Internet Mental Health

OPPOSITIONAL DEFIANT DISORDER




Diagnostic Features of Oppositional Defiant Disorder

SYMPTOM DEFINITION SELF-DESCRIPTION
ANTAGONISM
Hostility Using threats or force against others; being verbally abusive, bullying, mean, or vengeful "I argue or fight when people try to stop me from doing what I want."
  • Children or adolescents with oppositional disorder have aggressive disrespect for non-siblings (e.g., defiance, disobedience, and disruptiveness).

  • For children younger than 5 years, the behavior should occur on most days for a period of at least 6 months, unless otherwise noted.

  • For individuals 5 years or older , the behavior should occur at least once per week for at least 6 months.

  • This disorder lacks delinquent behaviors (e.g., physical violence, property destruction, law-breaking, reckless thrill-seeking) or more serious antisocial behaviors (e.g., callousness, manipulativeness, and deceitfulness).

  • Not due to a medical or substance use disorder, or a more serious mental disorder.

Prediction

    Onset before age 8 and usually not later than early adolescence. Most children grow out of this; otherwise it usually becomes conduct disorder.

Problems

    Occupational-Economic Problems:

    • Limited: Present at home, but may not be evident at school or in the community.

    • Generalized: Frequent conflict with parents, teachers, and peers.

    Antagonistic (Low Agreeableness):

    • Angry/Irritable Mood:

      • Often loses temper.

      • Is often touchy or easily annoyed.

      • Is often angry and resentful.

    • Argumentative/Defiant Behavior:

      • Often argues with authority figures or with adults.

      • Often actively defies or refuses to comply with requests from authority figures or with rules.

      • Often deliberately annoys others.

      • Often blames others for his or her mistakes or misbehavior.

    • Vindictiveness:

      • Has been spiteful or vindictive at least twice within the past 6 months.

    Associated Findings:

    • Precocious use of alcohol, tobacco, or illict drugs.

    • Unlike Conduct Disorder, doesn't have the following delinquent behaviors: deceitfulness, physical violence, property destruction, or law-breaking.

    • Unlike Antisocial Personality Disorder, doesn't have the following antisocial behaviors: callousness, deceitfulness, manipulativeness, irresponsibility, impulsivity, or reckless risk taking.

    • More prevalent in families in which child care is disrupted by a succession of different caregivers or in families in which harsh, inconsistent, or neglectful child-rearing practices are common.

    • Unclear to what extent maternal depression results from or causes ODD in children.

    • Increased rates of Attention Deficit - Hyperactivity Disorder

    • May be associated with Learning Disorders, Communication Disorders

SAPAS Personality Screening Test

Individuals with this disorder would have a significant impairment in the behaviors that are displayed in red :

Most of the time and in most situations:

      In general, do you have difficulty making and keeping friends?
      Would you normally describe yourself as a loner?
      In general, do you trust other people? (No)
      Do you normally lose your temper easily?
      Are you normally an impulsive sort of person?
      Are you normally a worrier?
      In general, do you depend on others a lot?
      In general, are you a perfectionist?

Answer "Yes" or "No" to each of these 8 questions.


7-Question Well-Being Screening Test (By P. W. Long MD, 2020

Individuals with this disorder would have a significant impairment in the behaviors that are displayed in red :

      Agreeableness: I was kind and honest. (Instead had angry, argumentative, defiant, vindictive behavior)
      Conscientiousness: I was diligent and self-disciplined. (Instead had oppositional behavior.)
      Openness/Intellect: I showed good problem-solving and curiosity.
      Sociality: I was gregarious, enthusiastic, and assertive.
      Emotional Stability: I was emotionally stable and calm.
      Physical Health: I was physically healthy.
      Role Functioning: I functioned well socially and at school/work.

How often in the past week did you do each of these 7 behaviors:



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Diagnose Oppositional Defiant Disorder

Diagnose Childhood Disorders

Limitations of Self-Diagnosis

Self-diagnosis of this disorder is often inaccurate. Accurate diagnosis of this disorder requires assessment by a qualified practitioner trained in psychiatric diagnosis and evidence-based treatment.

