# ODD (Oppositional Defiant Disorder) and a Big WTF?!? **URL:** \ **Category:** Great Debates\ **Created:** [September 22, 2003, 6:28pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145 "2003-09-22T18:28:39Z")\ **Posts on this page:** 20\ **Page:** 7
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [October 4, 2003, 12:44pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/121 "2003-10-04T12:44:52Z")
“You have to show that you know something about science.” Please. Tell me, you _wunderkinder_ you, which of you can tell me why operationalization is such an important part of social science? If you were following a recipe like this: > [@](#): > > \*A sufficient amount of water > Just enough flour > a reasonable amount of sugar > the obvious among of nutmeg > a non-excessive dusting of cloves > the appropriate number of eggs > > Put the ingredients in a proper mixing container in the correct order. Beat until the right consistency is reached, then cook in an oven that’s almost but not quite too hot until they’re cooked enough. - Who thinks that the results would be anything close to the intended comestible? ---
**Author:** ![NutWrench](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nutwrench/32/20193_2.png) [@NutWrench](https://boards.straightdope.com/u/NutWrench)\ **Post date:** [October 4, 2003, 3:02pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/122 "2003-10-04T15:02:58Z")
Can’t we just call them “morally-challenged?” ---
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [October 4, 2003, 3:11pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/123 "2003-10-04T15:11:56Z")
But is it immoral to disobey “rightful authority”? Who decides what “rightful authority” is in the first place? Anyway, that term would probably be better applied to those people previously referred to as “sociopaths”, and even then it would be extremely inaccurate. ---
**Author:** ![greck](https://avatars.discourse-cdn.com/v4/letter/g/7ab992/32.png) [@greck](https://boards.straightdope.com/u/greck)\ **Post date:** [October 4, 2003, 4:24pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/124 "2003-10-04T16:24:28Z")
> [@](#): > > \*Originally posted by TVAA \* > > * * * > > \*\* Citations for _what_? That children and adolescents are generally not given a say in the therapies they’re given? > > **AHunter3** had an excellent post a while ago about his experiences with the mental health system. Why don’t you go read it for an example of what can happen when the rules are obeyed? \*\* yes, show proof that children and adolescents are generally not given a say in their therapies. I defy you to do it. you can’t. neener neener neener. you can’t do it, and I think you know you can’t which is why you’ve ignored the challenge to present some reason people should believe what you say. Your ignorance and arrogance are astounding. that next one’s a gem. the old “you can just ask AHunter3 if you don’t believe me” argument. That one stopped working in the 5th grade. he/she is exactly 1 person; no more, no less. That means that the experience he/she had represents the experience of 1 person. You made a generalization from that? And you wonder why anyone doubts your science background. :rolleyes: ---
**Author:** ![greck](https://avatars.discourse-cdn.com/v4/letter/g/7ab992/32.png) [@greck](https://boards.straightdope.com/u/greck)\ **Post date:** [October 4, 2003, 4:25pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/125 "2003-10-04T16:25:31Z")
Oh, and by the way, My mom makes GREAT bread by exactly that method ---
**Author:** ![mrsface](https://avatars.discourse-cdn.com/v4/letter/m/a9adbd/32.png) [@mrsface](https://boards.straightdope.com/u/mrsface)\ **Post date:** [October 4, 2003, 4:32pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/126 "2003-10-04T16:32:58Z")
## quote: 1. “Defiance” is NOT merely willingness to ignore the desires of another. It’s refusal to adhere to legitimate authority. * * * ## Now, give us an objective and non-ideological definition of “legitimate authority”. Exactly. TVAA has made some important points about the subjective definitions of normality used to define deviance, the potential for reification through labelling and the use of drugs to engineer conformity (and generate massive profit). This is not a new debate - it has raged since Freud first wrote about his patients (and whoever said that psychotherapy does not contain the potential for abuse of power is seriously naive). It continued over ECT and psychosurgery, over Valium and Prozac, from encounter groups to “recovered memories”. It’s a debate that should never be closed down. Therefore it is a little depressing to read some of defensive and contemptuous responses to TVAA here. What on earth does it matter if TVAA has a degree in psychology or not? I have no degree in politics and no experience, but I don’t hesitate to question the actions of politicians. Qualifications and experience do not immunise you from lay challenges. Psychologists and psychiatrists