Disruptive Behavior Disorder
Disruptive behavior disorders typically manifest early in life, and they’re often diagnosed before a child reaches 8 years of age. Children like this display aggression, hostility or unruly behavior for more than six months, and they show these acts almost all of the time.
Kids aren’t adults, shrunk down to a smaller size. Their brains are still developing, and they still have much to learn about interacting in the adult world in a way that’s both comfortable and acceptable. It’s common for children to try on personalities, looking for an interaction strategy that will maximize pleasure and minimize pain. For some children, those personality choices are unpleasant, and the behaviors these children can demonstrate can be hard to tolerate. In some cases, the behavior could be so far outside of what’s considered normal that the child becomes dangerous or even frightening.
Children like this might have a disruptive behavior disorder, and while that diagnosis might sound frightening, parents who know what their children are dealing with will be in a good position to provide appropriate help.
According to the Substance Abuse and Mental Health Services Administration, disruptive behavior disorders typically manifest early in life, and they’re often diagnosed before a child reaches 8 years of age. Children like this display aggression, hostility or unruly behavior for more than six months, and they show these acts almost all of the time.
An oppositional defiant disorder (ODD) lies on the mild end of the spectrum, even though the behaviors children like this display can be incredibly distressing to the people around them, including:
- Outbursts of anger
- Frequent arguments, particularly with authority figures
- Deliberate attempts to annoy or irritate others
- Lack of remorse for pain or anguish these acts cause
- Spiteful or vengeful acts
Children with ODD seem just hostile, negative or argumentative almost all of the time, and their behaviors have a deep impact on their relationships and their grades in school. They are very concerned with upsetting others, so they pay little attention to their own success in life.
If left untreated, ODD symptoms tend to grow more and more severe, until the child becomes more and more dangerous. In time, these children can develop a conduct disorder (CD), which is characterized by:
- Acts of bullying
- Physical distress wielded on people or animals
- Criminal acts
- Violation of rules
- Verbal or physical threats or intimidation
For those with CD, breaking the rules and getting away with these acts is the sole source of joy in life, and they may feel as though each act they undertake could be augmented and made just a little bit more significant. Often, children like this run into legal trouble, as their actions aren’t generally accepted by the society at large.
ODD and CD diagnoses aren’t handed out lightly, and there are some children who have aspects of these conditions without reaching a level that would be considered clinically significant. These teens might still be argumentative, aggressive and destructive, for example, but they might not have displayed these behaviors quite long enough to merit a full diagnosis. Reaching children like this before they transition into a severe state could be key to stopping the damage and halting the progression of the behavior.
Understanding Root Causes
Sometimes, ODD and CD develops on its own, outside of any other mental health issue. These children might have parents who struggle with the same kinds of mental health issues, or they may have endured a damaging environmental event in childhood that placed them on an unhealthy mental health course.
Often, however, ODD and CD develop alongside other mental health concerns, including attention deficit hyperactivity disorder (ADHD). According to the National Resource Center on ADHD, about 40 percent of people with ADHD have ODD, and about 45 to 50 percent of adolescents with ADHD have CD. The conditions can blend and blur, as some people with ADHD also have difficulty with structure, rules and authority. They may interrupt, play tricks, utilize verbal abuse and more during the course of their disease, and it can be hard for parents to determine when ADHD stops and a conduct disorder takes over.
Transition to Substance Abuse
An article in the Journal of Psychoactive Drugs suggests that the “majority” of teens who have disruptive behavior disorders also have substance abuse disorders. For some teens, this substance abuse is the perfect form of rule breaking. They like the idea of flouting the societal conventions, so they take in drugs and alcohol despite the laws that tell them such use isn’t allowed. Unfortunately, the adolescent mind is changing at such a rapid pace that drugs and alcohol can cause persistent damage, and a quick snort of drugs can bloom into a raging addiction in a brain that’s under construction in this way. Teens who intended only to experiment may find that they simply can’t control how often take they drugs.
In a study of the issue, published in the Journal of Abnormal Child Psychology,teens with behavior disorders were asked to complete a gambling game that measured the risky decisions they took. When scores of children with conduct disorders were measured against the scores of children without these issues, those with conduct disorders made “significantly more risky choices.” It’s not clear why impulsivity like this is attached to conduct disorders, but it’s easy to see why it would lead to substance use and abuse. An altered brain like this can’t make good long-term decisions, and abusing substances might seem reasonable when the impact is only measured in the here and now. This is particularly tragic, as many addictive drugs also cause impulse control problems, as they starve the portions of the brain that control impulsivity and planning. Teens with behavior problems and addictions may find that they’re even more impulsive and dangerous than they were before they started dabbling in drugs. They have trouble handling their thoughts and controlling their behavior.
