Saint Cloud Technical College Saint Cloud Technical College Paper: Psychology Answers 2021

Saint Cloud Technical College Saint Cloud Technical College Paper: Psychology Answers 2021

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RUNNING HEAD: OPPOSITIONAL DEFIANT DISORDER
1
Oppositional Defiant Disorder (ODD)
Ky Rolland
Georgia Gwinnett College
12 March 2021
Commented [KB1]: You don?t include the date on an APA
style title page
OPPOSITIONAL DEFIANT DISORDER
2
Oppositional Defiant Disorder (ODD)
The Diagnostic and Statistical Manual for Mental Disorders (DSM-5), defines
Oppositional Defiant Disorder (ODD) by three main characteristics: angry/irritable mood,
Commented [KB2]: Define the abbreviation here and
then you may use it throughout your paper
argumentative/defiant behavior, and vindictiveness. All three of these carry their definitive
characteristics with angry or irritable mood including a loss of temper, consistent annoyance, and
consistent patterns of anger and resentment (Riley et al., 2016). Argumentative or defiant
behavior is further explained in terms of arguments with authority figures in the case of adults
and with adults or adolescents in the case of children. The criteria for this symptom also include
resistance towards authority figures and rules, deliberate attempts made to annoy others, and
blaming others for one?s lapses inappropriate and normal behavior. Vindictiveness has been
qualified as a pattern to become spiteful or spiteful within a period of the last two months (Riley
et al., 2016). These patterns need to persist for at least six months for any four of the diagnostic
criteria, including the conditions of the said abnormal behavior not being a consequence of any
other medical or mental health condition and the fact that the behavior is a significant departure
from normal or appropriate social behavior and it has been causing marked distress in social
settings and contexts.
ODD has been classified into three categories based on the severity of symptoms. It can
Commented [KB3]: Looks like there?s an extra space
there
be either diagnosed as mild, moderate, or severe. For mild ODD, the symptoms are visible in
only one social setting. For a diagnosis of ?moderate? ODD, the client needs to exhibit these
symptoms in at least two social contexts, whereas it will be classified as ?severe? if the
symptoms begin to manifest themselves in across more than two social settings (Riley et al.,
2016). Research has estimated the incidence of ODD to be approximately 3.3 percent across
Commented [KB4]: The APA manual now lets us use the
% symbol
OPPOSITIONAL DEFIANT DISORDER
3
different cultures. There have been estimates that have declared the prevalence rate to be up to
sixteen percent.
Having ODD increases one?s chances of struggling with mood and anxiety disorders. The
risk increases with comorbid mental health conditions such as ADHD and CD (Burke &
Romano-Verthelyi, 2018). It has also been predicted that those with an inclination towards anger
or irritability are more at risk for developing anxiety or depression (or other mood disorders) as
compared to those who have symptoms related to argumentativeness, defiance, or vindictiveness
(Burke & Romano-Verthelyi, 2018). Those with a preponderance of these symptoms can go on to
develop conduct disorder. This disorder has been understood to come under the category of
disruptive behavioral and externalizing disorders (Katzmann et al., 2019).
When it comes to the causes of ODD, it has been historically understood to be a
consequence of maladaptive parenting practices. However, a genetic dimension to the incidence
of ODD has also been observed but the dividing line between genetic and environmental causes
remains unclear. Children born among families with low socio-economic status are more likely
to develop symptoms of ODD (Ghosh et al., 2017). Although parenting practices do tend to have
a significant relationship with the development, course, and interventions for ODD, recent
studies have cautioned against marking this disorder to be a direct cause for nothing but flawed
parenting. It has been found that there could be a number of factors that influence the
development and course of this disorder (Ghosh et al., 2017). All of these have a unique way of
impacting the dynamics by which this disorder plays out and presents itself. It also affects the
way ODD may be treated. It would be nothing but a height of oversimplification to state
parenting to be the only culprit behind a diagnosis of ODD. The notion can also contribute to
Commented [KB5]: 16
Commented [KB6]: Cite this
Commented [KB7]: Define these before you use the
abbreviations
OPPOSITIONAL DEFIANT DISORDER
4
biases that increase the chances of stigmatization of individuals with ODD, thus interfering with
the prognosis and effectiveness of interventions.