potentially hold enormous power both over patients and public opinion. And we are all potential patients. You cannot hold such power and be surprised and offended when it is challenged or questioned. You should welcome it. Also, even though few psychs will set out with the intention of “engineering conformity”, the potential for this is always present, and becomes more likely the more you shut your eyes to it. I don’t know what the situation is in the US, but in the UK the psych professions are far from united over ADHD, ODD etc. The point is that it is still a DEBATE. Who is defining deviance, against what standard, and why. This question is as pertinent as ever. (BSc Hons Psych, since you ask) ---
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [October 4, 2003, 5:12pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/127 "2003-10-04T17:12:46Z")
> [@](#): > > \*Originally posted by greck \* > \*\*yes, show proof that children and adolescents are generally not given a say in their therapies. > I defy you to do it. > you can’t. \*\* Don’t you know _anything_ about the way our medical systems work? Children and adolescents do not possess the right to refuse medical treatment of any kind. Their legal guardians (usually their parents) have that right. This is precisely why some homosexual adolescents are forcibly imprisoned in special psychiatric “hospitals” and “treated” for their “condition” against their will. ---
**Author:** ![greck](https://avatars.discourse-cdn.com/v4/letter/g/7ab992/32.png) [@greck](https://boards.straightdope.com/u/greck)\ **Post date:** [October 4, 2003, 6:08pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/128 "2003-10-04T18:08:16Z")
> [@](#): > > \*Originally posted by TVAA \* > \*\*\*\* Don’t you know _anything_ about the way our medical systems work? Children and adolescents do not possess the right to refuse medical treatment of any kind. Their legal guardians (usually their parents) have that right. > > This is precisely why some homosexual adolescents are forcibly imprisoned in special psychiatric “hospitals” and “treated” for their “condition” against their will. \*\* still no cite huh? no proof? I know that in the psych hospital where I worked and in the two residential treatment centers for adolescents, every hallway had the patient’s rights posted (state law) one of which was the right to refuse treatment in each case. Forcing kids to take medication only occurred when the kid was actively trying to hurt himself or someone else. I’ll stand behind the decision to hold a kid while the nurse gave him a shot every time I made it. See if this helps: [http://www.angelfire.com/on2/camhpra/16.html](http://www.angelfire.com/on2/camhpra/16.html) that’s in californina. Pay attention to section G. particuarly where it outlines a minor’s right to refuse psychotropic medication. nice distractor with the whole homosexuality thing by the way. You were cornered, so you pointed toward an obvious one. Yeah it’s wrong to institutionalize someone for being homosexual. But what’s that got to do with ODD? ---
**Author:** ![Zenster](https://avatars.discourse-cdn.com/v4/letter/z/cdc98d/32.png) [@Zenster](https://boards.straightdope.com/u/Zenster)\ **Post date:** [October 4, 2003, 6:09pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/129 "2003-10-04T18:09:28Z")
> [@](#): > > \*Originally posted by TVAA \* > … I’ve seen psychologists and psychiatrists define patients’ behaviors and beliefs as “unhealthy” without anything even approaching a rational reason. I’ve seen them consider any opinion or belief they didn’t understand as symptoms of illness. I’ve watched them judge people as “sick” because they didn’t want to be what the doctors thought they should be. And this is one of my own major concerns about “diagnoses” of ODD and CD. Some questions:[ul][li] Is the behavior outlined by descriptions of ODD and CD regarded as voluntary or involuntary?[/li] [li] If such behavior is “compulsive” (or obsessive), to what is this type of (mis)conduct attributed?[/li] [li] What is currently regarded as the most effective therapy for ODD and CD?[/li] [li] Are there alternative treatments for ODD and CD?[/li] [li] What drugs (if any) are being prescribed for the treatment of ODD and CD? What are their effects?[/li] [li] What are the official guidelines related to earliest manifestation or typical age of onset for ODD and CD?[/li] What other co-related disorders are commonly found to accompany ODD and CD?[/ul] I also want to thank people for contributing so much information to this thread. Whether I agree or not, it is still good to see such an exchange of viewpoints. ---