Any substance might be ripe for abuse in teens with behavior disorders, but a study in the American Journal of Psychiatry suggests that teens follow a predictable path of use, beginning with alcohol or tobacco, followed by marijuana, followed by street drugs. This study also suggests that the mental health issue comes first, meaning that these teens didn’t develop their mental health disorders due to persistent damage caused by drugs. Instead, they began using substances when their mental health concerns were already in play. The substance use can make the mental health issue much worse, of course, but the mental health problem came first for these teens.
Finding the Source
Disruptive behavior disorders can be distressing for parents, and for the teachers who work with these troubled students, but not all incidents of difficult behavior can be laid at the feet of this specific mental illness. In fact, some physical ailments can cause children to act in strange and unpredictable ways, and some substance abuse issues can cause children to behave in ways that are baffling to parents and caretakers. A full physical workup, followed by a session with a licensed mental health expert, is the best way to determine if the issues the parents are seeing is caused by a disruptive behavior disorder. Just guessing isn’t the right way to handle an issue that’s so very important. Mental health testing for these conditions might involve simple question-and-answer sessions, and the tests are often scored using very strict requirements. At the end of a testing period, parents might have more information than they ever thought possible.
With a diagnosis in hand, medical experts may suggest a course of treatments with stimulant medications. According to the American Academy of Pediatrics, stimulant drugs can reduce levels of aggression in children with disruptive behavior disorders, and when this anger is removed, the child might be able to develop healthy relationships and a sense of empathy appropriate for his/her age. Sometimes, stimulants can prepare a child for more intensive learning, and that might take place in therapy.
In therapy sessions for disruptive behavior disorders, clients learn more about how to control their impulses and live in the world without trouncing on the rights of other people. They might also learn more about how substance abuse can make their condition worse, and how they can handle their mental illness without leaning on the crutch of addictive drugs or alcohol. Inpatient programs may provide a good resource for some children, as these programs allow them to escape normal routines and normal expectations of family and friends, so they can learn and try on new personalities without feeling pressure to revert to the old ways. Some teens, however, fare just as well in outpatient programs, as long as they have the love and support of their parents.
Raising a child with a disruptive behavior disorder isn’t easy, and parents of children like this might even be a little frightened of their children, and they may wonder what their children are capable of. At Muir Wood, we understand. We know you love your child and you want what’s best, but you’re at your wit’s end about how to help, and you don’t know where to turn. Please call us. We offer treatments for adolescent boys who have mental illnesses, addictions or both. We might provide just the solution your family has been looking for. Please call us to find out more.
Behavioral Problems in Teens
While behavioral problems in teens might be confusing or even distressing, there are some things parents can do to help turn the tide, and sometimes, counselors can help to reinforce those lessons and ensure that teens get on the right track once more.
Raising a child can be one of the most rewarding jobs available. Parents watch their babies learn to talk, walk, speak and eat, and they teach their children how to share, listen and love. During adolescence, however, parenting can be tough. Teens might begin to make absolutely baffling decisions, and they might be completely unable to explain the choices they’ve made. Adolescents might also start to behave in ways that parents, as well as members of society, find completely unacceptable. While behavioral problems in teens might be confusing or even distressing, there are some things parents can do to help turn the tide, and sometimes, counselors can help to reinforce those lessons and ensure that teens get on the right track once more.
Predictably Bad Choices
It’s not uncommon for teens to act up as adulthood draws near. In fact, according to an article published by Medscape, about a fifth of adolescents admit that they engage in poor behavioral choices, including:
- Skipping school
Adolescents might also begin to dabble in drug and alcohol abuse. According to the National Center for Children in Poverty, about 10 percent of those ages 12 to 17 were current users of illicit drugs in 2009, while 26 percent of those ages 16 to 17 admitted to alcohol use. These teens might not think of their substance abuse as a behavioral issue, but the fact remains that young people are not legally allowed to drink alcohol, and people of any age aren’t allowed to use illicit drugs. As a result, it’s safe to lump substance use in with other behavioral problems.
Teens might also engage in more benign acts of defiance, including breaking curfew, refusing to do chores or talking back to their parents. Some teens only perform these acts from time to time, but others seem to escalate with time, growing more and more difficult to control as they realize their parents can’t really fight back in an effective manner.
