. Bivariate analyses comparing demographic and clinical characteristics for children with and without revisits and a multivariable logistic regression were performed. Of the children presenting to the ED, 186 (21.0%) had at least 1 revisit in the subsequent 180 days. Thirty-one percent of initial visits presented as urgent, 55% presented as emergent. Children presenting with more severe symptoms at their initial visit were more likely to return within 6 months. Female gender, suicidal and disruptive behavioral symptomatology, and a diagnosis of oppositional defiant disorder were associated with repeat visits. Children with mental health system involvement were more likely to have revisits than those who were "treatment naive." Revisits to the ED are driven by both clinical factors, including severity and psychosocial complexity, and barriers to accessing services. Addressing the problem of return ED visits will require the development of a robust mental health service system that is accessible to children and families of all socioeconomic levels.

Carboxylesterase1, alpha 2a adrenergic receptor and noradrenalin transporter gene polymorphisms and their clinical effects in attention deficit hyperactivity disorder in Turkish children

The objective of this study was to examine the association between ADHD and G1287A polymorphism in the NET1 gene, C1291G polymorphism in the ADRA2A gene on the adrenergic pathway and Gly143Glu polymorphism in the CES1 gene on the metabolic pathway, and their clinical effects.The study population included 114 children with ADHD and 83 healthy controls. 103 patients are followed for 6 months, their scale points are recorded and side effects are questioned in each interview.Every patient in both control and ADHD group are found to have GG genotype when Gly143Glu polymorphism in the CES1 gene is examined, thus we came to a conclusion that Turkish population is homozygote in the mentioned polymorphism. No significant association between NET1 gene G1287A polymorphism genotypes and ADHD was found. It was found that ADRA2A C1291G polymorphism C allele and CC genotype is a risk factor for ADHD (p = 0.003, OR: 2.17, CI: 12.8–37.0) and the risk is higher in males (p = 0.013, OR: 2.43, CI: 12.0–49.5). There was no significant relation between ADRA2A C1291G polymorphism and clinical parameters but it was found that individuals with NET1 G1287A polymorphism AA genotype have less concurrent Oppositional Defiant Disorder diagnosis (18.8% vs. 81.2%, p = 0.039), their initial CTRS-attention deficit points are higher (17.47 ± 3.73 vs.16.15 ± 4.58, p = 0.045).In conclusion, our study showed that the ADRA2A C1291G polymorphism C allele and CC genotype is associated with ADHD. NET1 G1287A polymorphism AA genotype is mainly associated with attention deficit cluster.

Oppositional Defiant Disorder: The Psy Apparatuses and Youth Resistance

ABSTRACTThis article, situated in Foucauldian, anti-psychiatry, and mad studies literature, provides a theoretical intervention into the practice complexities and complicities of working with young people marked with the diagnosis of oppositional defiant disorder. Using a composite vignette as a proxy for social work practice, I map the particular harms of the deployment of the oppositional defiant disorder diagnosis, using Foucault and others to provide insight, in order to reorder and rethink work with young people marked as disorderly. Scholars effectively trace the manifold harms of the psychiatrization of young people; this article knits together the ways in which these harms operate, with the expressed intention of psychiatrizing youth resistance through multiple targets. The article concludes with tentative formulations for reconceptualizing youth resistance, in particular, using contributions from Sara Ahmed’s work on willfulness and Eve Tuck’s work on dangerous dignities. My aim is to use these emerging formulations to position our work with young people in alignment with their own resistance to injustice, rather than in concert with the efforts to psychiatrize their actions.

6.18 Caregiver-Reported Side Effects of Methylphenidate and Comorbid Oppositional Defiant Disorder Diagnosis in Children With Attention-Deficit/Hyperactivity Disorder (ADHD)

6.18 Caregiver-Reported Side Effects of Methylphenidate and Comorbid Oppositional Defiant Disorder Diagnosis in Children With Attention-Deficit/Hyperactivity Disorder (ADHD)