Angry, Defiant Youth: Origins & Treatment
Many couples report being surprised, hurt and stressed by the defiant
and angry behaviors of the children. These parents often relate, "If I
ever treated my parents as he/she treats us, I would have been severely
disciplined. I would have never treated them as he/she treats us."&&Unfortunately, most parents in our experience have little understanding of the nature of anger, how they can protect their children from excessive anger and also how they can teach their to master this powerful and complex emotion.& In this chapter the most common manifestation of childhood anger, Oppositional Defiant Disorder, will be&examined in depth, as well as child disorders and methods for mastering the anger in anger associated with&them.
I was surprised in the early years of my practice that the history of
these very angry children frequently did not reveal any serious
emotional pain or hurts in their lives. Instead, these youngsters were
overly indulged emotionally or materially by their parents who acted
toward them in a permissive rather than in a responsible manner. The
problem was that these children were not given appropriate correction
and punishment for their hostile and disrespectful behaviors and were
not taught virtues by their parents which can lead to the development of
a healthy personality. In other children, however, angry and defiant
behaviors are not the result of selfishness, but of serious emotional
hurts from selfish, irresponsible or angry parents, siblings or peers or
of modeling after angry parents, siblings or peers.
This chapter will attempt to help parents determine the origin(s) of anger and will describe an empirically proven, effective approach, forgiveness therapy, Forgiveness Therapy: An Empirical Guide for Resolving Anger and Restoring Hope
(American Psychological Association Books, 2015), to diminish
excessive anger in youth.&
Anger disorders in youth include Oppositional Defiant Disorder, Conduct Disorder, Intermittent Explosive Disorder and the new diagnosis, Disruptive Mood Dsyregulation Disorder (DSM 5).& However, excessive anger and anger attacks are also highly prevalent in depressive disorders and various anxiety disorders including obsessive-compulsive disorder, social anxiety disorder and PTSD&from divorce and bullying trauma.&
Severe, chronic irritable mood has long presented a challenge in child psychiatry because of its poor diagnostic specificity and its inclusion in numerous mood, anxiety, ADHD and disruptive behavior disorders. A consequence has been the frequent diagnosis of bipolar&disorder in children with a chronically irritable mood.& The new diagnosis of Disruptive Mood Dysregulation Disorder, which will be described later, was introduced into the new diagnostic manual (DSM 5) to preclude the erroneous diagnosis of bipolar disorder in children with chronic irritable mood&(Roy, et al., 2014).
The origins of angry, defiant behaviors in children (ODD)
Excessive anger and ODD can be the result of numerous unjust hurts and disappointments
with parents, siblings and peers. A child may also acquire ODD from
modeling after an angry parent, sibling or peers. In fact, ODD is more
common in families where there is serious marital discord (DSM-IV TR)
which results in both sadness and anger in children. We should not be surprised that children model after the excessive anger in a parent&and later overreact in anger as did that parent.
Another major cause is
selfishness that can lead to the regular overreactions in anger. This personality weakness
leads to a determination to have things/relationships one’s own
way, a lack of respect for parents and others, pride, impatience and a
desire to control. These conflicts make the child vulnerable to become
easily frustrated and uncooperative with resulting overreactions in
anger and with an unwillingness to be cooperative with reasonable
requests by parents, teachers and other authority figures such as teachers..
Other causes of excessive anger are
jealousy, loneliness, lack of confidence and excessive television
viewing that fosters selfishness.& In our professional opinion excessive selfishness precedes the
development of ODD in many children.&&Also, emotional, physical and sexual abuse results in significant sadness&and anger that can be manifested in defiant behaviors.&Engaging in violent video games is another factor in the overreactions of children in anger.
Also, a frequent cause of intense anger in children is the result of divorce trauma.& Most of these children are not aware of the origin of their anger and periodic&rage that they often misdirect at others.
Children who have very strong personalities often have great difficulty in being
obedient to parents and can defiant. They can overreact in anger when asked to be
responsible. An effective parental response to these strong children can
be communicating that it is good to be strong, but harmful to be controlling. These
children can also be encouraged to grow in the virtue of gentleness that
can balance their strength. Also, children with faith can be encouraged
to consider that God is in control -- not them.& They may need to hear this many times daily.
In a number of studies of ODD, it has been
shown that males were over represented, as were children of divorced
parents and of mothers with low socioeconomic status (Kadesjo C, 2003.)
Identifying angry, defiant behaviors (ODD)
The first step in addressing anger in children is a careful history
of the child that is helped by evaluating the degree of active and
passive-aggressive anger, the degree of selfishness and the number of
ODD behaviors.
Please identify the symptoms of ODD in your child by identifying the
behaviors listed in the DSM IV-TR for this diagnosis:
Often losing temper
Often arguing with adults
Often actively defying or refusing to comply with adults’
requests or rules
Often deliberately annoying people
Often blaming others for his or her mistakes or misbehaviors
Being often touchy or easily annoyed by others
Being often angry and resentful
Being often spiteful or vindictive.
The child must demonstrate at least four of these symptoms for at
least 6 months to establish the ODD diagnosis. In our view a number of
these behaviors are an indication of selfishness in the child. These
Often actively defying or refusing to comply with requests or rules
from adults
Often deliberately annoying people
Regularly blaming others for his or her mistakes or misbehaviors
Regularly becoming touchy or easily annoyed by others.
Based on over 38 years of clinical experience I believe that the
following symptoms of the covert (sneaky) or passive-aggressive
expression of anger should be added to the description of ODD symptoms.
Identifying Covert/Passive-Aggressive Angry Behaviors
Failure to respond when addressed
Refusal to cooperate with teachers at school
Refusal to do home work
Deliberate lateness
Refusal to keep order in the home or in bedroom
Provocation of siblings
Unwillingness to be sensitive to others.
Please consider completing the more extensive evaluation of anger in your child on the anger checklist
and try to identify the number of active and passive aggressive
angry behaviors in him/her.
Next, please complete the
for your child.
Oppositional Defiant Disorder
Oppositional defiant disorder (ODD) is the most common
psychiatric disorder seen in children. Epidemiological
data have indicated that by the age of sixteen 23% of children will meet
the criteria for a behavior disorder, most frequently oppositional
defiant disorder, 11.3% (Costello EJ, et al., 2003.)
As every parent knows, acts and words of defiance in direct or covert
ways can begin at an early age. Unfortunately this anger often is not
properly identified, understood and addressed by busy parents, family
members, educators and mental health professionals. The failure to
identify and address this anger has serious consequences for the child,
the parents and family, schools and society.