One of the most discussed causative factors for ODD remains to be parental hostility. It
has been proposed that when parents treat their children with hostility and harshness, the child
goes on the develop anger management, defiance, and non-compliance problems. Many studies
have also tried to stress the fact that the relationship can also be bidirectional. ODD stands out to
be one of the most stressful mental disorders for parents because of the gargantuan nature of the
task of handling and coping with extreme non-compliance and aggression exhibited towards
adults by children diagnosed with ODD (Ghosh et al., 2017). ODD is a disorder that is mostly
diagnosed among children. Also, ODD is a strong predictor of divorce. The challenges of raising
a child with ODD can cause stress of their own that can become chronic. Nonetheless, parental
and family hostility have been known to be the best predictors of ODD. It remains unclear
whether the role of temperaments and disposition is stronger when it comes to causative factors
of ODD or whether hostile parenting has a greater role to play (Ghosh et al., 2017). The next
factor associated with an incidence of ODD has been termed coercive parent-child relationships.
It has been found that the level of involvement, communication, supervision, and a construct
known as ?timid discipline? can have a role to play in the incidence of ODD among children.
Timid discipline can be defined as the hesitance to implement discipline and rules on part of
parents because they fear their child?s reactions and responses towards these efforts (Ghosh et al.,
2017). It has been made clear through several studies that timid discipline can be a predictor of
exacerbation of symptoms related to ODD. This has been dubbed as a reciprocal relationship
between parenting and children?s behavior.
Commented [KB8]: Just like I commented on your prerough draft, you can and should summarize a lot of your
paper up to this point to allow you more space for
discussing intervention programs.
OPPOSITIONAL DEFIANT DISORDER
5
Morshed et al (2019) have found that while the exact extent to which parenting or
dispositions of children can be implicated remains unclear, there is ample evidence of a positive
relationship between more adaptive parenting practices and ODD. This can help offer ideas that
can be translated into intervention models because no matter what the direction of this
Commented [KB9]: Same comment as in your pre-roughdraft. A positive relationship means that as one increases,
the other increases?. So this says that as parenting
improves, ODD symptoms increase.
relationship is, parenting practices can be modified to help alleviate the issues related to ODD
(Burke & Romano-Verthelyi, 2018). Similarly, Moratori et al (2020) has explained that
interventions that are based on improving the ability of children to be more receptive to
discipline and adults can also help ease such problems. Findings related to the elevated and
chronic stress levels among parents can also help in suggesting ways to cope with stress, making
it easier for these parents to cope with the challenges of raising children with ODD (Burke &
Romano-Verthelyi, 2018). The bidirectional relationship can be used to offer bidirectional
interventions that can help to make the prognosis of ODD better and more productive. More
research is needed to present an even clearer picture but most of the interventions devised for
ODD and other disruptive behavioral disorders revolve around this bidirectional relationship.
As far as the treatment for ODD is concerned, several interventions have been devised
that alleviate symptoms of ODD. A popular term used for these interventions is ?individualized
treatment plans? which refers to the idea of developing unique kinds of programs that cater to the
specific needs of children and their families (Katzmann et al., 2019). It is important to remember
that almost all of these interventions believe in considering the participation and involvement of
families and parents in the interventions (Katzmann et al., 2019). The reason for these is
embedded in the same bidirectional relationship explained above. It has been found that early
interventions can result in a greater tendency for those diagnosed with ODD to prevent the
incidence of substance use and abuse disorders later in life. The fact that prevention of other
Commented [KB10]: You can make this a bit more clear
with something like ??interventions for ODD can reduce the
likelihood that patients will develop substance use and
abuse disorders later in life.?
OPPOSITIONAL DEFIANT DISORDER
6
disorders associated with a diagnosis of ODD is possible with early detection, diagnosis, and
therapy speaks volumes about the efficacy of these interventions. Delinquency, which remains to
be one of the long-term outcomes of ODD, has been known to be avoided if the children and
their families get a chance to get the symptoms identified and treated at the right time during
early childhood (Katzmann et al., 2019). This is easy in the case of ODD because most of these
symptoms do present themselves mostly be five to six years of age.