However, if no such professional is available, our free computerized diagnosis is usually accurate when completed by an informant who knows the patient well. Computerized diagnosis is less accurate when done by patients (because they often lack insight).

Example Of Our Computer Generated Diagnostic Assessment

Oppositional Defiant Disorder 313.81

This diagnosis is based on the following findings:
  • Criteria are not met for Antisocial Personality Disorder or Conduct Disorder
  • Often loses temper (still present)
  • Often is touchy or easily annoyed (still present)
  • Often is angry and resentful (still present)
  • Often argues with authority figures (or, for children and adolescents, with adults) (still present)
  • Often actively defies or refuses to comply with requests from authority figures or with rules (still present)
  • Often deliberately annoys others (still present)
  • Often blames others for own mistakes or misbehavior (still present)
  • These symptoms cause clinically significant distress or disability (still present)
  • This hostile or defiant behavior is not due to a Substance Use, Psychotic or Mood Disorder

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Diagnostic Features

Oppositional Defiant Disorder is characterized by a frequent and persistent pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness. The symptoms of this disorder may be confined to only one setting (usually home). In more severe cases, the symptoms are present in multiple settings (e.g., home, school, community). The behavior must lead to significant problems in school or social activities. WARNING: Because symptoms of this disorder are more likely to occur with people the individual knows well, these symptoms may not be apparent during a clinical examination. Individuals with this disorder usually do not regard themselves as angry, oppositional, or defiant. Instead, they often justify their behavior as a response to unreasonable demands or circumstances.

Course

Oppositional Defiant Disorder usually starts during the preschool years and rarely later than early adolescence. Often these individuals develop Conduct Disorder, but many do not. Those with defiant, argumentative, and vindictive symptoms are most at risk for developing Conduct Disorder. Those with angry-irritable mood symptoms are most at risk for developing anxiety and depression.

Complications

This disorder causes frequent conflicts with parents, teachers, supervisors, peers, and romantic partners. This disorder is associated with increased risk for suicide attempts.

Associated Laboratory Findings

No laboratory test has been found to be diagnostic of this disorder.

Prevalence

The average prevalence of Oppositional Defiant Disorder is 3.3%. It is somewhat more prevalent in males than in females (1.4:1) prior to adolescence, but the males and females are equally prevalent in adolescence and adulthood.

Comorbidity

This disorder often co-occurs with Attention Deficit - Hyperactivity Disorder, Anxiety Disorders, Major Depressive Disorder, and Substance Use Disorders. High levels of emotional reactivity and poor frustration tolerance are predictive of this disorder.

Outcome

Ten years after diagnosis, the majority of these children no longer have this disorder. If this disorder perisists and worsens, it develops into Conduct Disorder in adolescence, and some of these individuals develop Antisocial Personality Disorder in adulthood. These individuals are also at increased risk for developing antisocial behavior, impulse-control problems, substance abuse, anxiety, and depression.

Risk Factors

Oppositional Defiant Disorder is more prevalent in families in which child care is disrupted by a succession of different caregivers or in families in which harsh, inconsistent, or neglectful child-rearing practices are common.

Effective Therapies

Parent training and developing the child's skills in tolerating frustration, being flexible, and avoiding emotional overreaction has proven to be effective.

Ineffective therapies

Physical punishment is seldom effective; likewise medication is seldom effective against the core features of this disorder. Vitamins and dietary supplements are ineffective for this disorder.

Trustworthy Research (PubMed.gov)


A Dangerous Cult: Videos


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Videos

Stories

Rating Scales


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Diagnostic Features of Conduct Disorder

ABNORMAL BIG-6 DIMENSION OF MENTAL ILLNESS CONDUCT DISORDER
ANTAGONISM
Hostility

Oppositional Defiant Disorder F91.3 - ICD10 Description, World Health Organization

Conduct disorder, usually occurring in younger children, primarily characterized by markedly defiant, disobedient, disruptive behavior that does not include delinquent acts or the more extreme forms of aggressive or dissocial behavior. The disorder requires that the overall criteria for F91 be met; even severely mischievous or naughty behavior is not in itself sufficient for diagnosis. Caution should be employed before using this category, especially with older children, because clinically significant conduct disorder will usually be accompanied by dissocial or aggressive behavior that goes beyond mere defiance, disobedience, or disruptiveness.