Oppositional behaviors occupy a central position in the development
of emotional and mental illnesses.& ODD can lead to the development
of a conduct disorder in which children manifest intensely angry and
even violent behaviors. This disorder in turn can lead to the
development of a sociopathic or criminal personality disorder. Also,
there is a substantial overall between ODD and ADHD.&
The wide range of association of ODD with other disorders is also
reflected in the finding that it is one of the most common precursors
for most psychiatric disorders in adolescence and young adulthood
(Kim-Cohen, J. 2003 and Nock, MK, 2007.)
A major study estimated that children with ODD were 17 times more likely to have a depressive or anxiety disorder than children without ODD (Boylan, K, et al, 2007.)
Our professional experience indicates that if defiant and angry
behaviors are dealt with effectively in young children the emotional and
mental health of the child and the family can be protected and
strengthened. The serious problems that develop if children do not learn
how to control their angry impulses can be prevented.
The American Academy of Child and Adolescent Psychiatry offers
excellent resources on ODD at www.aacap.org/cs/ODD.ResourceCenter.
Research on Children with ODD
In an important paper on ODD published in the leading journal of
child psychiatry in 2007 Dr. Whittenger wrote, "It is imperative that
clinicians ( and parents) pay specific attention to the presence of
childhood ODD behaviors." Her research in England demonstrated the
serious negative prognosis of ADHD with associated (co-morbid) conduct
disorder (Whittenger, N.S., et al. 2007.) Since, ODD is the major
precursor of conduct disorder, we believe that the effective treatment
of ODD can prevent the development of conduct disorder and assist in the
treatment of ADHD.
Preschool children with ODD are likely to continue to exhibit
disorder with increasing association (co-morbidity) with ADHD, anxiety,
or mood disorders (Lavigne JV , 2001.)
The Development of emotional pain in children and its relationship to anger
The diagram below attempts to demonstrate the relationship between hurts and the development of anger and sadness, anxiety/mistrust and insecurity.& Both research and clinical experience demonstrate the strong relationship between sadness, anxiety, insecurity and excessive anger.
The second diagram attempts to present how anger can &encapsulate& sadness, anxiety and insecurity and how it can interfere with&the healing of these conflicts.
Three methods of dealing with childhood anger
Parents can provide valuable assistance to
children by helping them develop an understanding of the three basic mechanisms
used to cope with anger. These are denial, expression and forgiveness.
During early childhood, the most common method for dealing with
anger is denial. The dangers attached to denial include emotional harm to the
child, increased feelings of sadness, guilt and shame, or the misdirection of
the resentment toward others.
2. Expression
The next method commonly used for dealing with anger is either
to express it openly and honestly or to release it in a passive-aggressive
manner. It is of benefit to review with children the numerous ways in which
anger can be vented passively. The therapist might consider having the young
patient complete an anger checklist to identify these behaviors. Many parents
can also participate in the evaluation of their child's anger by completing an
anger checklist in relation to their son or daughter and thus provide the
therapist with additional information on the degree of the child's anger.
It may be helpful to view actively expressed anger as
encompassing three types: appropriate, excessive, and misdirected. Children
benefit from learning the value of healthy assertiveness as well as the danger
of responding consistently to situations in an excessively angry manner. It is
important for them to realize that when they do not resolve their anger from a
particular hurt, they may later misdirect the resentment toward others. Such
anger can damage friendships, interfere with learning, harm family
relationships, and limit participation in team sports. In clinical practice, we
find that the most common recipients of misdirected anger are younger siblings,
peers, mothers, and teachers.
Concepts of displacement and the consequences of displacing
anger can be difficult for children to understand and accept so concrete
examples need to be used. At times, it can be helpful if parents or a therapist
relate stories of misdirected anger from their own youthful experience.
Some therapists believe they have been successful in treating
anger in children and adolescents when their young patients express the anger
they had previously denied. Actually, what has been accomplished is only one
step toward actual resolution because, in itself, expression is incapable of
freeing children from the burden of resentment which they carry. The experience
of anger can lead to a desire for revenge which does not diminish until the
existence of the resentful feelings are uncovered and subsequently resolved.
Without this uncovering and resolution, anger can be displaced for many years
onto others and erupt decades later in loving relationships. Anger may not be
fully resolved until a conscious decision is made to work on forgiving the
3. Forgiveness - the most effective way to master anger
Not surprisingly, what forgiveness is not needs clarification.
We find that children need to learn the following issues. Specifically,
forgiveness is not tolerating and enabling angry, abusive people to express
their anger. It is not being a doormat or acting in a weak manner and it does
not limit healthy assertiveness. It does not mean trusting or reconciling with
those who are abusive, insensitive, or show no motivation to change their
unacceptable behavior. Finally, forgiveness is not necessarily going to others
and informing them that one is forgiving them.
As already stated, clinicians often discover that the
relationship in which children experience the greatest degree of
disappointment, and subsequently the greatest degree of anger, is in the
parental relationship, especially the one with the father. This is particularly
true at the present time when almost forty percent of children and teenagers do
not have their biological fathers at home. Numerous studies have documented
difficulties with resentment and aggressive behavior in the children of divorce
(Block, Block, & Gjerde, 1988; Guidubaldi, 1988; Hetherington, 1989;
Johnston, Kline, & Tschann, 1989; Wallerstein , 1991; Wallerstein
& Blakeslee, 1989). One study of parental love-deprivation and forgiveness
revealed that most respondents implicated the father, not the mother, as being
emotionally distant (Al-Mabuk, Enright, & Cardis, 1995).
The major cause of anger in the father relationship is the
result of growing up with a father who had difficulty in communicating his love
and in affirming his children. Misdirected father anger may be a contributing
conflict in our schools and homes today. Many children who have intense
father-anger present with conduct disorders, oppositional defiant disorders,
attention-deficit/ hyperactivity disorders, and intermittent explosive
disorders.
Difficulties in the mother relationship that lead to intense
anger can be the result of not experiencing enough love and praise, feeling
controlled or criticized, or being made to feel that one does not measure. Children also become very angry with mothers who give into the influence of selfishness and become less giving to them.& At times, too, the child may have felt overly responsible for
the mother, or may have come to the conclusion that she was overly critical or mistrustful of
the father.
