Friday, October 22, 2010

ODD Diagnosis Change?

Recent articles suggest many things are going to change with the release of the DSM V (The Diagnostic and Statistical Manual of Mental Disorders), and much of it bound to affect young people. We've heard that things like video game addiction are on the table now along with questionable changes to the interpretation of youth homosexuality, but the one that seems to capture the imaginations is this thing called Oppositional Defiant Disorder (ODD). Some articles have gone so far to suggest that the DSM V is going to make "free thinking a mental disorder," and thus render non-conformism and rebellious behaviors (especially in children and teens) as mental disorders.

In actuality, ODD has been in the DSM for quite some time. In my copy of the DSM III (back at least to 1987), it's listed as 313.81 under Disruptive Behavior Disorders, with a differential diagnosis linking it to Conduct Disorder, so there's nothing "new" about it being listed as a disorder other than perhaps new (big-pharma-backed) research into it.

One interesting note from this earlier version of the DSM hints at why Opposition Defiant Disorder shouldn't be confused for Conduct Disorder, though baring many of its features. This is due to the fact that ODD individuals appreciate the basic rights of others more and don't violate age-appropriate social norms as much as individuals with conduct disorder. From this, the basic idea (at least as it is presented in earlier drafts of the DSM) is that mild ODD (according to its own criteria for severity) only causes minimal or no impairment in school or social functioning...and therefore not be enough to make the diagnosis.

So the idea, at least as it was at one time, was that the only way a child could be considered ODD was if their rebellious attitude caused them "impairment in their social functioning with peers or adults." If there was no impairment, then a child could be as rebellious and free thinking as their personalities lead them to be. In fact, it's well understood that an oppositional temperament is one of the varieties of human emotion observed right out of the womb, with some infants being more tolerant and others being more oppositional, more or less. The thinking is that temperament is genetically caused, and simply a fact of nature.

I'm not sure what has happened in the definition of diagnosis for ODD, but if they have decided that "social functioning impairment" is not enough to qualify for diagnosis, then they probably went a step deeper and said "not only should the impairment be present, but the behavior itself as well." If that is the case, with the hope of squeezing more of these cases into the "treatable tent," then I think what we have is a deplorable situation which has effects on other disorders as well. "Behavior" whether it benefits the individual or not by itself shouldn't necessarily be labeled as a disorder, just those behaviors that are counterproductive to the individual.

Thursday, October 7, 2010

9 Year Old Sex Offender

Next time you say, or hear someone say "all sex offenders should be shot," just remember this... children and teens make up a majority of them.

State Rep. Melanie George (D-Bear) has a bill that would allow Family Court judges to decide if children younger than 14 (mandated by the Adam Walsh Act) should be listed on the registry. Of course, she can’t get it out of committee because legislators don’t want to be painted as soft on sex offenders in lieu of the Earl Bradley case.