    F91 Conduct disorders
    Disorders characterized by a repetitive and persistent pattern of dissocial, aggressive, or defiant conduct. Such behavior should amount to major violations of age-appropriate social expectations; it should therefore be more severe than ordinary childish mischief or adolescent rebelliousness and should imply an enduring pattern of behavior (six months or longer). Features of conduct disorder can also be symptomatic of other psychiatric conditions, in which case the underlying diagnosis should be preferred.
    Examples of the behaviours on which the diagnosis is based include excessive levels of fighting or bullying, cruelty to other people or animals, severe destructiveness to property, fire-setting, stealing, repeated lying, truancy from school and running away from home, unusually frequent and severe temper tantrums, and disobedience. Any one of these behaviours, if marked, is sufficient for the diagnosis, but isolated dissocial acts are not.
Oppositional Defiant Disorder - Diagnostic Criteria, American Psychiatric Association

An individual diagnosed with oppositional defiant disorder needs to meet all of the following criteria:

  • A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following categories, and exhibited during interaction with at least one individual who is not a sibling.

    • Angry/Irritable Mood

    • Often loses temper.

    • Is often touchy or easily annoyed.

    • Is often angry and resentful.

    • Argumentative/Defiant Behavior

    • Often argues with authority figures or, for children and adolescents, with adults.

    • Often actively defies or refuses to comply with requests from authority figures or with rules.

    • Often deliberately annoys others.

    • Often blames others for his or her mistakes or misbehavior.

    • Vindictiveness

    • Has been spiteful or vindictive at least twice within the past 6 months.

      Note: The persistence and frequency of these behaviors should be used to distinguish a behavior that is within normal limits from a behavior that is symptomatic. For children younger than 5 years, the behavior should occur on most days for a period of at least 6 months, unless otherwise noted. For individuals 5 years or older, the behavior should occur at least once per week for at least 6 months, unless otherwise noted. While these frequency criteria provide guidance on a minimal level of frequency to define symptoms, other factors should also be considered, such as whether the frequency and intensity of the behaviors are outside a range that is normative for the individual's developmental level, gender, and culture.

  • The disturbance in behavior is associated with distress in the individual or others in his or her immediate social context (e.g., family, peer group, work colleagues), or it impacts negatively on social, educational, occupational, or other important areas of functioning.

  • The behaviors do not occur exclusively during the course of a psychotic, substance use, depressive, or bipolar disorder. Also, the criteria are not met for disruptive mood dysregulation disorder.


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Treatment Guidelines



World Health Organization Behavioral Disorder Treatment Guidelines

Download Printable Version


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Monitoring Your Progress

NOTE: When each of the following presentations finish; you must exit by manually closing its window in order to return to this webpage.

The Healthy Social Behavior Scale lists social behaviors that research has found to be associated with healthy social relationships. You can keep score (totaling its 4-point scale answers) on a separate piece of paper to monitor your progress.



The Mental Health Scale lists behaviors and symptoms that research has found to be associated with mental health (or disorder). You can keep score (totaling its 4-point scale answers) on a separate piece of paper to monitor your progress.



The Life Satisfaction Scale lists the survey questions often used to measure overall satisfaction with life. You can keep score (totaling its 4-point scale answers) on a separate piece of paper to monitor your progress.



Life Satisfaction Scale (5-Minute Video)

The "Big 6" Dimensions of Mental Health

Research has shown that there are 5 major dimensions (the "Big 5 Factors" or Five-Factor Model) of personality disorders and other mental disorders.