Other sources of anger sometimes result from hurts and
disappointments from siblings or rejection by peers. Often an older child
misdirects anger at a younger sibling that is really meant for a parent or
peers. Many children and adolescents crave peer acceptance to develop a
positive sense of self and to protect themselves from loneliness. Those
children who are scapegoated regularly in school rarely tell their parents how
they are being treated because they are so ashamed or because they believe that
their parents cannot protect them. Therefore, parents need to be aware of the
various ways in which this conflict can manifest itself. These include:
isolation, withdrawal, ventilation of hostility toward others, social anxiety,
or depression.
Some children have difficulties with their anger as a result of
modeling after a parent who could not control anger. This excessive expression
of anger is then passed from one generation to the next. In our experience,
this modeling occurs most often with the father.
Many in the mental health field believe that the excessive anger
seen in ADHD and other disorders in children is biologically determined (see,
for example, Hechtman 1991). However, at this time, no specific
neurotransmitters have been identified which cause excessive anger. Also, the
use of addictive substances can trigger excessive anger as well as personality
conflicts, especially narcissism.
Parents can assist their children in their character development
by teaching them to be understanding and forgiving when angry. We refer to this
as an immediate forgiveness exercise. This does not preclude punishing a child
for a display of excessive or misdirected anger, nor asking an angry child to
apologize to the recipient of their excessive anger. Appropriate punishment for
angry behaviors often helps a child learn to control anger.
After an angry incident the child can be recommended to try to
forgive if they have been truly hurt by another. Also, children can learn to
stop denying their anger and to resolve it by thinking at bedtime of forgiving
anyone who may have hurt them on that particular day or in the past. In
Ephesians 4, St. Paul recommends that we not let the sun go down on our anger.
Unfortunately, many children and adults do because they do not work on
developing and using the virtue of forgiveness at the end of the day.
Children are usually pleased to learn how the virtue of
forgiveness can help them control and resolve their angry feelings.
The role of forgiveness in diminishing ODD
The psychotherapeutic use of forgiveness can play an important role
in decreasing or resolving the hostile feelings, thoughts and behaviors
seen in ODD. The acquisition of this virtue is most important and
helpful for children to develop in order to control and resolve their
The following case study on the treatment of a defiant child which is
taken from our textbook, Helping Clients Forgive: An Empirical Guide
for Resolving Anger and Restoring Hope, demonstrates the effective
use of forgiveness in the treatment of ODD.
Sean, a seven-year-old, became increasingly angry and rebellious with
his mother after his father left the family. He regularly lost his
temper, refused to listen to his mother, and provoked his sisters. He
also became much more defiant and narcissistic and demanded that his
mother buy him new toys several times weekly.
In the sessions with his mother and sisters, Sean admitted,
"I’m really mad at Dad. He doesn't’t care about us. All he
ever did was watch TV anyway." Sean’s mother told him that his
anger was hurting her and his sisters and that it reminded her of his
father’s selfish temper tantrums. Sean became tearful and
remorseful during the session and stated that he did not want to hurt
anyone. He agreed to try to let go of his anger with his father on a
daily basis and thus attempt to avoid repeating his dad’s
self-centered behaviors. This intervention seemed to motivate Sean and
when he slipped back into oppositional defiant behavior, his mother
would remind him to continue to forgive his father. Over the course of
several months, the work of daily thinking that he wanted to understand
and try to forgive his father helped Sean to gain more control over his
angry feelings and behaviors. However, there were times when, after
spending a weekend with his selfish father, it would take several days
to gain control over his sad and angry feelings. Unfortunately, the
attempt to engage his father was unsuccessful.
While employing forgiveness therapy in the treatment of the defiant
anger in children, the major obstacles that therapists encounter
include: the sense of control their anger gives clients over others,
modeling after their parents, and a sense of strength and self-esteem
derived from the expression of anger. It is not uncommon, either, for
the process of forgiveness to be blocked by parents who excuse all angry
behaviors in their children, claiming that their behavior is solely the
result of biological factors over which their children have no control.
Such parents may have serious problems with excessive resentment
themselves and therefore they attempt to undermine efforts made to teach
their children to be responsible for their anger and to resolve their
hostile feelings. Subsequently, therapy often focuses on encouraging
parents to identify their own anger and to work on forgiving those who
have hurt them. However, the fathers, in particular of those whose
children have excessive anger, are often highly resistant to participate
in treatment and often have no desire to control their excessive anger.
By modeling forgiveness, the majority of parents can bring about a
marked improvement in the level of resentment and acting-out behaviors
in their children.
Selfishness to ODD
It is our opinion that serious conflicts with selfishness often
precede the full development of ODD. Most serious cases of ODD we treat
are associated with a high level of selfishness. The repeated excessive
expression in the home reinforces insensitive and selfish behavior
patterns. These behaviors and emotional overreactions then contribute to
the weakening of the personality and can lead to the development of
strong narcissistic personality traits and later a narcissistic
personality disorder (NPD.)
We caution parents that the failure to address selfishness in
children can be the most important factor in the child’s failure
to learn how to control angry impulses. If selfishness is properly
corrected in many children by growth in numerous virtues and by proper
parental education and correction, our professional opinion is that ODD
may not develop (see the .)
Selfishness and Co-Morbidity
The diagram below demonstrates that selfishness can influence the
development of numerous other conflicts as the person grows. In this
diagram CD refers to conduct disorder, SUD to substance abuse disorder
and NPD to a narcissistic personality disorder which is diagnosed in
young adulthood.& The ongoing sense of entitlement from
selfish/narcissistic thinking can contribute to the development of
inflated and grandiose thinking which is seen in bipolar disorders.
Also, a number of our patients who had ODD and severe selfishness as
children later developed bipolar disorder with severe irritability as
adolescents.
Permissive Parenting, Selfishness and Angry Behaviors
In the permissive parenting style the adult overly indulges a child
emotionally and/or materially and fails to provide healthy correction of
character weaknesses. The parental failure to form character in a
healthy manner results in a weakening of a child’s ability to
control impulses, a lack of respect for others, an inflated sense of
self, a sense of entitlement, an overreaction in anger when the child
cannot have his or her way, etc.
Many factors contribute to permissive parenting and these include the
desire to have the child as a friend, as well as weak confidence,
selfishness, fear of losing the child’s love or a comfort seeking
mentality with a dislike for correction. Psychologist Susan Linn, author
of Consuming Kids: The Hostile Takeover of Childhood (2004),
wrote that the parent-child relationship is being reversed by a trend
that sees parents consulting their kids about everything from choosing a
movie to the mother’s choosing a new partner. She attributes this
change in parenting to the increase in single parent families, incessant
marketing that gives children "the trappings of maturity", increased
access to information children have because of the internet and Peter
Pan parents who think they can stay young and relevant by swapping
advice with teenagers.
