“…Rebelliousness, classically has been represented in the seventh art as a lack of obedience and lack of direction marked by incomprehension and violence; whose cause seems to lie solely in the parents’ misunderstanding of their children’s problems or in an unstructured family environment.
In this way, the “maladjusted youth” overwhelmed by loneliness desperately seeks the understanding of other young people in the same situation, and is forced to prove his “manhood” through cruel and daring acts, which lead him to border on delinquency…”.
This premise, however, analyzed from a Child Neurology perspective, is only a half-truth, a vision biased by the “nostalgic romanticism” that envelops in an iconic wake the quintessential symbol of American rebellious youth, James Dean. It should be borne in mind that in the early 1950s the importance of “biological individuality” and its influence on behavior was not yet recognized, and that it was not until 1956 when an American study that followed 133 children into adulthood (“The New York Longitudinal Study”) was able to identify the existence and persistence of biological differences in the behavior of all children.
Fortunately, thanks to advances in neuroscience, in recent decades we have witnessed a change in the paradigmatic model of behavioral disorders and have evolved towards a much more eclectic position that accepts not only the importance of the environment, but also of the brain, genetics, and the complex interrelationship that exists between all of them.
Body and psychological changes during puberty: some rebelliousness is normal.
For example, if we think of a normal adolescent, it is common for him/her to show a certain degree of “rebelliousness”, since he/she is in a moment of transition to adulthood, of change and acceptance of a new reality. It should be taken into account that during puberty, a series of bodily and psychological changes take place, as well as brain changes (especially in the frontal lobe and its closest connections) which, as a whole, are the ones that explain the cognitive-behavioral changes typical of adolescence. And, since the frontal lobe is responsible for self-control, reason, judgment and decision-making (and is the last region to mature), it is logical and inevitable that, during this period of life, there will be more or less intense frictions with parents about the way to dress, the time to go home, the friends to go with or even moral, ethical and/or religious values. However, as the years go by, this “rebellious spirit” usually subsides and disappears, thanks to the fact that full cerebral maturity is reached (marked in blue-violet in the following image).
Oppositional-defiant disorder: rebelliousness taken to the extreme
However, in some children these behaviors of defiance, rebellion and opposition to the norms of adolescence can go to the extreme, being openly hostile, negative and provocative in their actions. This is what is known in medicine as Oppositional Defiant Disorder (ODD) and usually occurs in childhood and early adolescence. It affects 3-8% of the population, is more common in boys than in girls and, although it can occur in isolation, 40% of children with attention deficit hyperactivity disorder (ADHD) have it in association. However, and since these are two very different disorders, the type of behavior exhibited by children and adolescents with oppositional-defiant disorder must be differentiated from that present in ADHD, in which the child does not obey orders because he/she is absent-minded and does not remember them or because he/she is too active to listen to reason, or because his/her behavior is thoughtless and impulsive and does not know how to control him/herself at a given moment.
Children with oppositional-defiant disorder are very belligerent and show a very defiant attitude towards the authority figure, often doing the opposite of what they are ordered to do and behaving in a stubborn, defiant and provocative manner. These children often say “no” as a rule, adopt an attitude of rejection and defiance, and prefer to lose out rather than give in or ask for forgiveness. And, in more extreme cases, they may become resentful, vindictive and hostile, intentionally picking on others and blaming them for their problems.
Unlike the classic “rebellious adolescent”, in which the problems are milder and may last a few weeks and then improve and reappear depending on the environment, in oppositional-defiant disorder the disruptive behavior is long-lasting, intense and has a negative impact on the daily life of the child, his family and other people around him.
And, to complicate matters even more, some of these children with oppositional defiant disorder may go on to develop conduct disorder (CD), which is the most severe form of behavioral disorder. They are usually adolescents who repeatedly break the rules of social coexistence and violate the rights of others, and may become juvenile delinquents. It is not about sporadic hooliganism but about difficult-to-handle children who create serious problems for their parents and who, in many cases, come into contact with the judicial system at a very early age.
What can be the causes of oppositional defiant disorder?
But what is the cause of oppositional defiant disorder and conduct disorder? Today we know that its origin is neurobiological (i.e., it is a medical problem that causes a deficit or abnormal functioning of certain parts of the brain and its interconnections), and that there are certain genetic and environmental factors that influence the expression of these alterations. And both the incidence and severity of both disorders can be profoundly modulated by the family environment and the type of education received. Because parents who raise their children by force and who confront them with hostility, physical and/or verbal violence, increase the risk and severity of such disorders. But this does not mean that family breakdown or marital problems, poverty or unemployment are the only cause of these disorders.
This is where the current neurobiological approach sheds light on the origin of behavioral disorders in childhood and adolescence, considering them as the result of a complex interrelationship between biological, genetic and environmental factors. All of them are important and, therefore, must be addressed in each particular case by a multidisciplinary team that can provide an “overview” of these disorders and the context in which they develop, and that contemplates, understands and knows how to handle not only the purely psychological and behavioral aspects in isolation but also the medical, genetic and environmental ones. Because as important as knowing how to see and appreciate the qualities of the forest as a whole, is to be able to do the same with the individual trees that make it up.
“The most effective discipline is that which combines firmness with approval in a delicate balance. Because disciplining does not necessarily imply punishing, but maintaining consistency between the model of limit setting that both parents use and learning techniques that help modify behavior by encouraging improvement.”