UNDERSTANDING OPPOSTIONAL DEFIANCE DISORDER, CONDUCT DISORDER

Intimidating Teen Behavior: Is It ODD or Conduct Disorder?

By Kim Abraham, LMSW and Marney Studaker-Cordner, LMSW

What do you do when your teen is intimidating you? Not just throwing a tantrum to get something he wants, but outright trying to scare you? How do you respond to an adolescent who gets up and blocks your way when you’re trying to leave the room, towering over you and looking at you in a way that makes your stomach ache? Is this oppositional defiant disorder or conduct disorder, and how can you deal with this?

 

These are tough questions with no easy answers. We talk every day with parents who feel their dream of raising a child has turned into a parenting nightmare. This article is intended for parents facing intimidation—perhaps even bullying—by their adolescent or teen in their own home. Our focus is on understanding and responding to this behavior, while supporting a specific group of parents who often feel isolated and as if no one understands their situation. We’re here to say we do understand, and you are not alone.

 

Is it Oppositional Defiant Disorder (ODD) or Conduct Disorder?

 

Many parents and professionals have difficulty recognizing the differences between ODD and conduct disordered behavior. Oppositional defiant disorder (ODD) is characterized by a child or teenager who fights against authority figures, such as parents and teachers.

Kids with ODD often lose their tempers, argue, resist rules and discipline, refuse to comply with directions and in general have a low frustration tolerance. The defining characteristic is a fight against being controlled. For a child like this, being controlled feels like drowning. Conduct disorder is used to describe an older child or adolescent who has moved into a pattern of violating the rights of others: intimidation or aggression toward people or animals, stealing or the deliberate destruction of property. The DSM-5, a diagnostic handbook used by mental health professionals, describes these individuals as having “a callous and unemotional interpersonal style.” It means a lack of empathy—not understanding or caring about how their behavior may physically or emotionally hurt others.

 

If a neighbor’s kid was physically intimidating you, what would you do? Avoid escalating the situation.

 

A key difference between ODD and conduct disorder lies in the role of control. Kids who are oppositional or defiant will fight against being controlled. Kids who have begun to move—or have already moved—into conduct disorder will fight not only against being controlled, but will attempt to control others as well. This may be reflected by “conning” or manipulating others to do what they want, taking things that don’t belong to them simply because “I want it,” or using aggression or physical intimidation to control a situation. Parents of kids who exhibit this type of behavior describe feeling afraid in their own home: “My son actually runs the house. We walk on eggshells.” Living with a child who is oppositional and defiant can leave a parent frustrated, angry, disheartened and sad. It doesn’t typically lead to fear. If you believe your teen is moving into conduct disorder—or if you know he’s already there—here are five things that can help you.

UNDERSTANDING SCHOOL REFUSAL AND WHAT YOU CAN DO AS PARENT

When kids begin refusing to go to school, some parents worry that their children will drop out, or that they’ll get a visit from a truant officer. School refusal, however, is different from truancy.

Children who are truant from school don’t want to go because they’d rather do something else—and they often concoct complex schemes to get out of school. Truancy is also more common in older children and teens, while school refusal can happen at any age.

So what is school refusal exactly? Some common signs of school refusal include:

  • Complaining of physical symptoms, such as a stomachache, to get out of school. At school, kids who refuse school may repeatedly visit the school nurse. If the child is allowed to stay home, the symptoms rapidly disappear. This does not, however, mean the child is faking; the symptoms may be a physical manifestation of anxiety.

  • Separation anxiety. Children with school refusal may have a history of separation anxiety, or may suddenly develop fears of being separated from parents, grandparents, or other attachment figures.

  • Changes in mood or behavior. Children refusing to go to school may be clingy or anxious, may throw tantrums, may begin struggling at school, or may behave in other ways that are out of character.

  • Negative experiences at school. Bullying, a bad teacher, trauma, or a generalized fear of going to school can initiate a chain reaction that leads to school refusal. Finding out what’s happening at school is critical to understanding school refusal.

School anxiety and refusal affect 25 percent of children, and often occurs between the ages of 5 to 6, and then again between 10 and 11. Children who refuse to go to school are often bright, with a history of excelling at school.

What parents can do to help

When a child won’t go to school, it’s tempting to treat it as a behavioral problem, or to simply ignore it and hope it goes away. But for children who are afraid of school, being forced to go to school can be extremely distressing. In this way, going to school becomes like a phobia. Consider how you’d feel if forced to do the thing that scares you most. That’s how your child feels.

What not to do

The way you respond to your child’s school refusal can make things worse. After all, you're your child’s biggest ally. If your child feels they cannot count on you, they may feel even more anxious. Avoid the following:

  • Telling your child’s friends or peers about their school anxiety.

  • Shaming or punishing your child for not going to school.

  • Threatening your child for not going to school.

  • Making fun of your child, or allowing siblings to make fun of your child, for not going to school.

  • Assuming the issue will work out on its own.

Children who refuse school need help, and a few sessions with a counselor are often all it takes to get things back on track.