Dr. William Doherty, professor at the University of Minnesota, in his
book, The Intentional Family, 1997, criticized permissive
parenting particularly in regard to family meals by stating, "We are
talking about a contemporary style of parenting that is overindulgent of
children. It treats them as customers who need to be pleased."
The Onset of ODD
ODD is usually diagnosed between the ages of 6 to 10. However,
symptoms may appear much earlier. In addition, ODD angry behaviors may
not emerge until adolescence. We have even seen these behaviors
intensify after high school.
The later development of ODD is often the result of unresolved anger
from childhood experiences that can no longer be denied. Another major
factor in the later manifestation of ODD is growth in selfishness and in
a tendency to want to control parents, siblings and others.
Victims of Misdirected Anger
The excessive anger in children is regularly misdirected at others either because they are not aware of how they can master their anger or because they enjoy its expression.& The expression of anger can be a source of pleasure from a feeling of revenge, from a false sense of strength it may give and from a sense of being able to intimidate or control others.&They major victims of misdirected childhood anger are:
& siblings
& teachers
& The Church/God (see Faith of the Fatherless: The Psychology of Atheism, P. Vitz)
The Serious Consequences of ODD
The manifestations of angry and defiant behaviors can harm the
child’s and teenager’s family relationships, academic
performance and friendships. ODD has been shown to have extremely
detrimental effects in many areas of the lives of children.& Also, it is seen as occupying a central position in the developmental psychopathology (illness.)
One of the major studies of ODD in over 600 children from the
Department of Psychiatry at the Harvard Medical School revealed that
these teenagers and children had significant impairment in family
functioning with parents and siblings and in social adjustment with
problems with peers and at school. Also, families of ODD youth were
characterized by significantly poor cohesion and high conflict.
In addition this particular study showed that children with ODD had
high rates of associated disorders including ADHD, severe major
depression, bipolar disorder, pervasive development disorder, multiple
anxiety disorders, Tourette’s disorder and language disorders,
Greene RW, (2002).&In a national co morbidity survey replication of
3,199 individuals of those with lifetime ODD, 92.4% meet criteria for at
least one other lifetime DSM-IV disorder, including: mood (45.8%),
anxiety (62.3%), impulse-control (68.2%), and substance use (47.2%)
disorders, Nock MK (2007).
ODD is a serious problem in children that impacts everyone in the
family. In fact, parents of children with ODD are more likely to utilize
child mental health services than parents of children with other
disruptive behavior disorders.
ODD and Criminal Behavior
A 2014 study of the crime and psychiatric disorders in 10,123 adolescents revealed that 18.4% had committed a crime.
The four most prevalent psychiatric diagnosis in these teenagers were social phobia (14.5%), intermittent explosive disorder (14.1%), major depressive disorder (10.8%) and oppositional defiant disorder (10.1%) (Coker, K.L. et al. 2014).& If children were taught to master their anger by employing forgiveness when angry, there is a&strong possibility that later criminal behavior could be prevented.
ODD and Attention Deficit Hyperactivity Disorder
ODD is also often seen in children with ADHD. A number of studies
reveal that 40% and more of those with ADHD also have ODD. Our clinical
experience is that ODD may contribute to the development of the
hyperactive and impulsive types of ADHD. We have found that treatment of
the anger in ODD can also diminish the hyperactive and impulsive
symptoms in these two types of ADHD.
ODD and Anxiety
ODD has been shown to be directly predictive of future anxiety and
depression, and anxiety predicted future depression as well. (Burke JD,
2005).&Anxiety in children with ODD can be the result of a
difficulty in trusting from hurts with parents, siblings or peers and of
a fear of his/her strong angry impulses.
ODD and Depression and Suicide
Irritability symptoms in childhood predict later depression (Burke, J.D., 2010) with the most consistent adolescent or adult diagnosis made in children with ODD is depression (Nock MK, 2007.)& A major study in 2007 revealed that risk for youth suicide was
strongly associated with current depression and ODD and current
depression with anxiety, specifically generalized anxiety disorder
(Foley DL, 2006.) Also, children with depression are more than 16 times more likely to have concurrent ODD than those without depression (Costello EJ, et al, 2003.) Our clinical experience confirms the research of
Dr. Bob Enright at the University of Wisconsin, Madison, that
diminishing excessive anger by the use of forgiveness also decreases
symptoms of depression and anxiety.
ODD and Bipolar Disorder
ODD is strongly associated with bipolar (manic-depressive) disorders
in children and in teenagers.)
One study demonstrated that 43% of children with bipolar I disorder
had ODD (Birmaher B, 2006.)&
There is a veritable epidemic in the U.S. of the diagnosis of bipolar disorders in children with a 40 fold increase in&this diagnosis between 1994 and 2004 - a jump to 800,000 children from 20,000.& Dr. Roger McIntyre of the Mood Disorders Psychopharmacology Unit at Columbia University as stated,&That&s
a staggering increase, and it has rightly raised questions about whether
there has really been a true increase of that magnitude.&&This increase has been attributed to using a chronic irritable mood as a criteria for defining bipolar illness in youth.& Recent research indicates that youth with chronic irritability should not be diagnosed with bipolar disorder&(Roy, A.K., 2014).
Growth in virtues in children and family therapy can help in a marked
reduction of the ODD symptoms in children. We suspect that the
successful treatment of ODD may possibly help in the prevention of
bipolar I disorders.& Much more research is needed on nature of
childhood irritability and its treatment given the serious possible
long term side effects from the use of atypical anti psychotics in
Finally, we recommend that the parents of all children with severe
irritability and rage rate the selfishness in these children because
this conflict regularly predisposes children and adults to serious
overreactions in anger.
ODD and Substance Abuse
In at least one community research study the number of ODD symptoms
in childhood was a significant predictor of later alcohol use. (White,
H.R., 2001). The results suggest that drug use prevention programs
should target youths with early symptoms of excessive anger. Also, ODD
in association with ADHD, is associated with elevated risk of drug use
(August, G.J., 2006).
ODD to the far more serious Conduct Disorder in Children
The International Classification of Diseases 10th Revision (ICD-10)
classifies ODD as a mild form of conduct disorder (CD), and it has been
estimated that up to 60% of patients with ODD will develop CD.&Therefore, ODD should be identified and
treated as early and effectively as possible, (Turgay, A. 2009.)