Consequences of Poor Behavior
Adolescents who behave badly can strain their relationships with their parents. They show very little respect and very little understanding, and parents can grow increasingly frustrated as they try to reach in and communicate with the little person they once knew so well, buried now underneath a wall of sneering adolescence. Families that fray like this can make life even more difficult for a teen, as the teen might feel yet more isolated, alone and at sea. Teens like this might escalate substance abuse or engage in other unhealthy behaviors, just to ease their pain.
Teens with behavioral problems might perform worse in school, according to a study published in the Journal of Health and Social Behavior, bringing home lower GPAs and perhaps dropping out of school before completing their degree. These students are more focused on acting out than they are on learning, and this could be a trait that sticks with them for the rest of their lives and truly limits their ability to succeed.
Why The Problem Manifests
Some teens exhibit behavioral problems because they’re dealing with a life stress, such as:
- The death of a loved one
- A divorce in the family
- A serious illness
- A move to a new community
Teens might also develop behavior problems simply because they’re hardwired to do so. According to the American Academy of Child and Adolescent Psychiatry, the portion of the brain responsible for instinctual reactions (the amygdala) is well developed in adolescence, but the part of the brain that deals with reason and impulse control (the frontal cortex) develops later in life. As a result, teens are simply wired to make snap decisions and act impulsively. Their brains just can’t react in another way.
How to Deal With Problem Behavior
Parents can help by coaching their children and teaching them how to make better long-term decisions. They can ask a teen to talk about the moments that led up to a poor decision, and they can provide the teen with pointers on how to handle that situation differently. Praising the teen for good decisions and appropriate behavior is also an apt choice, as parents of difficult children may inadvertently focus all their attention on bad choices and forget to help the child learn how to behave in another way. Consistent rules at home may also help teens learn that the rules must always be followed, no matter what that teen might prefer to do.
There are some times in which all the parenting skills in the world won’t help a teen to improve. Counseling might be a better option in situations like this, and parents often send their children for professional help when the problem doesn’t seem to be improving at home. According to the 2007 National Survey on Drug Use and Health, about 25 percent of teens who received mental health care did so because they were breaking rules or otherwise acting out. It’s a common, and a good, reason to provide a teen with mental health care.
Counseling for drug abuse or addiction can help teens to explore why they abuse substances, and what they might try to do to ease discomfort without leaning on drugs. Resisting peer pressure, improving confidence, and making good decisions might all play a role in an appropriate counseling program. Teens might also find that participating in support groups, such as Alcoholics Anonymous or Narcotics Anonymous, is helpful, as they’ll have the ability to meet other people who are working toward long-term sobriety.
Family therapy might also play a role in teen behavioral problems, as parents and their children might need to repair the damage the destructive behavior has caused within the family unit. In family therapy sessions, the group comes together to discuss their communication styles, coping strategies and more, all with the aim of developing a welcoming family that isn’t impacted by substance abuse or poor behavioral choices.
If you’d like to know more about how therapy could help your son to amend his behavior, please contact us. At Muir Wood, we provide a variety of treatments that can help young men to understand their peers, develop their sense of purpose and resolve, and put together a healthy and productive life. Please call us to find out more.
Oppositional Defiant Disorder: More Than Teen Angst
According to the Mayo Clinic, symptoms of ODD typically appear before a child reaches 8 years old, and the signs tend to increase in severity as the child ages.
“Mine! Mine! Mine!” It’s the battle cry of a 2-year-old child, and it’s certain to raise the hackles of any parent standing nearby. Arguments often ensue, as parents attempt to teach their children to respect the wants, wishes and needs of others. These are difficult lessons, and many of these arguments end in tears. As the years pass, however, and the child learns how to navigate the adult world, screams come with less regularity and disagreements become less and less frequent.
For the estimated 20 percent of school-age children with oppositional defiant disorder (ODD), however, arguments like this become more common with time. For these young people, hostility and anger are the rule of the day, and attending to the needs of others is never as important as addressing the needs of the self. Parenting a child like this can be a challenge, but with help, children like this can grow to be focused, thoughtful, valuable members of society.
According to the Mayo Clinic, symptoms of ODD typically appear before a child reaches 8 years old, and the signs tend to increase in severity as the child ages. By the time adolescence arrives, these children are deeply unhappy, with a variety of signals that are difficult if not impossible, for parents to ignore, including:
- Persistent anger and resentment
- Lack of obedience
People with ODD may argue with both strangers and peers, and they may seethe with anger when conversations don’t seem to go as planned. At school, teens with ODD might pick fights, annoy teachers, blame others or disrupt the classroom. Teens with ODD might also bully other students, according to a study in the Journal of Developmental and Behavioral Pediatrics, picking on students who have developmental disabilities or other differentiating characteristics.
