The nurse is aware that outcome criteria would be appropriate for a child diagnosed with oppositional defiant disorder?

Correct Answer: A. Accept responsibility for own behaviors

Children with oppositional defiant disorder frequently violate the rights of others. They are defiant, disobedient, and blame others for their actions. Accountability for their actions would demonstrate progress for the oppositional child. Oppositional defiant disorder (ODD) is a type of childhood disruptive behavior disorder that primarily involves problems with the self-control of emotions and behaviors. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the main feature of ODD is a persistent pattern of angry or irritable mood, argumentative or defiant behavior, or vindictiveness toward others.

• Option B: This is incorrect as the oppositional child usually, focuses on his own needs. Temperamental factors such as irritability, impulsivity, poor frustration, tolerance, and high levels of emotional reactivity are commonly associated with ODD. While not all children diagnosed with ODD show callous and unemotional traits, it has been shown that such traits are highly heritable and may be seen more frequently in a subset of children with more significant disruptive behaviors.
• Option C: Treatment of oppositional defiant disorder is multimodal and should involve the patient, family, school, and community. Identifying and treating comorbidities (like ADHD, depression, and anxiety) and modifiable risk factors (such as bullying and learning difficulties) should be done. Treatment may also vary based on whether oppositional behavior primarily occurs in specific contexts or if the behavior is pervasive and thus requires more intensive treatment.
• Option D: This is not an outcome criterion but an intervention. Parent Management Training or PMT is based on the principles of social learning theory and is the main treatment for oppositional behaviors. The guiding principle in PMT is the use of operant conditioning (using the role of positive reinforcement in changing behaviors) to decrease unwanted behaviors and promote prosocial behaviors. Methods include teaching parents to identify problem behaviors as well as positive interactions and to apply punishment or reinforcement as appropriate.