This website uses these 5 major dimensions of human behavior (i.e., Agreeableness, Conscientiousness, Openness/Intellect, Extraversion/Sociability, and Emotional Stability) to describe all mental disorders. This website adds one more dimension, "Physical Health", to create the "Big 6" dimensions of mental health.

The behaviors of the "Five Factor Model of Personality" represent five adaptive functions that are vital to human survival. For example, when one individual approaches another, the individual must: (1) decide whether the other individual is friend or foe [ "Agreeableness" ], (2) decide if this represents safety or danger [ "Emotional Stability" ], (3) decide whether to approach or avoid the other individual [ "Extraversion/Sociability" ], (4) decide whether to proceed in a cautious or impulsive manner [ "Conscientiousness" ], and (5) learn from this experience [ "Openness/Intellect" ].



Desiderata (5-Minute Video)



The following "Morning Meditation" allows you to plan your day using these "Big 6" dimensions of mental health.



The following "Evening Meditation" allows you to review your progress on these "Big 6" dimensions of mental health.




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    "In physical science a first essential step in the direction of learning any subject is to find principles of numerical reckoning and practicable methods for measuring some quality connected with it. I often say that when you can measure what you are speaking about and express it in numbers you know something about it; but when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory kind: it may be the beginning of knowledge, but you have scarcely, in your thoughts, advanced to the stage of science, whatever the matter may be."

    Lord Kelvin (1824 – 1907)


  • The best summary on bad research is given by Laura Arnold in this TEDx lecture. If you read nothing else about research, you owe it to yourself to watch this short video - it is excellent!

  • Economist in grim battle against deceptive scholarship

  • List of Predatory Journals and Publishers

  • The power of asking "what if?"

  • The active placebo effect: 2300 years ago, the Greek Stoic philosophers taught that it is not the objective event, but our subjective judgment about the event, that determines our behavior. The active placebo effect bears witness to this ancient wisdom.

  • Criteria For High Quality Research Studies

  • It is troubling that a recent study found that two-thirds of important psychological research studies couldn't be replicated. High quality research must meet the following criteria:

    • Randomized Controlled Trial:
      Ask: Was the trial randomized? Was the randomization procedure described and was it appropriate? The best research design is to have research subjects randomly assigned to an experimental or control group. It is essential that confounding factors be controlled for by having a control group or comparator condition (no intervention, placebo, care as usual etc.).

    • Representative Sample:
      Ask: Do the research subjects represent a normal cross-section of the population being studied? Many psychological research studies using university students are flawed because their subjects are not representative of the normal population since they are all W.E.I.R.D. (White, Educated, Intelligent, Rich, and living in a Democracy).

    • Single Blind Trial:
      Ask: Was the treatment allocation concealed? It is essential that the research subjects are kept "blind" as to whether they are in the experimental or control group (in order to control for any placebo effects).

    • Double Blind Trial (Better Than Single Blind Trial):
      Ask: Were blind outcome assessments conducted? In a double blind study, neither the research subjects nor the outcome assessors know if the research subject is in the experimental or control group. This controls for both the placebo effect and assessor bias.

    • Baseline Comparability:
      Ask: Were groups similar at baseline on prognostic indicators? The experimental and control groups must be shown to be comparable at the beginning of the study.

    • Confounding Factors:
      Ask: Were there factors, that weren't controlled for, that could have seriously distorted the study's results? For example, research studies on the effectiveness of mindfulness cognitive therapy in preventing depressive relapse forgot to control for whether the research subjects were also simultaneously receiving antidepressant medication or other psychological treatments for depression.

    • Intervention Integrity:
      Ask: Was the research study protocal strictly followed? The research subjects must be shown to be compliant (e.g., taking their pills, attending therapy) and the therapists must be shown to be reliably delivering the intervention (e.g., staying on the research protocol).

    • Statistical analysis:
      Ask: Was a statistical power calculation described? The study should discuss its statistical power analysis; that is whether the study size is large enough to statistically detect a difference between the experimental and control group (should it occur) and usually this requires at least 50 research subjects in the study.

