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Dr. O'Leary discusses his critical perspective on Oppositional Defiant Disorder (ODD) and argues that ODD is not a primary diagnosis but rather a "risk syndrome," a set of symptoms (defiance, irritability, and vindictiveness) resulting from various underlying conditions like ADHD, anxiety, or trauma. He explains that conceptualizing ODD as a stand-alone disorder often leads to the risky treatment pathway of off-label antipsychotic medication, whereas recognizing it as a syndrome necessitates an etiology-focused approach to treat the true root cause, typically with safer, condition-specific interventions. Dr. O'Leary traces the evolution of ODD criteria through the DSM manuals and urges clinicians to use comprehensive evaluations rather than relying on simple screeners, especially when an ODD diagnosis is present.

A more in depth discussion with references can be found here: https://sciencebasedpsych.blogspot.com/2025/10/oppositional-defiant-disorder-not.html

Referenced resources can be found within the show transcripts at https://psydactic_caps.buzzsprout.com

Feedback can be emailed to feedback@psydactic.com OR submitted via a form at https://psydactic.com.

This is not medical advice. Please see a licensed physician for any personal questions regarding your own or your child's health.

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This is part 3 of a series on pediatric trauma, delving into the treatment of trauma and stress-related disorders in children. Dr. O'Leary emphasizes that therapy is always the starting point for these conditions, highlighting Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR) as highly effective, evidence-based interventions for PTSD. For attachment disorders, the focus shifts to improving the caregiver-child relationship through programs like Attachment and Biobehavioral Catch-up (ABC), while for acute stress and adjustment disorders, early CBT and psychoeducation are crucial. The discussion also addresses pharmacological interventions, noting that no medications are FDA-approved specifically for pediatric trauma, but they may be used to manage co-occurring symptoms, always with a preference for therapy as the primary approach and strong cautions against benzodiazepines and antipsychotics for routine use.

Referenced resources can be found within the show transcripts at https://psydactic_caps.buzzsprout.com

Feedback can be emailed to feedback@psydactic.com OR submitted via a form at https://psydactic.com.

This is not medical advice. Please see a licensed physician for any personal questions regarding your own or your child's health.

Let me know what you think! -

This is the second of a three-part series on pediatric trauma, delveing into the epidemiology and underlying mechanisms of trauma-related disorders in children and adolescents. Dr. O'Leary discusses what might increase risk of developing PTSD after trauma. The discussion also explores the neurobiological impact of trauma, detailing how it can dysregulate the hypothalamic-pituitary axis, alter neurotransmitter systems, and affect crucial brain regions like the amygdala, hippocampus, and prefrontal cortex. The episode highlights the profound effects of early deprivation on attachment disorders and outlines the diverse manifestations of trauma across various developmental stages, from infancy through adolescence, underscoring the importance of considering age-specific presentations and potential regressions when assessing affected youth.

Referenced resources can be found within the show transcripts at https://psydactic_caps.buzzsprout.com

Feedback can be emailed to feedback@psydactic.com OR submitted via a form at https://psydactic.com.

This is not medical advice. Please see a licensed physician for any personal questions regarding your own or your child's health.