Ewend - Assign 4.3 - ODD and CD

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Running head: A Comparison of Oppositional Defiance Disorder and Conduct Disorder 1

A Comparison of Oppositional Defiance Disorder (ODD) and Conduct Disorder (CD)

Eleanor Wend HS 513 T301 Assignment 4.3 Bellevue University September 24, 2011

A Comparison of Oppositional Defiance Disorder and Conduct Disorder 2

Abstract This paper will explore the etiology and diagnoses of Oppositional Defiance Disorder (ODD) and Conduct Disorder (CD). It will also discuss the prognoses into adulthood of these diagnoses. Keywords: Oppositional Defiance Disorder (ODD), Conduct Disorder (CD), adult prognoses

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Introduction Oppositional Defiance Disorder (ODD) and Conduct Disorder (CD) are two of the most frequent diagnoses and those most frequently referred to Mental health professionals for youth and young adults. It is estimated at a prevalence of approximately 5-20% of school age children with 3 males for every female diagnosed. The common symptoms will be compared and contrasted of ODD and CD. When the criteria for both are met CD takes precedence and ODD is not diagnosed. There is also a 75 percent co-morbidity with ADHD diagnosis. Differences and similarities in ODD and CD The common symptoms of both diagnoses include negativistic, defiant, uncooperative behavior patterns. In ODD the recurrent pattern is defiant and disobedient, hostile behavior toward authority figures which persists for a minimum of 6 months (APA, DSM IV-TR, 1994). The difference in CD is that this pattern of behavior violates the basic rights of others and/or age appropriate norms and rules are violated. The symptoms these two disorders share in common include more aggressive social skills, less empathic, more deficient social problem-solving. There is a frequent misperception that the social environment is hostile and the intentions of others are hostile. There is a constellation of behaviors which includes irritability, over reactivity, nonadaptability, high activity level and a low tolerance for stimuli. In CD the following additional symptoms may exist: 1. repeated aggression toward people and animals; 2. Destruction of property, fires and vandalism; 3. Deceitfulness, theft of property; 4. Violation of rules. There are frequently other diagnoses in addition to ODD and CD such as mood disorders like anxiety and

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depression or ADHD. It is estimated that up to 75% are also diagnosed with ADHD. (Netherton, et al., 1999) Possible causes of ODD and CD Possible causes for these diagnoses include innate disposition, dysfunctional family environment, developmental delays in processing thoughts and feelings. Many of the children diagnosed with ODD or CD have close family members who have other mood disorders. Childhood abuse, trauma and substance abuse in the home also are contributing factors. One study I found linked prenatal alcohol exposure and onset of conduct disorder in adolescence. (Larkby, et al., 2011) Low mental capacity, school failure, exposure to violence, lack of supervision are all contributing factors that have been identified in the literature. A biochemical imbalance has been identified where there is evidence of a lack of serotonin in the brain. (mayoclinic.com, 2011)

Prognoses in adolescents and adulthood Both these diagnoses may lead to school failure, job difficulties, and low self-esteem. There is also evidence that there is early sexual precocity and an increase in superficial sexual encounters. Early onset of substance use leading into substance abuse and dependence is also noted. The prognoses of both these diagnoses into adulthood includes: superficial sexual encounters, job difficulties, low self esteem and depression and substance abuse or dependence.

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Conclusion In conclusion there is a common constellation of symptoms with both ODD and CD. The differentiation with CD is when the symptoms also include aggression on people and animals, destruction of property with fire and vandalism, theft, deceitfulness and consistent violation of rules. When the criteria for both are met, the diagnosis of CD takes precedence. The causes include substance abuse and physical abuse in childhood, mental illness in the parents, low IQ, comorbidity with ADHD, peer group violence and

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References Francis, Allen et al., Task Force. (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, D.C.: American Psychiatric Association. Farrington, Murray J. (2010). Risk Factors for Conduct Disorder and Delinquency: Key Findings from Longitudinal Studies. Canadian Journal of Psychiatry: October, 2010, No. 10, pp.63342. Retrieved September 24, 2011, from http://www.mentalhealth.com/dis-rs/frs-ch02.html . Larkby CA, Goldschmidt L, Hanusa BH, Day NL. (2011). Prenatal alcohol exposure is associated with conduct disorder in adolescence: findings from a birth cohort. Journal of American Academy of Child and Adolescent Psychiatry: March, 2011, Vol. 50, No. 3, pp 262-71. Retrieved September 24, 2011, http://www.mentalhealth.com/dis-rs/frs-ch02.html The Mental Health and Conduct Disorder. (n.d.) Retrieved September 25, 2011, from Mayo Clinic website: http://www.mayoclinic.com/health/oppositional-defiantdisorder/DS00630/DSECTION=risk-factors

Netherton, Sandra D., Holmes, Deborah & Walker, Eugene C. (Eds.). (1999). Child and Adolescent Psychological Disorders: A Comprehensive Textbook. New York. Oxford University Press.

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