      Ask: Are the results both statistically significant and clinically significant? Many medical research findings are statistically significant (with a p-value <0.05), but they are not clinically significant because the difference between the experimental and control groups is too small to be clinically relevant.

      For example, the effect of a new drug may be found to be 2% better than placebo. Statistically (if the sample size was large enough) this 2% difference could be statistically significant (with a p-value <0.05). However, clinicians would say that this 2% difference is not clinically significant (i.e., that it was too small to really make any difference).

      Statistically, the best way to test for clinical significance is to test for effect size (i.e., the size of the difference between two groups rather than confounding this with statistical probability).

      When the outcome of interest is a dichotomous variable, the commonly used measures of effect size include the odds ratio (OR), the relative risk (RR), and the risk difference (RD).

      When the outcome is a continuous variable, then the effect size is commonly represented as either the mean difference (MD) or the standardised mean difference (SMD) .

      The MD is the difference in the means of the treatment group and the control group, while the SMD is the MD divided by the standard deviation (SD), derived from either or both of the groups. Depending on how this SD is calculated, the SMD has several versions such, as Cohen's d, Glass's Δ, and Hedges' g.

        Clinical Significance: With Standard Mean Difference, the general rule of thumb is that a score of 0 to 0.25 indicates small to no effect, 0.25-0.50 a mild benefit, 0.5-1 a moderate to large benefit, and above 1.0 a huge benefit. It is a convention that a SMD of 0.5 or larger is a standard threshold for clinically meaningful benefit.

      The statistical summary should report what percentage of the total variance of the dependent variable (e.g., outcome) can be explained by the independent variable (e.g., intervention).

      In clinical studies, the study should report the number needed to treat for an additional beneficial outcome (NNTB), and the number needed to treat for an additional harmful outcome (NNTH).

        Number Needed To Benefit (NNTB): This is defined as the number of patients that need to be treated for one of them to benefit compared with a control in a clinical trial. (It is defined as the inverse of the absolute risk reduction.) Note: Statistically, the NNTB depends on which control group is used for comparison - e.g., active treatment vs. placebo treatment, or active treatment vs. no treatment.

        Number Needed To Harm (NNTH): This is defined as the number of patients that need to be treated for one of them to be harmed compared with a control in a clinical trial. (It is defined as the inverse of the absolute increase in risk of harm.)

        Tomlinson found “an NNTB of 5 or less was probably associated with a meaningful health benefit,” while “an NNTB of 15 or more was quite certain to be associated with at most a small net health benefit.”

      Ask: Does the researcher accept full responsibility for the study's statistical analysis? The researcher should not just hand over the study's raw data to a corporation (that may have $1,000 million invested in the study) to do the statistical analysis.

    • Completeness of follow-up data:
      Ask: Was the number of withdrawals or dropouts in each group mentioned, and were reasons given for these withdrawals or dropouts? Less than 20% of the research subjects should drop out of the study. The intervention effect should persist over an adequate length of time.

    • Handling of missing data:
      Ask: Was the statistical analysis conducted on the intention-to-treat sample? There must be use of intention-to-treat analysis (as opposed to a completers-only analysis). In this way, all of the research subjects that started the study are included in the final statistical analysis. A completers-only analysis would disregard those research subjects that dropped out.

    • Replication of Findings:
      Ask: Can other researchers replicate this study's results? The research study's methodology should be clearly described so that the study can be easily replicated. The researcher's raw data should be available to other researchers to review (in order to detect errors or fraud).

    • Fraud:
      Ask: Is there a suspicion of fraud? In a research study, examine the independent and dependent variables that are always measured as a positive whole number (e.g., a variable measured on a 5-point Likert-type scale ranging from "1 = definitely false to 5 = definitely true" etc.). For each of these variables, look at their sample size ( n ), mean ( M ) and standard deviation ( SD ) before they undergo statistical analysis. There is a high suspicion of fraud in a study's statistics:

