Oppositional Defiant Disorder

Unlike traditional psychiatry, which rarely looks at the brain, Amen Clinics uses brain imaging technology to identify brain patterns associated with oppositional defiant disorder.

What is Oppositional Defiant Disorder?

Every child has an occasional moment of disobedience or misbehavior. But when uncooperative, argumentative, and vindictive behavior is so frequent and severe that it disrupts everyday life and relationships, it could be a sign of oppositional defiant disorder (ODD). ODD is a behavioral disorder that is characterized by children being chronically defiant with parents, peers, teachers, and other authority figures. They tend to say no even when saying yes is clearly in their best interest.

Who Has ODD?

ODD is primarily diagnosed in children, however, it is also seen in adolescents and adults. Research estimates that as many as 5% of all children are affected by ODD and over 10% of people will experience the condition at some point during their lifetime. The condition is more common in boys than girls. Adults with oppositional tendencies who were never diagnosed with the condition as a child may continue to remain undiagnosed.

Core Symptoms of ODD

Signs and symptoms associated with ODD in children and teens include:

  • Frequent outbursts/loss of temper
  • Excessive arguing with adults
  • Blaming others for their mistakes
  • Easily annoyed by others
  • Instigating conflict with others
  • Ignoring, questioning or resisting established rules
  • Saying mean or spiteful things when upset
  • Swearing or using obscene language

Considering that every child may occasionally exhibit these symptoms, it can be difficult for parents to know if their child is just having a bad day or if their behavior is a cause for concern. Children or adults with ODD are a lot less likely to comply even after multiple requests. With ODD, it isn’t just the person with symptoms who suffers—it’s the whole family, as well as friends, colleagues, and classmates. That’s why it’s critical to seek help.

What Causes ODD?

Researchers have yet to identify specific causes of ODD, however, it is believed that a combination of biological, psychological, and social factors play a role in its development. Possible risk factors include a family history of mental health issues such as ADD, substance abuse, obsessive compulsive disorder, or mood disorders; aggressive behavior or difficulty regulating emotions; and growing up in an abusive household or a lack of parental supervision. In addition, traumatic brain injuries (TBIs) can contribute to symptoms of ODD.

Untreated ODD can have alarming consequences and is associated with higher incidences of:

  • Poor academic achievement
  • Being suspended or expelled from school
  • Antisocial behavior
  • Difficulty landing and keeping a job
  • Having trouble maintaining relationships
  • Getting divorced
  • Having family dysfunction
  • Impulsivity
  • Substance abuse
  • Getting into trouble with law enforcement
  • Suicidal thoughts and behavior

Why Choose Amen Clinics For Treating ODD?

Unfortunately, traditional psychiatry remains the only medical specialty that rarely looks at the organ it treats. In conventional psychiatry, ODD is typically diagnosed based on symptom clusters, and because some of the symptoms of ODD may overlap with those of other mental health conditions, it can be misdiagnosed. By not looking at the brain, mental healthcare professionals may also miss underlying issues, such as a traumatic brain injury, that can contribute to disruptive behaviors associated with ODD. Healthcare professionals are quick to prescribe medications that may work for some people but can make other people worse! It is not uncommon for it to take weeks, months, or even years for a child or adult to get an accurate diagnosis and the proper treatment. This amounts to a lot of needless suffering. Brain SPECT imaging changes everything.

ODD Brains Work Differently

In people with ODD, brain scans show marked increased activity in an area of the brain called the anterior cingulate gyrus (ACG). Considered to be the brain’s gear shifter, the ACG—when it is healthy—helps people shift from one thought to another or one activity to the next. When activity is excessively high in this region, people tend to get stuck on thoughts or on a single course of action. For those with ODD, this means getting stuck on saying no, being argumentative, and refusing to budge.

Healthy Brain Scan

ODD Brain Scan

SPECT (single photon emission computed tomography) is a nuclear medicine study that evaluates blood flow and activity in the brain. Basically, it shows three things: healthy activity, too little activity, or too much activity. A healthy “active” scan shows the most active parts of the brain with blue representing the average activity and red (or sometimes red and white) representing the most active parts of the brain. In the healthy scan on the left, the most active area is in the cerebellum, at the back/bottom part of the brain. In the ODD brain on the right, there is marked hyperfrontality indicating excessive activity.

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Oppositional Defiant Disorder Can Affect All Ages

The symptoms seen in children, teens, and adults may range from mild to severe. With ODD, it isn’t just the person with symptoms who suffers—it’s the whole family, as well as friends, colleagues, and classmates. It’s important to know that having ODD is not a character flaw. In people with ODD, brain scans show marked increased activity in an area of the brain called the anterior cingulate gyrus (ACG). Considered to be the brain’s gear shifter, the ACG—when it is healthy—helps people shift from one thought to another or one activity to the next. When activity is excessively high in this region, people tend to get stuck on thoughts or on a single course of action. For those with ODD, this means getting stuck on saying no, being argumentative, and refusing to budge. However, for adults, the signs and symptoms of ODD may differ slightly. Those signs can include:

  • Feeling angry at the world
  • Feeling restrained
  • Being easily angered
  • Experiencing road rage
  • Contempt for authority
  • Thinking rules are unfair
  • A strong need to win arguments
  • Feeling like a rebel
  • Being vengeful or vindictive
  • Difficulty taking criticism
  • Blaming others for their own mistakes

 

“With A Better Brain Comes A Better Life”

– Daniel G. Amen, M.D.

 

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