Angst Over Teen Angst
by Bradley T. Wajda, D.O.
Most parents are confronted with brief episodes of behavior by their children which leads those parents to wonder whether or not the behavior is “normal”. For some parents these episodes aren’t brief and can be a source of worry and stress that is in addition to the distress the behavior causes within the home. There are many websites that provide checklists intended to help parents identify behavioral problems in their children; however, it is important to remember that a checklist is just a screening tool intended to give a preliminary idea of when there may be a problem. The findings on a checklist must be followed by a more detailed examination of the child’s behaviors and what those behaviors mean. This is especially true because the items on the checklist often describe what could be considered normal adolescent behaviors (depending on the severity of the behavior). Another important variable is in how you respond to the items on the checklist- this certainly influences the interpretation of the results. It is important to find out if others see the behaviors in your child the same way you do. Exasperated parents (often stressed due to unrelated issues) frequently describe adolescents as significantly more problematic than they really are.
A diagnosis of a “Conduct Disorder” is clearly a problem needing professional attention and is defined by:
- Aggression toward people and animals
- Destruction of Property
- Theft and/or deceitfulness
- Serious rules violations
Additionally threats of self-harm, substance abuse, abrupt behavioral extremes, and complaints about mood issues severe enough to impair their ability to function academically, socially, and occupationally (when applicable) require immediate professional attention. Frequently, recent or abrupt changes in behavior are connected to substance abuse.
The difficult issue is in discerning between more subtle behavioral problems such as Oppositional Defiant Disorder (ODD), Attention Deficit Hyperactivity Disorder (ADHD), and normal adolescent behavior. It is important to note that there is a requirement on each of these diagnoses that the behavior results in a “significant impairment”. This requirement is part of the definition of these disorders contained in the “Diagnostic and Statistical Manual, Fourth Revision Text Revised (DSM IV-TR)” published by the American Psychiatric Association.
Oppositional Defiant Disorder (ODD) is an ongoing pattern of disobedient, hostile, and defiant behavior toward authority figures that goes beyond the bounds of normal childhood behavior and is defined by:
- Arguing with adults
- Losing their temper easily
- Being angry or resentful of others
- Actively defying adult requests or rules
- Blaming others for their own mistakes or behaviors
- Being easily annoyed by others
- Deliberately annoying others
- Acting spiteful or vindictive
If you read the list of behaviors and think, “That could be any normal kid” you would be right. The difference between normal behavior and a problem is determined by the level of “significant impairment” in the home, at school, or in the workplace (when applicable).
If you have a question or concern about your child’s behavior, talk with your pediatrician, family physician, or mental health professional. The earlier problems are detected, the better the chances are that your child will return to the normal - albeit annoying - behavior of childhood and adolescence.