The first line therapeutic technique used for most of the cases of ODD has been based on
behavioral parenting interventions. In case of a later age of onset, the therapy focuses on
developing individualized behavioral strategies as demonstrated by Morshed et al (2020). Childbased therapies revolve around the development and improvement of problem-solving skills
among the children themselves. These interventions focus on the different needs of these
children and offer ways to cater to their unique issues. Parent management therapies are
concerned with educating parents on how to respond to behaviors exhibited by children that are
part of the symptoms associated with ODD (Katzmann et al., 2019). According to the study
conducted by Morshed et al (2020), parent management therapies are successful because they
offer chances for parents to understand the dynamics between responses to children that may
encourage maladaptive behaviors due to positive reinforcement of such behaviors. This study
hasMorshed and colleagues developed an individualistic therapeutic model and a group play
model based on cognitive behavior therapy. The sessions have beenwere collaborative in nature
in that i.e. they have ensured the participation from parents and teachers (Morshed et al, 2020).
For example, when a child displays aggression, a parent may panic and begin to offer rewards.
This could lead to the child being more likely to exhibit the same behaviors because they have
just been unintentionally discouraged. Parents are taught the concepts and consequences of
Commented [KB11]: Put a period after ?al? ? check for
this throughout your paper
OPPOSITIONAL DEFIANT DISORDER
7
positive reinforcement, negative reinforcement, positive punishment, and negative punishment
(Khadar et al., 2013). It has been corroborated by Dunsmore et al (2016) that these strategies
Commented [KB12]: Remember to use the active voice
as much as possible
help them build timely, appropriate, and predictable responses to their children?s disruptive
behaviors. Studies have pointed towards the efficacy of group interventions based on parenting
techniques to resolve issues related to child conduct, parental stress, and parenting skills. The
experiment has designed an intervention based on emotional regulation, targeting dyads of
mothers and their children diagnosed with ODD.
Commented [KB13]: Cite this and describe this
intervention!
Several different models based on collaborative interventions have cropped up. There
have been several studies like the one conducted by Muratori et al (2020) regarding the use of a
mindfulness based intervention to address symptoms of ODD. This intervention has been based
to develop strategies to cater to the areas of deficits related to ODD. It has catered to fifty male
students ranging from ages eight to twelve who have been exposed to a mindfulness based
intervention (one and a half hour sessions over a period of nine weeks). It bases its rationale on
the premise that children with ODD tend to have poor skills of emotional regulation. They
cannot become aware of the dynamics of their emotions of anger becoming out of control due to
increased impulsivity and not being aware of others around them and their needs (Muratori et al,
2020). The sessions are based on goals of the therapeutic intervention whereas these goals are
derived from extant research and theoretical models upon which these interventions are based.
Katzmann et al (2017) designed a study that recruited ninety-one participants (aged six
to twelve years). This study had been based on social skills training and a resource-activating
Commented [KB14]: See the APA manual for dealing with
numbers and address this throughout your paper
play group. This study was designed upon a children-based approach towards a treatment for
Commented [KB15]: Again, use the active voice as much
as possible
ODD. The intervention had beenwas carried out by thirteen professional and experienced child
therapists. Data were collected at various points throughout the study i.e before treatment, three
Commented [KB16]: According to the APA manual, we
can only use abbreviations like this for parenthetical
material. When it is in-text, you have to write out what you
mean
OPPOSITIONAL DEFIANT DISORDER
8
times during the treatment, immediately after the intervention, and twelve months after the
intervention (Katzmann et al., 2019). The intervention for the social skills training group
comprised twenty-five weekly sessions, each lasting for forty-five minutes. In these sessions,
children were taught particular social cognitive skills and anger management strategies as
opposed to the playgroup (active control group). The latter had groups of children assigned to
attend twelve sessions (biweekly). Each session lasted for ninety minutes. The children were
encouraged to participate in proactive social interactions without any specific focus on the
development of skills as in the case of the first group (Katzmann et al., 2019). The results were
measured by using various instruments measuring the levels of social skills, conduct disorder
symptoms, oppositional defiant disorder symptoms, and anger management (Katzmann et al.,
2019). Social skills training was found to be more effective and efficacious as it worked on the
development of skills to alleviate symptoms of ODD.