**Author:** ![greck](https://avatars.discourse-cdn.com/v4/letter/g/7ab992/32.png) [@greck](https://boards.straightdope.com/u/greck)\ **Post date:** [October 4, 2003, 6:19pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/130 "2003-10-04T18:19:02Z")
> [@](#): > > \*Originally posted by mrsface \* > \*\*quote: > Therefore it is a little depressing to read some of defensive and contemptuous responses to TVAA here. What on earth does it matter if TVAA has a degree in psychology or not? > > You cannot hold such power and be surprised and offended when it is challenged or questioned. You should welcome it. > \*\* It’s not the debate that’s the problem. It would be one thing if someone admittedly was ignorant of the issues and was questioning practices, seeking information to formulate an opinion. I do welcome that and I’d take to task any therapist who doesn’t. It’s quite another for someone to represent himself as knowledgeable (nay, even all knowing) even to the point of being smug and insulting, when he obviously knows little about the subject at hand. ---
**Author:** ![greck](https://avatars.discourse-cdn.com/v4/letter/g/7ab992/32.png) [@greck](https://boards.straightdope.com/u/greck)\ **Post date:** [October 4, 2003, 6:42pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/131 "2003-10-04T18:42:17Z")
[QUOTE] \*Originally posted by Zenster \* \*\*And this is one of my own major concerns about “diagnoses” of ODD and CD. Some questions:[ul][li] Is the behavior outlined by descriptions of ODD and CD regarded as voluntary or involuntary?[/li] [li] If such behavior is “compulsive” (or obsessive), to what is this type of (mis)conduct attributed?[/li] [li] What is currently regarded as the most effective therapy for ODD and CD?[/li] [li] Are there alternative treatments for ODD and CD?[/li] [li] What drugs (if any) are being prescribed for the treatment of ODD and CD? What are their effects?[/li] [li] What are the official guidelines related to earliest manifestation or typical age of onset for ODD and CD?[/li] [li] What other co-related disorders are commonly found to accompany ODD and CD?[/ul] \*\*[/li][/QUOTE] the behavior is voluntary, but often heavily influenced by subconscious or semiconscious processes re: treatment, See Hentor’s post Tons of them. Alternative to what though? There is no drug to treat ODD or CD specifically, a person might be prescribed something to target some symptoms like impulsivity or maybe comorbid depression or ADD. With conduct disorder (sorry I don’t have my DSM here so I’m guessing) about school age. When the kid starts fire in the class or tortures the class hamster. ODD it’s a little trickier. In my experience, comorbidity with: ADD, Depression, Drug/alcohol addiction, bipolar sometimes. It gets really hard to divine what begat what sometimes. ---
**Author:** ![mrsface](https://avatars.discourse-cdn.com/v4/letter/m/a9adbd/32.png) [@mrsface](https://boards.straightdope.com/u/mrsface)\ **Post date:** [October 4, 2003, 7:05pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/132 "2003-10-04T19:05:27Z")
> [@](#): > > \*Originally posted by greck \* > \*\* > nice distractor with the whole homosexuality thing by the way. You were cornered, so you pointed toward an obvious one. Yeah it’s wrong to institutionalize someone for being homosexual. But what’s that got to do with ODD? \*\* It’s got everything to do with this debate. Namely that what is defined as deviant behaviour changes from one decade to the next. I’m sure the docs who set out to “treat” homosexuality were as sincere and well intentioned as you are now. The homosexuality example is a perfect illustration of the dangers of pathologising aspects of human behaviour which are seen, by some, as awkward or threatening. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [October 4, 2003, 7:52pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/133 "2003-10-04T19:52:37Z")
TVAA, Oh, I’ve read both the ADD thread and this one. I actually began with some bias to your position over Hentor’s, insomuch as I felt that Hentor was underappreciative of the limits of our current state of knowledge and tools. I was soon swayed by your apparent absolute lack of understanding how either science or clinical work actually function however. That children “do not have a say” in deciding what is good for them is irrelevant to the discussion of whether a label allows care to be forced upon them. Children are always subject to parental control over what is good for them. As a parent I can tell you that is not just my right; it is my obligation. I don’t need a psychologist telling me that my kid has disorder X to allow me to impose “behavior modification” or force him to go to a drug rehab program or to take his insulin or whatever. It is my job and I will do it. When it comes to my kids you are damn straight that I am the rightful authority … as long as my wife says its okay. 