Studies and clinical experience have demonstrated that ODD can
precede the onset of conduct disorder (CD), the most serious anger
disorder in children and adolescents, by several years. The angry
behaviors in ODD can escalate into aggressive behaviors against people
and property. CD in children is associated with the most intense
expressions of anger and aggression against people and property. A
significant percent of these youngsters with CD will go on to become
criminals in young adult life and may be diagnosed with an antisocial
personality disorder (ASPD).
Again, our clinical belief is that if the anger in ODD is properly
uncovered and worked on in family and individual therapy that such an
effort can prevent the development of conduct disorder in many
youngsters.
ODD to Diagnosis of Conduct Disorder
The DSM-IV categorizes conduct disorder behaviors into four main
groupings: (a) aggressive conduct that causes or threatens physical harm
to other people or animals, (b) non- aggressive conduct that causes
property loss or damage, (c) deceitfulness or theft, and (d) serious
violations of rules. Conduct Disorder consists of a repetitive and
persistent pattern of behaviors in which the basic rights of others or
major age-appropriate norms or rules of society are violated. Typically
there would have been three or more of the following behaviors in the
past 12 months, with at least one in the past 6 months:
Aggression to people and animals
often bullies, threatens, or intimidates others
often initiates physical fights
has used a weapon that can cause serious physical harm to others
(e.g., a bat, brick, broken bottle, knife, gun)
has been physically cruel to people
has been physically cruel to animals
has stolen while confronting a victim (e.g., mugging, purse
snatching, extortion, armed robbery)
has forced someone into sexual activity
Destruction of property
has deliberately engaged in fire setting with the intention of
causing serious damage
has deliberately destroyed others' property (other than by fire
Deceitfulness or theft
has broken into someone else's house, building, or car
often lies to obtain goods or favors or to avoid obligations (i.e.,
"cons" others)
has stolen items of nontrivial value without confronting a victim
(e.g., shoplifting, but without b forgery)
Serious violations of rules
often stays out at night despite parental prohibitions, beginning
before age 13 years
has run away from home overnight at least twice while living in
parental or parental surrogate home (or once without returning for a
lengthy period)
is often truant from school, beginning before age 13 years
Disruptive Mood Dysregulation Disorder (DMDD)
In two large community studies, approximately 70% of children with DMDD met the criteria for ODD (Copeland, W.E., et al.,2013).& Also, youth with DMDD are at elevated risk for anxiety and depressive disorders (Leibenluft, 2011).&
It is important to understand that this new diagnosis in DSM-5 was introduced to preclude the erroneous diagnosis of bipolar disorder in children with chronic irritable mood.& One of the reasons is that bipolar disorder in youth is often treated with antipsychotic medication which has recently been shown to increase the risk of type II diabetes three fold in youth.&
Treatment evidence includes
cognitive behavioral therapy, especially parental intervention, but there is a
pressing need for research on adjunctive pharmacological treatment, as well as other methods of psychotherapy (Krieger, et
al. 2013).& Forgiveness
therapy should also be considered in treating the chronic irritability that is the defining feature of DMDD (Enright & Fitzgibbons, 2014, in press).
Children of Divorce
The profound sadness with children from divorced families
results in their regularly overreacting in anger in the home, in school and in friendships.& Frequently, these children have no conscious awareness of the cause of their anger, in part, because
divorce trauma is so severe.
&In regard to their sadness many teenagers have commented that the only pain worst they can imagine that would be worse than the divorce of their parents would be the death of one of them.
We recommend that parents of these children teach them about the 3 options for dealing with the powerful emotion of anger, that is, denial, expression and forgiveness can be helpful in decreasing their anger which at times is severe.& Then, forgiveness is explained as the best option for resolving anger.& The child is told that forgiveness can occur by thinking of understanding and deciding to forgive, by emotionally feeling like forgiving or by giving one's anger to the Lord in prayer or in the sacrament of reconciliation.&
Some parents find it helpful to&engage in this forgiveness exercise at bedtime with their children.& The child is asked then to consider thinking of forgiving anyone he/she may be angry with including either parent, a sibling, friends or others.& This forgiveness exercise opens children to admit the presence of their anger because it gives to them a method which can decrease it.&&
The profound sense of the loss of an intact family in a home with a&father and a mother can result anger that is so severe that it is difficult for a child to think of forgiving the parent he/she blames for the divorce.& In Catholic families these children experience significant relief from their anger by taking it regularly into the sacrament of reconciliation.
In some families wounded by divorce the intense emotional pain in&the children of sadness and hopelessness, excessive anger, severe insecurity and a disabling mistrust in relationships can lead the parents to reconsider their relationship and the causes of the divorce.& We support this approach to help children because two-thirds of divorces occur in marriages with low levels of conflict, because in our clinical experience most marital conflicts can be resolved and because of the long term benefits to children&of marital reconciliation.&&If this approach is of interest to you, please consider viewing this divorce prevention webinar,
A growing body of research is demonstrating the relationship&between divorce and violent behaviors in the children of divorce, particularly males.& &Dr. Brad Wilcox, sociologist at the University of Virginia, has written, &social scientific evidence about the connection between violence and broken homes could not be clearer.&
I have also written about this relationship, as one of a number of factors, in regard to the Sandy Hook tragedy in 2012,
Intermittent
Explosive Disorder (IED)
Intermittent explosive disorder is a highly prevalent,
persistent, and seriously impairing adolescent mental disorder that is both
understudied and under treated.& In one
major study of 6483 adolescents, nearly two-thirds of adolescents (63.3%) reported
lifetime anger attacks that involved destroying property, threatening violence,
or engaging in violence. &Intermittent explosive disorder had an early age at onset (mean
age, 12.0 years) and was highly persistent, as indicated by 80.1% of lifetime
cases (6.2% of all respondents) meeting 12-month criteria for IED.& It was also significantly comorbid with most DSM-IV mood, anxiety, and substance
disorders with 63.9% of lifetime cases meeting
criteria for another such disorder. Although more than one-third (37.8%) of
adolescents with 12-month IED received treatment for emotional problems in the
year before the interview, only 6.5% of respondents with 12-month IED were
treated specifically for their anger. Twenty-four
percent met the criteria for ODD and for CD, while 19.6% met the criteria for
ADHD (McLaughlin, Green, Hwang, Sampson, Zaslavsky & Kessler, 2012).
&&&&&&&&&&&&& The early age at onset of IED, the significant
associations with comorbid mental disorders that have later ages at onset, and the
low proportion of cases in treatment all make IED a promising target for early
detection, outreach, and treatment (Kessler, Coccaro, Fava, Jaeger, Jin,
Walters, 2006).