These behaviors don’t appear out of the blue, as most teens with ODD have been labeled “difficult” from a very young age. When these teens were babies, they might have seemed rigid, upset and hard to care for, demanding a specific type of care or a particular ritual, or else screaming would begin. Parents of children with ODD might be habituated to their children’s behavior, certain that this falls within the realm of what is normal. Unfortunately, children and teens with ODD can be so destructive and so hurtful to those around them that school officials may not be willing to forgive the behavior. These students may be disciplined or expelled due to the havoc they wreak.
Finding a Diagnosis
All children go through oppositional phases, and adolescence is a particularly trying time both for parents and their children. Teens must learn how to leave childish behaviors behind and function as autonomous adults, and during this period of experimentation, it’s not unusual for teens to try on personalities and test the patience of their parents. They’re attempting to determine how much independence is considered socially acceptable, and a little arguing and combativeness is a normal part of the experimentation process. However, those with ODD tend to have behaviors that are out of proportion to the behavior displayed by their peers. These are people who stand out from others, year in and year out, and who don’t seem to modify their behaviors based on what others want, say or do. When the behaviors interfere with the ability to succeed in society, it’s clear that help is needed.
The American Academy of Child and Adolescent Psychiatry reports that ODD can resemble other psychiatric conditions, including:
- Attention deficit hyperactivity disorder
- Learning disabilities
- Bipolar disorder
- Anxiety disorder
- Conduct disorder
Some people with ODD have these other conditions riding alongside ODD, and still others develop these other conditions if their ODD is not treated. A psychiatrist or other mental health expert is best qualified to make a diagnosis, finding all the factors that could be contributing and coming up with a plan to help those symptoms to fade. Taking a teen to a mental health expert can be difficult, but parents who do so may be helping their children to get better.
Risks of Ignoring the Problem
It can be tempting to ignore the problem, allowing the child to just move forward with life in the hopes that the problem will disappear with time. Parents of ODD children might be accustomed to allowing their children to control situations, as it’s the best way to keep the peace in the household, and as a result, it can be hard for parents to even think about coming to their children with a proposal to enter a treatment program. While avoiding the conversation might help parents to skirt a tough talk in the moment, long-term denial can lead to long-term problems.
They may do so poorly in school that they’re unable to obtain entrance into higher education facilities, or they may believe that they’re not “smart enough” to continue their educational experience. As mentioned, teens with ODD tend to be hostile and cunning, willing to inflict injury on others for no reason whatsoever. As communities crack down on bullying and antisocial behaviors in schools, teens who behave this way face an increasing risk of enduring harsh criticisms at school. Teens who are able to stay in school may be unable to learn, as they’re not focusing on their lessons as much as they’re focusing on the people around them.
Avoiding ODD can also lead to other mental health problems, including depression. In a study of the issue in the journal Psychological Medicine, researchers found that ODD was associated with major depression during the four-year period of the study. This same research uncovered a link between ODD and substance abuse. As these people attempt to medicate their pain on their own and live a life that won’t cause others distress, they may turn to addictive drugs in the process. Those with ODD may also abuse substances as they’re told not to do so by their parents and other authority figures. The substance abuse becomes another way to rebel, but the teen is the person who pays the ultimate price.
Helping a Teen With ODD
Parents can have a huge influence on children with ODD, even though these children may never admit that they look to their parents for help. By amending their approach to parenting and discipline, parents may help their children to focus on the positive, and learn that arguing isn’t always an effective way to reach a goal.
Parents can help their children by:
- Praising a child for flexibility, instead of punishing a child for arguing
- Walking away when anger builds, instead of escalating an argument
- Prioritizing struggles, allowing the teen to feel some semblance of control
- Maintaining interests outside of parenting the child
Some parents find that these changes are much too difficult to make, unless the child is also changing. Placing the child and the parent in therapeutic programs can help. While the child learns more about what ODD is and how it can influence behavior, the parent is learning how to model good behavior and make a home for the child that is safe and supportive. The two can work together in therapy, and their relationship may grow stronger as a result.
At Muir Wood, we provide therapies for adolescent boys who have mental illnesses, substance abuse issues or both. We believe that families have such an important role to play in recovery that we include parents in almost every treatment plan we put together. We provide parents with individual learning sessions, as well as group sessions with their teens, and we provide intensive follow-up care to ensure that the family continues to improve when the formal treatment program has ended. If you’d like to know more about this option, or you’d like to enroll your son in our treatment program, please call us. We can help.