      • If the M is mathematically impossible (online calculator): This is one of the easiest ways to mathematically detect fraud. The mean ( M ) is defined as "the sum ( Sum ) of the values of each observation divided by the total number ( n ) of observations". So: M = Sum / n . Thus: ( Sum ) = ( M ) multiplied by ( n ). We know that, if a variable is always measured as a positive whole number, the sum of these observations always has to be a whole number. For these variables to test for fraud: calculate ( M ) multiplied by ( n ). This calculates the Sum which MUST be a positive whole number. If the calculated Sum isn't a positive whole number; the reported mean ( M ) is mathematically impossible - thus the researcher either cooked the data or made a mistake. A recent study of 260 research papers published in highly reputable psychological journals found that 1 in 2 of these research papers reported at least one impossible value , and 1 in 5 of these research papers reported multiple impossible values. When the authors of the 21 worst offending research papers were asked for their raw data (so that its reliability could be checked) - 57% angrily refused. Yet such release of raw data to other researchers is required by most scientific journals. (Here is an example of a research paper filled with mathematically impossible means.)

      • If the SD is mathematically impossible (online calculator): When researchers fraudulently "cook" their data, they may accidently give their data a mean and standard deviation that is mathematically impossible.

      • If the SD/M is very small (i.e., the variable's standard deviation is very small compared to the mean suggesting data smoothing).

      • If the SD's are almost identical (i.e., the variables have different means but almost identical standard deviations).

      • If the 4th digit of the values of the variables aren't uniformly distributed - since each should occur 10% of the time (Benford's Law).

      • If the researcher is legally prevented from publishing negative findings about a drug or therapy because that would violate the "nondisclosure of trade secrets" clause in the research contract (i.e., it is a "trade secret" that the drug or therapy is ineffective - hence this can not be "disclosed"). Approximately half of all registered clinical trials fail to publish their results.

      • If the researcher refuses to release his raw data to fellow researchers (so that they can check its validity). In order to be published in most scientific journals, a researcher must promise to share his raw data with fellow researchers. Thus a researcher's refusal to do so is almost a sure indicator of fraud.

      • If the research study's data contradicts the study's own conclusions - surprisingly, this often occurs.

  • Calling Bullshit In The Age of Big Data - "Bullshit is language, statistical figures, data graphics, and other forms of presentation intended to persuade by impressing and overwhelming a reader or listener, with a blatant disregard for truth and logical coherence." Reading the syllabus of this university course should be required reading for every student of mental health. This syllabus is absolutely fantastic!

  • Statistical Methods in Psychology Journals: Guidelines and Explanations - American Psychologist 1999

  • Not All Scientific Studies Are Created Equal - video

  • The efficacy of psychological, educational, and behavioral treatment

  • Estimating the reproducibility of psychological science

  • Psychologists grapple with validity of research

  • Industry sponsorship and research outcome (Review) - Cochrane Library

  • 'We've been deceived': Many clinical trial results are never published - (text and video)

  • Junk science misleading doctors and researchers

  • Junk science under spotlight after controversial firm buys Canadian journals

  • Medicine with a side of mysticism: Top hospitals promote unproven therapies - Are some doctors becoming modern witchdoctors?

  • When Evidence Says No, But Doctors Say Yes


  • Cochrane Reviews (the best evidence-based, standardized reviews available)

Research Topics

Oppositional Defiant Disorder - Core Clinical Journals

Oppositional Defiant Disorder - All Journals

Oppositional Defiant Disorder - Review Articles - Core Clinical Journals

Oppositional Defiant Disorder - Review Articles - All Journals

Oppositional Defiant Disorder - Treatment - Core Clinical Journals

Oppositional Defiant Disorder - Treatment - All Journals

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Normal Distribution Of Human Attributes

Regression to the Mean (Or Why Scientific Experiments Require A Control Group)

The "Big 6" Dimensions of Mental Health

Research has shown that there are 5 major dimensions (the "Big 5 Factors" or Five-Factor Model) of personality disorders and other mental disorders. There are two free online personality tests that assess your personality in terms of the "Five Factor Model of Personality". Although not computerized online, the Big Five Inventory (BFI) is a 44-item test often used in personality research.