😉 And yes, I am looking for more than “AHunter says so” as a cite. I have read some of his threads. He has some very strong views based on perceptions of some very particular personal experiences. But I’d be looking for more than a few personal anecdotes and individual cases. You have posited that being labelled with a mental disorder in and of itself abrogates an individual of the right to make healthcare decisions. That will be a big surprise to many people I know who have anxiety disorder or depression or ADD or so on, who make their own decisions quite well thank you. Including ignoring advice from various clinicians that either they felt was wrong or was tried and wasn’t helpful. Mrsface: What matters is that he provides some basis to believe what he says. Evidence in a study perhaps. That’s best. Next best is extensive personal experience … as a patient, or patient family or freind, or as a treating clinician. But to state that a certain med causes kids to act in a certain way (for example) when those of us who work with this population know that such is untrue, and to be unwilling to back up his statement, well, that makes us question if he has any basis for anything he says. Your question “Who is defining deviance, against what standard, and why.” is indeed as pertinent as ever. I have issues myself with the pathologizing of every difference. But if you come declaring that you know the answer to that question then you should come prepared to explain how you know it to be true. Otherwise you be called out as an arrogant and ignorant blowhard. ---
**Author:** ![greck](https://avatars.discourse-cdn.com/v4/letter/g/7ab992/32.png) [@greck](https://boards.straightdope.com/u/greck)\ **Post date:** [October 4, 2003, 8:24pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/134 "2003-10-04T20:24:00Z")
> [@](#): > > \*Originally posted by mrsface \* > \*\* > The homosexuality example is a perfect illustration of the dangers of pathologising aspects of human behaviour which are seen, by some, as awkward or threatening. \*\* Right, I get it, I know. I’m the first one to make the argument in most cases. I’ts just that I don’t want my side of the debate made sound stupid by someone who will distort it and undermine it with his ignorance. It’s too important. ---
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [October 4, 2003, 9:00pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/135 "2003-10-04T21:00:54Z")
> [@](#): > > \*Originally posted by DSeid \* > \*\*I was soon swayed by your apparent absolute lack of understanding how either science or clinical work actually function however. \*\* Genuine science retains awareness that its descriptions of phenomena might have absolutely nothing to do with the phenomena themselves. Scientists are often reminded that categories they believe to have observed in the world aren’t real – consider the paleoarcheologists’ disputes over the classifications of stone tools, for example. Unfortunately, there is a distinct tendency for people to react more strongly to behaviors that have been given a clinical label than they would otherwise. Actual science also relies heavily on operationalization, which psychiatry does not. > [@](#): > > b]That children “do not have a say” in deciding what is good for them is irrelevant to the discussion of whether a label allows care to be forced upon them. \*\* No one _decides_ what is good for anyone. People generate beliefs about what is good; that is all. > [@](#): > > \*\*You have posited that being labelled with a mental disorder in and of itself abrogates an individual of the right to make healthcare decisions. That will be a big surprise to many people I know who have anxiety disorder or depression or ADD or so on, who make their own decisions quite well thank you. Including ignoring advice from various clinicians that either they felt was wrong or was tried and wasn’t helpful. \*\* Fortunately for them, their condition was not perceived as serious enough to warrant commitment. > [@](#): > > \*\*But to state that a certain med causes kids to act in a certain way (for example) when those of us who work with this population know that such is untrue, and to be unwilling to back up his statement, well, that makes us question if he has any basis for anything he says. \*\* It’s not uncommon for children who take these drugs to complain about how they make them feel. More to the point, they can often be observed to be noticably less cheery. Whether this occurs is partially dependent on how positively the child himself feels about taking the drugs – kids whose lives are significantly improved by them are less likely to find them objectionable. I am personally not particularly impressed by your claims to knowledge when you’re not familiar with the history of this disorder. ---
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [October 4, 2003, 9:08pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/136 "2003-10-04T21:08:05Z")
> [@](#): > > The more common initial side effects of Ritalin include decrease in appetite, weight loss, irritability, abdominal pain, headaches and emotional oversensitivity (e.g., crying easily). Less common side effects include rebound (i.e., as the dose wears off) overactivity and irritability, dysphoria (low mood), insomnia (which is why late-in-the-day doses are not prescribed), anxiety, picking at skin or pulling at hair, and decreased social interest. It’s not that uncommon, although it’s admittedly not the case with everyone who takes them. ---
