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Oppositional Behavior in Children

Every year thousands of children are evaluated and treated by clinicians because their parents or teachers complain that these children frequently disobey, argue, lose their temper, deliberately annoy others or in other ways are disruptive. Some research suggests that psychosocial factors such as family conflict and parent mental health problems are related to oppositional behavior in children. Treatment hinges on assessing both the child and the family setting.

How do you know if your child has Oppositional Defiant Disorder? According to the DSM-IV-TR, to meet the criteria a child must have four of the eight symptoms more frequently than is typical for the child’s age and developmental level and lasting at least six months. These symptoms are: often loses temper, often argues with adults, often actively defies or refuses to comply with adults’ requests or rules, often deliberately annoys people, often blames other for his or her mistakes or misbehavior, is often touchy or easily annoyed by others, is often angry and resentful and is often spiteful or vindictive.

A good clinician will help clarify whether your child has these symptoms in addition to another set of symptoms which may better explain why your child is oppositional. For example, many children with Attention Deficit Hyperactivity Disorder have these symptoms but when both are treated, the prognosis is much better. It is important to recognize that sometimes children develop these symptoms in reaction to some stress in their life. Some children with depression develop many of these symptoms. In that case, the depression needs to be treated as well as the oppositional behavior in order for your child to get better. Some children with autism spectrum disorders develop these symptoms and treatment has to be tailored with that in mind otherwise there will be little progress. Sometimes these symptoms can be stemming from a bipolar disorder.

Assessing factors in the family are especially important. When parents are under stress due to their own mental health problems, financial stress or marital conflict, it is more difficult to be an effective parent. Helping parents be the best that they can is an important component of treating oppositional behavior. Parent training should be a vital part of the treatment. Furthermore, treatment of oppositional behavior in a child may lead to the detection of mental health problems in a parent or serious marital problems. In these situations, when all the problems in the family are addressed, the outcome is the best.

Virginia Fowkes Clark, Ph.D.

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