&&&&&&&&&&&&& In
McElroy and colleagues& (1998) study of&
IED 88% of subjects experienced tension 75% felt
relief from their aggressive acts, and 48% experienced pleasure with these
acts.& Ninety-three percent had a
life-time DSM-IV diagnos 48%, subst
48%, 22%, and 44%, other impulse- control
disorders other than intermittent explosive disorder. Finally, 60% receiving
therapy with an anti-depressant or mood stabilizer reported a moderate or marked
reduction of their aggressive impulses and/or episodes.
&&&&&&&&&&&&& A
major focus of forgiveness therapy in youth with IED is to motivate the person
to want to learn control of their aggressive impulses and to change behavioral
patterns that harm others and the self.&
Many have no interest in changing because of the secondary gain from the
release of& anger.& For those willing to try controlling their
aggression, the release of inner rage begins by incorporating some physical
activity, such as hitting a punching bag.&
While hitting the bag, the person is encouraged to reflect, &I want to
let go of my inner aggression and rage without harming others&, or& &I want to let go of my rage and not seek
revenge against others&, or& &I don&t
want to hurt others as I was hurt when I was young&, or &I want to stop relying
upon my hatred as a source of strength&, or&
&I don&t want to continue to be as aggressive as my father was or peers
&&&&&&&&&&&&& This
exercise is followed by a cognitive decision to try letting go of impulses for
revenge.& As understanding the offenders
deepens, they are encouraged to consider forgiveness.& This step can be difficult if they were
neglected or abused as children.&
However, if they persevere, even though they may not feel like
forgiving, relief from aggressive and vengeful impulses slowly begins to
occur.& The ability to control their
aggressive symptoms usually requires many years of therapy and is marked by
periodic relapses into aggression. The most difficult aspect of the treatment
of males with IED is that of strengthening their self-esteem so that they do
not need to rely upon anger and aggression as a source of strength.
&&&&&&&&&&&&& While employing forgiveness therapy
in the treatment of the anger in ODD, IED and CD, the major obstacles that
therapists encounter include: the sense of control their anger gives clients
over others, modeling after their parents, and a sense of strength and
self-esteem derived from the expression of angers.& Parents with excessive anger are also asked
to engage in forgiveness therapy.&& The
fathers, in particular of those whose children have conduct disorders, are
often highly resistant to participate in treatment and often have no desire to
control their excessive anger.& By
modeling forgiveness, the majority of parents can bring about a marked
improvement in the level of resentment and acting-out behaviors in their
children with ODD, IEP and CD.&
Chronic Irritability or Bipolar Disorder (BP)
Between the mid 1990s and
early 2000s in the United States, there was a dramatic increase in the rate of
diagnosis of BD in children and adolescents, paralleling a discussion in the
professional literature about the presentation of BD in youth.& The proportion of bipolar diagnosis of all
psychiatric inpatient discharges in the United States rose from 10 to 34% in
children and from 10 to 49% in adolescents in 8 years. In 1996, there were 1.3
discharges with a bipolar diagnosis per 10,000 children and adolescents in the
general population, whereas in 2004 the ratio was 7.3 per 10,000, a five-fold
increase.& (Balder & Carlson, 2007).& In outpatient settings, the increase was
approximately 40-fold during that period (Moreno, et al., 2007).
&&&&&&&&&&&&& Retrospective studies showed that in
50% of cases BD begins during adolescence.
et al., 2005).&
&&&&&&&&&&&&& Stringaris (2011) has stated that this dramatic increase in the diagnosis
of BP in youth may have been the result of the assertion that irritability,
which is continually present from a very young age, should be considered the
typical mood of early mania (Leibenluft, 2003; Leibenluft, 2006). Yet, he stated that chronic irritability does
not seem to conform to what is usually thought of as a mood that occurs within
a relatively sharply demarcated episode.&
In the words of the DSM:& &a
distinct period of abnormally and persistently elevated, expansive, or
irritable mood,& p.124.& He recommended that studying the
distinction between episodic and non-episodic mood changes&and more generally
the time scales and variability of irritable mood&is crucial for diagnosis and
treatment.
&& & & & & & Krieger, et al. (2013) claim in their
research that chronic irritability has been misdiagnosed as a pediatric bipolar
disorder and, instead, support the new DSM-5 diagnosis of disruptive mood
dysregulation disorder (Krieger, Leibenluft, Stringaris & Polanczyk, 2013.)
Parental Response to the Angry, Defiant Child
Parents benefit by understanding the nature of excessive anger and
methods of being able to master this powerful emotion. Such knowledge is
essential for their role in the development of healthy personalities in
children. We recommend communicating to children that they have 3
options for dealing with their anger. These are denial, expression and
forgiveness.
Parents play an important role in helping their children with defiant
anger. In our clinical experience ODD is prevented in many children and
resolved in others by their parents helping them to grow in early
childhood in the virtues of forgiveness, obedience, orderliness,
respect, generosity, gentleness and humility.
The following parental actions, some of which employ a faith
component when appropriate, can be helpful:
intense father involvement with an angry male child
work diligently to develop strong virtues in children and
adolescence
work to be a responsible parent, not to be a permissive one
work on having a healthy marital relationship
relate to aggressive males that hitting younger and smaller males
or females is not manly
try to avoid the expression of anger in the marriage by working on
understanding and forgiving one’s spouse
work to resolve marital conflicts and do not separate or divorce
unless severe abuse is present (most marriages can be healed)
teach children the virtues that can decrease anger and selfishness
correct appropriate selfishness and lack of respect in children
provide appropriate punishment for repeated acts of defiance and
selfishness
give praise when appropriate/ do not give praise excessively if it
is not warranted
try to overcome selfishness and anger in one’s life and share
with children how one tries to work against this vice
consider corporal punishment for strong acts of defiance
present role models of saints who worked to overcome their bad
tempers, such as St. Peter and St. Francis De Sales.
encourage teachers at school to teach virtues to children,
particularly, forgiveness, generosity and patience.