There have been others who seem to have focused on the development of better parentchildren collaborations. These have been based on the assumption that dealing with one aspect of
the bidirectional relationship pertaining to causes of ODD can assist in repairing the dynamics. It
is not deemed necessary by these interventions to deal with both aspects of this relationship
separately (i.e., children?s issues and parents? issues) (Booker et al., 2020). These models are
based on the assumption that parent-child interactions can be worked on and improved to
alleviate symptoms of ODD. When children learn to respond to parents in certain ways that are
adaptive instead of maladaptive, they can find a way to decrease levels of anger, resentment, and
non-compliance because they can experience the benefits of more effective communication with
adults in their lives (Booker et al., 2020). Similarly, if parents become aware of the reasons for
maladaptive behaviors that are playing a part in making communication ineffective between
OPPOSITIONAL DEFIANT DISORDER
9
them and their children, they can learn to respond in healthier ways, thereby helping themselves
and their children in sorting through their issues by improving upon mutual relationships and
patterns of communication. Such interventions also have the same underlying strategy of
planning sessions and measuring levels of desired variables as well as recording observations
and reports from other sources such as parents and teachers (Booker et al., 2020). The content of
these sessions is more concerned with giving the parents and children a chance to work on their
problem-solving strategies and communication patterns.
One such study by Booker et al (2019) has focused on designing a parent-centered
intervention compared to a collaborative model for treating ODD. The treatment groups had been
named as Parent Management Training and Collaborative and Proactive Solutions (Booker et al.,
2020). One hundred and thirty-four children, adolescents, and their parents participated in this
study. Parental warmth was the most significant predictor of improvement in adaptive skills of
children for the Parental Management Training group. Families assigned to the Collaborative and
Proactive Solution group found a buffer against family hostility (Booker et al., 2020). It seems
that both Parental Management Training and Collaborative Practice Solution interventions have
their unique strengths and prospects when it comes to the treatment of ODD.
Other interventions include art therapies and mindfulness training. Art therapy focuses on
providing other channels of expression to children besides anger. The idea is based on the
premise that these children will find it easier to sort through these emotions if they have healthier
outlets. These interventions expose children to opportunities to express themselves through art
for several sessions, assisting them in improving upon the regulation of their emotions and
learning to differentiate between productive and non-productive ways to express themselves. Art
therapies are mostly used in addition to other interventions. Results show that such interventions
Commented [KB17]: Maybe rephrase as something like
?The Collaborative and Proactive Solution interventions had
a buffering effect against family hostility?? Can you
elaborate on those interventions? Was the parent
management training less effective, or how did the two
programs compare in terms of results?
OPPOSITIONAL DEFIANT DISORDER
10
can act as facilitators for behavioral-based approaches. Different cognitive behavioral-based
Commented [KB18]: Can you elaborate on the research
here?
interventions have yielded varying results but most of these results have been encouraging
(Khadar et al., 2013). Today, these are the interventions mostly being used in addition to
pharmacological treatments in cases in whichof anxiety and depression that manifests itselfare
comorbid among children with ODD.
The results of a Painting Therapy-based intervention have been discussed in a study
designed by Khadar et al (2013). Participants comprised of children ranging from seven to
twelve years (Khadar et al., 2013). They attended twelve biweekly painting therapy sessions (of
forty minutes duration each) in which they were encouraged to express themselves emotionally.
This study was based on an experimental design that followed a pre-test/post-test model. The
experimental group that had been exposed to painting therapy showed a significant improvement
in symptoms of ODD post-intervention as compared to the control group that had not been
exposed to the experimental conditions (Khadar et al., 2013). This is another approach towards
treating O?

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