**Author:** ![greck](https://avatars.discourse-cdn.com/v4/letter/g/7ab992/32.png) [@greck](https://boards.straightdope.com/u/greck)\ **Post date:** [October 4, 2003, 9:11pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/137 "2003-10-04T21:11:15Z")
> [@](#): > > \*Originally posted by TVAA \* > > * * * > > Unfortunately, there is a distinct tendency for people to react more strongly to behaviors that have been given a clinical label than they would otherwise. > > \*\* It’s not uncommon for children who take these drugs to complain about how they make them feel. More to the point, they can often be observed to be noticably less cheery. Whether this occurs is partially dependent on how positively the child himself feels about taking the drugs – kids whose lives are significantly improved by them are less likely to find them objectionable. I am personally not particularly impressed by your claims to knowledge when you’re not familiar with the history of this disorder. \*\* I’d love to read about this “distinct tendency” somewhere, could you cite it please? A book? a pamphlet? Where did you read about the kids complaining about the drugs? When did you observe them to be “notably less cheery?” “history of this disorder” where did you learn all about it? Where can I? science is heavily dependent on proof. ---
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [October 4, 2003, 9:19pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/138 "2003-10-04T21:19:58Z")
And it’s been demonstrated that children taking the various stimulants used to treat conditions like ADD are more prone to irritability as a common side effect, with dysphoria, depression, anxiety, and general unhappiness as less common ones. If you’re not aware of this rather basic information, then either you’re not a psychiatric professional or you’re a remarkably uninformed one. ---
**Author:** ![greck](https://avatars.discourse-cdn.com/v4/letter/g/7ab992/32.png) [@greck](https://boards.straightdope.com/u/greck)\ **Post date:** [October 4, 2003, 9:33pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/139 "2003-10-04T21:33:10Z")
I’m not a psychiatric professional, I’m a therapist. Psychiatrists are medical doctors. I am aware of the side effects of ritalin, that information really isn’t that basic, although I would hope that any psychiatrist would know it. Hell, my wife’s a dental student and she’s got that information on her palm pilot. still no proof then? nice distractor argument, again. Actually, you seem to have gotten us off on this ritalin thing once again. Could you provide a cite stating that ritalin is a standard course of treatment for ODD? in other words: you’re full of crap. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [October 4, 2003, 11:00pm UTC](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145/140 "2003-10-04T23:00:44Z")
TVAA, Here is your statement about what stimulants do that I called you on > [@](#): > > stimulants have similar effects in all children: reduced initiative, reduced enthusiasm, and vague feelings of distress. The issue isn’t whether or not stimulants have a known risk and incidence of side effects that occur in some children on some meds but not others or on others. And more than the ones listed too. That are “not uncommon.” But not those particular “effects in all children.” That’s just crap. And your current caveat about science is correct and important. And fulfilled in psychologic research and in the ongoing process of the DSM. That’s why it is an evolving document as the assessment of new research leads to revisions … and yes that assesment is by consensus. If it turns out that some descriptor or test can differentiate between kids with ODD who are caused by some intrinsic neurochemical anomaly and those with a reactive behavior to a divorce or such, then such would be included in the future and one maigfht be called something else. If you are going to claim that the members of the APA look to the current DSM as the be all and end all statement of the final most meaningful way to categorize behaviors for further study and for treatment then you need to support it with more than your say so. Or that it is Academy policy to believe that these categories are the explanations of the behaviors rather than an evolving tool to study them, well then support that also. Is it a very flawed tool? Yes, I think so. Do some take it to mean more than it does? Sure. Does “the mental health establishment” have a predisposition to pathologise? Yes and I think it is sometimes harmful. It is also a consequence of our insurance industry’s approach of paying for treatment of disease rather than paying to help optimize health … you need to have code. [Previous page](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145.md?page=6) [Next page](https://boards.straightdope.com/t/odd-oppositional-defiant-disorder-and-a-big-wtf/203145.md?page=8)