protect children from angry and selfish peers
warn about the dangers of using others
discuss with the children the desire to stop the expression of
anger in the home because it harms everyone
remind the children that God is in control, then their parents and
finally them
suggesting that the kids ask others for forgiveness
At bedtime prayer ask the Lord for forgiveness for the way they may
have hurt others especially brothers and sisters
When the kids can't forgive, suggest that they give their anger to
Parental confidence is very important
in correcting children with oppositional defiant disorder.& Parents with faith benefit from asking the Lord to strengthen their confidence so that they can correct early and often defiant behaviors in their children.&
The benefits of forgiveness can be discussed regularly.& Also, families have found it helpful to reflect upon forgiving anyone who has inflicted hurt that day after saying the grace before meals or at bedtime.&
Virtues for ODD
Parents can help their children learn how to grow in healthy
personalities and avoid giving into angry and defiant behaviors by
teaching them daily the following virtues:
Forgiveness
Generosity
Self-giving/self-sacrificing
Gentleness (to balance strength)
Children can also fight against the tendency to be selfish and angry
by regular visits the sick and the elderly and by giving to the
poor.& Also, John Paul II has offered excellent advice for parents in The
Role of the Christian Family in the Modern World (FC, n.37):
&Children must grow up with a correct attitude of freedom with
regard to material goods, by adopting a simple and austere life style
and being fully convinced that &man is more precious for what he
is than for what he has (Gaudium et Spes, n.35.)&&
Parental anger toward children
When a parent feels angry toward a child, the immediate expression of
this anger can be harmful, especially if it is excessive. Instead of
giving in quickly to the expression of anger, we recommend that a parent
when angry with a child try to inwardly reflect a number of times, "I
want to understand, forgive, and love" or "I want to be patient." This
immediate forgiveness exercise usually diminishes anger. &
Communication to child ideally should occur only after the angry
feelings. If a parent works on the described immediate forgiveness's
exercise, correction can be given to a child in an appropriate manner
without excessive anger. Then a child feels safer and is often be more
receptive to constructive criticism and is less defensive. Parents also
need to be careful that they do not humiliate a child when giving a
correction.
When parents overreact in anger, a number of emotional responses can
occur in children including fear, anxiety, guilt, shame, sadness and
intense anger. The physical responses often include muscle spasms,
headaches, irritable bowel, nausea or diarrhea and weight gain. Also,
excessive anger toward children can seriously harm the child and the
trust in the child-parent relationship. Parents have a serious
responsibility to protect the trust in their children since it is the
foundation for all relationships.
At times a parent may recognize that he/she is repeating a negative
parental pattern of angry reactions toward children. Repetition of a
father's overreacting in anger or in impatience toward children is the
most frequently identified pattern here, particularly in fathers. If
this overreaction in anger toward children occurs in your family, I'd
recommend your reading the parental legacies chapter on our sister web site.
This chapter describes how one can break the negative parental legacy of
overreacting in anger.&
Asking a child for forgiveness
After an overreaction in anger, the child can be helped by the parent
apologizing and even explaining the reason for his/her behavior. The
parental request for forgiveness of a child is not easy and requires a
great deal of wisdom, humility and courage. The parent should request
that the child respond to a request for forgiveness by stating, &I
want to forgive you& or &I do forgive you.&
The common reasons for parental overreactions in anger toward
children include:
stress from numerous responsibilities and demands
selfishness
repetition of a grandparent's angry behaviors
misdirection of anger meant for those at work or for a spouse
a tendency to control
failure to forgive for past disappointments
weakness in trusting
perfectionistic tendencies
substance abuse .
The most common conflicts leading to overreactions in anger toward a
child are in men repeating their father's angry, critical behaviors and
in women repeating their mother's controlling behaviors.& The
healing of these harmful behavior patterns is presented in the parental
legacies chapter on this site.
If overreactions in anger continue, then therapy should seriously be
considered. If the angry parent refuses to seek help, then the other
parent should try to understand the causes of the anger, clearly
identify them, ask the spouse to work on these weaknesses and do
whatever is necessary to protect a child from inappropriate and harmful
Sibling Anger
Sibling conflicts are a major source of stress in many families. This
disruptive anger arises from many factors including jealousy,
selfishness, misdirected anger meant for a parent or for peers,
excessive competitiveness, insecurity, poor body image, loneliness,
materialism, a tendency to control, a failure to forgive and modeling
after angry peers or an angry parent(s).
Parental conflicts are often uncovered which contribute to this
anger. They include inappropriate anger, marital quarrelling and
irresponsible parenting with either emotional neglect or excessive
permissiveness or indulgence.
Parents can protect their children from the trauma of peer hostility
by helping them grow in a number of virtues that can diminish these
conflicts. These virtues include:
generosity and self-denial for selfishness
gentleness & kindness for excessive competitiveness
gratitude and charity for jealousy
forgiveness and respect for anger
detachment and faith for materialism
friendship for loneliness
hope for sadness
thankfulness for one’s gifts for insecurity.
Anger in youth and violent video games
Parents should protect their children from growing in anger and aggressive behaviors by refusing to allow such games into their homes.& Youth might benefit from being informed that
Anders Brevik stated that he had trained
for his attack at the Norwegian youth camp that killed 69 adolescents by
playing the video game &&Call to Duty 4: Modern Warfare.&
Also, Adam Lanza spent hours every
day playing violent video games. On one of his favorites, Combat Arms, he had
notched up 83,496 kills, with 22,725 head shots. He also played a game called
School Shooting in which the player controls a character who enters a school
and shoots students in which he also trained for his murderous attack on first graders and adults.
Cohabiting Homes - the Highest Risk
for Children
The most dangerous home environment for a child is in a home with his
mother and her live in boyfriend as documented by numerous studies.& In a major study in the journal
Pediatrics in 149 inflicted-injury deaths during the 8-year study period
children residing in households with unrelated adults were nearly 50 times as
likely to die of inflicted injuries than children residing with 2 biological
parents (adjusted odds ratio: 47.6; 95% confidence interval: 10.4-218).
Children in households with a single parent and no other adults in residence
had no increased risk of inflicted-injury death, Schnitzer PG, (2005)..
Forgiveness education in the classroom
Excessive anger and defiant behaviors are an increasingly serious
problems in the classroom. One student refuses to do her/his work.
Another lashes out at a teacher who tries to help. A third student
deliberately disrupts the classroom making it impossible for the teacher
to perform her job.
Research by Dr. Robert Enright and his associates at the University
of Wisconsin, Madison, has shown that forgiveness education programs in
schools can have a positive impact on the mental health of children by
diminishing levels of anger in students (Enright, et. al., 2007.) We
have described in an article, Learning to Forgive, in The American
School Board Journal, www.catholiceducation.org, how educators employ the
virtue of forgiveness in their classroom for angry students and how they
can teach this virtue.