This website uses these 5 major dimensions of human behavior to describe all mental disorders. (This website adds one more dimension, "Physical Health", to create the "Big 6" dimensions of mental health.)

The behaviors of the "Five Factor Model of Personality" represent five adaptive functions that are vital to human survival. For example, when one individual approaches another, the individual must: (1) decide whether the other individual is friend or foe [ "Agreeableness" ], (2) decide if this represents safety or danger [ "Emotional Stability" ], (3) decide whether to approach or avoid the other individual [ "Extraversion/Sociability" ], (4) decide whether to proceed in a cautious or impulsive manner [ "Conscientiousness" ], and (5) learn from this experience [ "Openness/Intellect" ].

    Which "Big 6" Dimensions of Mental Health Are Impaired in Oppositional Defiant Disorder?

    THE POSITIVE SIDE OF THE "BIG 6" DIMENSIONS OF MENTAL HEALTH THE NEGATIVE SIDE OF THE "BIG 6" DIMENSIONS OF MENTAL HEALTH THIS DISORDER
    Agreeableness
    Being kind and honest.
    Antagonism
    Being unkind or dishonest.
          Antagonism
    Conscientiousness
    Being diligent and self-disciplined.
    Disinhibition
    Being distractible, impulsive, or undisciplined.
    Openness/Intellect
    Showing good creativity, problem-solving, and learning ability
    Impaired Intellect
    Showing decreased creativity, problem-solving, or learning ability.
    Extraversion
    Being gregarious, assertive and enthusiastic.
    Detachment
    Being detached, unassertive, and unenthusiastic.
    Emotional Stability
    Being emotionally stable and calm.
    Emotional Distress
    Being emotionally unstable/distressed.
    Physical Health
    Being physically fit and healthy.
    Physical Symptoms
    Being physically unfit or ill.





    The Following Will Only Discuss The Dimensions of Mental Illness That Are Abnormal In This Disorder

    The problems that are characteristic of this disorder are highlighted with this pink background color.


    AGREEABLENESS VS. ANTAGONISM

    AGREEABLENESS (Helping Others)
    Description: Agreeableness is synonymous with compassion and politeness. Compassion reflects empathy, sympathy, and caring for others. Politeness reflects respect for others. Individuals with high Agreeableness do not hold grudges, are lenient in judging others, are willing to compromise and cooperate with others, and can easily control their temper. The Agreeableness dimension measures the behaviors that are central to the concept of JUSTICE and equality (fair, honest, and helpful behavior - living in harmony with others, neither harming nor allowing harm). Basic human rights are enshrined in the UN Universal Declaration of Human Rights. Individuals with high Agreeableness avoid manipulating others for personal gain, feel little temptation to break rules, are uninterested in lavish wealth and luxuries, and feel no special entitlement to elevated social status. High Agreeableness is associated with better: longevity, helping others, giving to charity, job [team] performance, and marital success. (This dimension appears to measure the behaviors that differentiate friend from foe.)
    Descriptors: Honest, humble, compassionate, polite, cooperative, nonaggressive.
    • From Between facets and domains: 10 aspects of the Big Five
      • Compassion:
        • Forgiving nature
        • Considerate and kind
        • Feel other's emotions
        • Inquire about others’ well-being
        • Sympathize with others’ feelings
        • Take an interest in other people’s lives
        • Like to do things for others
      • Politeness:
        • Seldom rude
        • Respect authority
        • Hate to seem pushy
        • Avoid imposing my will on others
        • Rarely put people under pressure
    • From International Personality Item Pool:
      • Would never cheat on taxes
      • Sympathize with the homeless
      • Trust others
      • Make people feel welcome
      • Am easy to satisfy
      • Dislike being the center of attention
    Chimpanzees: The Agreeableness-Antagonism dimension of human behavior can be traced back to our chimpanzee ancestory. Chimpanzee communities, like every social species, organize themselves according to status (video). In such status hierarchies, the dominant members actively protect their privileged status within the community by using domineering, antagonistic behavior towards subordinate members. This antagonistic, competitive behavior by high-status dominant members of the community is in contrast to the agreeable, cooperative behavior of the low-status, subordinant members. In humans, this same antagonistic behavior is used by those seeking to dominate others.
    Evolution: The brains of social species evolved to allow cooperation and altruism which require coordinating one’s goals with those of others. The core features of Agreeableness are empathy and fairness. In more intelligent species, there appears to be an almost instinctual sense of empathy and fairness (video).
    Language Characteristics: Pleasure talk, agreement, compliments, empathy, few personal attacks, few commands or global rejections, many self-references, few negations, few swear words, few threats, many insight words.
    Research: Higher scores on Agreeableness are associated with deeper relationships. Are you a giver or taker? (video). *MRI research found that Agreeableness was associated with increased volume in regions that process information about the intentions and mental states of other individuals.
    "I am helpful and unselfish with others."
    "I have a forgiving nature."
    "I am generally trusting."
    "I am considerate and kind to almost everyone."
    "I like to cooperate with others."
    "I don't find fault with others."
    "I don't start quarrels with others."
    "I am not cold and aloof."
    "I am not rude to others."
    "I feel other's emotions."
    "I inquire about others' well-being."
    "I sympathize with others' feelings."
    "I take an interest in other people's lives."
    "I like to do things for others."
    "I respect authority."
    "I hate to seem pushy."
    "I avoid imposing my will on others."
    "I rarely put people under pressure."
    ANTAGONISM (Harming Others)
    Description: Antagonism is synonymous with being very self-centered and lacking empathy. They find it hard to forgive, are critical of others' shortcomings, are stubborn in defending their point of view, and readily feel anger when provoked. They will flatter others to get what they want, break rules for personal profit, and feel a strong sense of self-importance.
    ICD-11 Description: The core feature of the Antagonism (or Dissociality) trait domain is disregard for the rights and feelings of others. Common manifestations of Antagonism (or Dissociality) include: self-centeredness (e.g., sense of entitlement, expectation of others’ admiration, positive or negative attention-seeking behaviors, selfishness); and lack of empathy (i.e., indifference to whether one’s actions hurt others, which may include being deceptive, manipulative, and exploitative of others, being mean and physically aggressive, callousness in response to others' suffering, and ruthlessness in obtaining one’s goals).
    Descriptors: Dishonest, arrogant, callous, rude, manipulative, aggressive.
    • From Between facets and domains: 10 aspects of the Big Five
      • Callousness:
        • Am not interested in other people’s problems
        • Can’t be bothered with other’s needs
        • Am indifferent to the feelings of others
        • Take no time for others
        • Don’t have a soft side
      • Manipulativeness:
        • Insult people
        • Believe that I am better than others
        • Take advantage of others
        • Seek conflict
        • Love a good fight
        • Am out for my own personal gain
    • From International Personality Item Pool:
      • Use flattery to get ahead
      • Believe in eye for eye
      • Distrust people
      • Look down on others
      • Have a sharp tongue
      • Think highly of myself
    Language Characteristics: Problem talk, dissatisfaction, little empathy, many personal attacks, many commands or global rejections, few self-references, many negations, many swear words, many threats, little politeness, few insight words.
    Video Example: Here is an example of a very antagonistic person - President Trump at a Mississippi political rally.
    Screening Questions:
    • "It’s no big deal if I hurt other peoples’ feelings."
    • "I crave attention."
    • "I often have to deal with people who are less important than me."
    • "I use people to get what I want."
    • "It is easy for me to take advantage of others."
    * Hostillity:
    "I am usually pretty hostile."
    "I always make sure I get back at people who wrong me."
    "I resent being told what to do, even by people in charge."
    "I insult people."
    "I seek conflict."
    "I love a good fight."
    ("Agreeableness vs. Antagonism" modified from "PID-5" by Kreuger RF, Derringer J, Markon KE, Watson D, Skodol AE and Between facets and domains: 10 aspects of the Big Five) [More Information]
    *MRI Research:
    Testing predictions from personality neuroscience. Brain structure and the big five.



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