Heroic Goal - No&Expressed Anger in the Home
We communicate to the families and couples who see us that a major goal in the protection of the psychological well being of children and parents is to help everyone in the family learn how to master their anger so that its expression can be brought to an end.& This goal can be attained by understanding the nature of anger, its origins&and the most effective method of resolving it - forgiveness.&&Parents and children can grow in their understanding and use of immediate and past forgiveness exercises that are explained in depth in the martial anger chapter at .
An essential aspect of protecting children from anger is to limit the significantly the amount of screen time in the home and to prohibit viewing violent movies and using violent video games.
Medication
Medication has been helpful in decreasing ODD while uncovering the
causes of anger and working on growth in virtues. A 1999 study reported
that stimulant medication produced significant improvement both in
ADHD-related and oppositional behaviors (MTA Cooperative Group, 1999.)
Other research has provided evidence for the effectiveness of
mood-enhancing medication (SSRIs) in children whose oppositional
behavior (Garland EJ,
1996.)& Atypical anti-psychotics have also been useful in some
highly disruptive children with ODD, however, they must be used only for brief periods because of their association with type II Diabetes in youth.& Patients with ODD and CD with
severe aggression may respond well to risperidone, with or without
psycho stimulants, (Turgay, A. 2009.)
A major concern in regard to medication in children is that from 1992
to 2002, the prescription of atypical anti psychotics for the treatment
of aggressive and disruptive behaviors in children increased seven fold,
(Correll, CU, et al. 2006 and Olfson, M, et al. 2006,)& This
research clearly demonstrates both the growing problem of excessive
anger in our children and the need for alternative approaches for
teaching children how to master their anger.&
The Challenge of Medicating Youth and Type II Diabetes
antipsychotic drugs are regularly prescribed for the treatment of bipolar disorder and excessive anger in
children and adolescents in addition to mood stabilizing drugs. In the United
States, the estimated number of office-based visits by youth that included
antipsychotic treatment increased from approximately 201,000 in 1993 to
1,224,000 in 2002.& From 2000 to 2002,
the number of visits that included antipsychotic treatment was significantly
higher for male youth (1913 visits per 100&000 population) than for female
youth (739 visits per 100,000 population), and for white non-Hispanic youth
(1,515 visits per 100,000 population) than for youth of other racial or ethnic
groups (426 visits per 100,000 population). Overall, 9.2% of mental health visits
and 18.3% of visits to psychiatrists included antipsychotic treatment.& From 2000 to % of visits with
prescription of an antipsychotic included a second-generation medication.
Mental health visits with prescription of an antipsychotic included patients
with diagnoses of disruptive behavior disorders (37.8%), mood disorders
(31.8%), pervasive developmental disorders 17.3%), and psychotic disorders
(14.2%) (Olfson, Blanco, Liu, Moreno, & Laje, 2006).
The trends in prescriptions of anti psychotics
within the Texas Medicaid Program demonstrated that the prevalence of atypical
antipsychotic use increased by almost 500% over 5 years, with an increase of
609% in children 5 to 9 years old (Patel, Sanchez, Johnsrud & Crismon,
2002).& Nearly 25% of youth on
antipsychotic medication in one study were aged nine years or younger and
nearly 80% of these were boys (Curtis, Masselink, Ostbye, Hutchinson, Dans,
Wright, et al., 2005).& Further,
prominent differences in psychotropic medication treatment patterns exist
between youth in the US and Western Europe with 1.5-2.2 greater use in the
et al., 2008).
Other treatment options for disruptive mood
and excessive anger in youth, such as forgiveness therapy, need to be
considered in view of the recent reports of serious side effects from the use
of atypical anti psychotics. Specifically, a 2013 retrospective cohort study of
youth in the Tennessee Medicaid program with 28,858 recent initiators of
antipsychotic drugs and 14,429 matched controls showed that the users of
anti psychotics had a 3-fold increased risk for type 2 diabetes that increased
with cumulative dose (Bobo, et al., 2013).
Alternative Placement
Some parents find that if numerous attempts to resolve their
child’s disruptive, defiant, disrespectful and angry behaviors fail that it may be necessary to
consider removing their child from the home. This is
particularly the case when the angry behaviors begin to have a negative
effect upon the physical and emotional health of a parent or other
siblings. Successful alternative placements have been with other relatives,
friends and even in boarding schools. A guiding principle in these cases is to
protect the spouses and children from the harmful effects of a
child’s excessively angry and defiant behaviors and to not enable it. Too often parents
err by not taking stronger steps to protect their family from the
harmful effects of ODD anger in a their child.
Faith and Anger
In year four of a 12 year study of excessive anger in children in
Belfast and in Milwaukee Dr. Robert Enright, U. W., Madison) reported
that more robust research findings are found for forgiveness use in
angry children when the option of spiritual forgiveness is offered,
(Enright, R., et al. 2007. Reducing anger through forgiveness
education: Teacher-led curricula for primary grade children in
impoverished and violent communities. J. Research in Education,
Fall, pp. 63-78.)
We have found that in youth in Catholic families the regular reception of the
sacrament of reconciliation is very effective in diminishing intense
irritability&caused by selfishness, loneliness, sadness, jealousy or other factors.& Such youth can totally disrupt a family, harm siblings and the mother, in particular, who is often the victim of the youth's misdirected intense anger.& With very disrespectful, angry children a meeting with the youth and a Catholic priest can be helpful in clarifying the origins of intense anger and the command of the Lord to forgive.& Youth with very intense excessive anger can benefit by regular, even weekly, meetings with a priest confessor.
For youth whose&anger is the result of intense loneliness, working with a priest on friendship with the Lord can help also diminish the deep sadness that gives rise to their angry outbursts.& Also, self-giving to trustworthy friendships is vital in diminishing sadness and, subsequently,
anger outbursts.
Reasons for Hope
Fortunately, some ODD behaviors resolve in children as they grow in
maturity.& Also, both clinical
experience and the research findings on angry children by my colleague,
Dr. Bob Enright at the University of Wisconsin – Madison
demonstrate the remarkable benefits of teaching children how to
master and resolve their excessive anger and subsequent defiant
behaviors through growth in the use of the virtue of forgiveness and in
other virtues such as generosity, patience and self-denial. &As parents learn to master their own anger by the use of immediate and past forgiveness exercises, they will be more helpful and effective role models for their children.& Also,
we hope that in the future research studies will done in angry,
defiant children which compare the use of medication with the
psychotherapeutic use of forgiveness.
Copyright & 2009 - 2016 Richard P. Fitzgibbons. All rights reserved. &}