RESEARCH PROPOSAL

PRESENTED BY: SWEETY.P.PAUL 1ST YEAR MSc Nursing MIMS CON

Title of the Study

Effect of family risk factors on oppositional defiant disorder among school children

Background of the problem

By birth children are creative. Childhood is a period of mischievous and it is a normal process. Mischievous is also said to be the manifestation of creativity .But when a child continuous this mischievous behavior in his later life period it may result in certain behavioral disorders like negativism, disobedience, argues with others, angry. This uncooperative behavior occurs more frequently in children and it is termed as oppositional defiant disorder1. Studies showed that factors which lead to the development of oppositional defiant are neurotransmitter imbalances in the brain, decreased cortisol, genetic components and dysfunctional family system2. A study conducted in 119 children including girls diagnosed with oppositional defiant disorder to identify the brain activation by using electro encephalogram. The electro encephalogram result showed that atypical right frontal brain activation pattern is seen in these children .It is well known that activation of right sided frontal brain region is related to negative emotions and withdrawal reactions3 Most of the children also show deviant behavior at least once in their life span it may be due to hungry, stress, and tiredness. But this oppositional behavior is a normal part of their development4. If oppositional defiant disorder becomes severe or persists more than six months, it affects the childs social, family, occupational and academic life3 and also shows additional symptoms like physical aggression, criminal behavior or other serious behaviors. If the parents and the society neglect these behaviors of their children ,which may worsen the condition of the child and result in severe psychiatric disorders like attention deficit hyperactivity disorder, mood disorders, learning disorders and conduct disorders3.

Need and Significance

Oppositional defiant disorder is a common childhood disorder and has an estimated Lifetime prevalence of 10.2% .The condition occurring commonly in boys approximately11.2% than females 9.2% 5. The condition is more common in boys before puberty and it is equally common in boys and girls after puberty3. Female children are not always physically aggressive but most of the time they exhibit verbal and relational aggression6. The prevalence rate of oppositional defiant disorder is 2-16% in the general population .The life time prevalence of oppositional defiant disorder is 8.5% in an epidemiological study conducted in United States of America7. A study conducted to find out the prevalence of conduct disorder in 4 schools of Kanke, India among students of classes V to X. The result shows that the prevalence rate of conduct disorder was 4.58%, more common in boys and the majority had childhood onset8.

Studies showed that the common reason for oppositional defiant disorder in children is disruptional family system. An aggressive family environment like parents with alcoholism, drug abuse and criminal back ground, lack of parental supervision, single parenting, and lack of encouragement are some of the actors influenced by the parents in children4.

It is said that parents are the first teachers, so they have a major role in the development of behavior of children. Dysfunctional family system is common in todays world and it may leads to destructive, physically violent and aggressive behavior in children which results in trouble at school ,family and society. These children are prone to involve in crimes and ending up their childhood in juvenile homes. When we look back to their past life history from the news papers, it can conclude that most of the childrens family environment influenced him to do so. So the investigator has a strong ambition to study the family risk factors which causes oppositional defiant disorder.

Purpose of the study

To identify the effect of family risk factors on oppositional defiant disorder among school children.

Statement of the problem

A study to assess the effect of family risk factors on oppositional defiant disorder among school children attending selected schools of coastal areas of Calicut and Malappuram.

Objectives
1. Identify the incidence of oppositional defiant disorder among school children attending selected schools of coastal areas of Calicut and Malappuram using Child Behavior Check list.

2. Identify family risk factors for oppositional defiant disorder among school children attending

selected schools of coastal areas of Calicut and Malappuram using structured questionnaire.

3. Identify the socialized conduct problems of children with oppositional defiant disorder using

Eyberg Child Behavior Inventory.

4. Compare the oppositional defiant disorder among school children attending selected schools of coastal areas of Calicut and Malappuram.

5. Determine the relationship with family factors and oppositional defiant disorder among school children attending selected schools of coastal areas of Calicut and Malappuram.

6. Determine the association between oppositional defiant disorders among school children of

Coastal areas of selected schools of Calicut and Malappuram and selected demographic variables.

Operational definitions

Effect Is a consequence or outcome of the family factors. Family risk factors Refers factors such as a dysfunctional family life, family history of mental illnesses, substance abuse and inconsistent discipline by parents may contribute to the development of behavior disorders in children. Oppositional defiant disorder Is a childhood disorder characterized by a pattern of disobedient, hostile, and defiant behavior towards authority figures. School Children:-Refers girls and boys who attend the school Schools of Coastal areas:-Schools which are situated in the seashore Conceptual frame work Based on the theory of Johnson Behavioral System Model Assumptions 1. Oppositional defiant disorder is seen in school children of coastal areas. 2. Family factors can lead to oppositional defiant disorder Hypothesis H1: There will be significant relationship between family factors and oppositional defiant disorder of school children H2: There will be significant association between oppositional defiant disorders of school children and selected demographic variables Research Methodology Approach: Non experimental Design: Descriptive Comparative Design Setting: Schools of coastal areas at Calicut & Malappuram Population: School children of coastal areas and their parents Sample: School children with oppositional defiant disorder and their parents who meet inclusion and exclusion criteria Sampling Technique: Purposive Sampling

Sample Size: 120

Pilot Study
Will be conducted on 10% sample Plan for data collection After obtaining consent, data will be collected using Child behavior checklist, Structured Questionnaire and Eyberg Child Behavior Inventory Tools & Techniques Section A: a) Child Behavior Checklist to identify the incidence of oppositional defiant disorder b) Structured Questionnaire to identify the family risk factors c) Eyberg Child Behavior Inventory to identify the conduct problems of school children with oppositional defiant disorder Section B: a) Demographic Proforma b) Plan for data collection c) Descriptive and inferential statics

Work plan

Week 1

Week Week 3 2

Week 4-9 Week 10

Week11 Week12

Week13

Tool

Pilot

Presentation Data

Analysis Writing of

Presentation Submission of of dissertation to KUHS

Finalization Study on report of collection of data (content validity and reliability) pilot study

research dissertation report & submission of report

Budget: By self Ethical considerations The research proposal will get approval from IRB. Informed consent will be obtained from the subjects. References Pardini D A., Frick P J & Moffitt T E. Building an Evidence base for DSM-5 Conceptualizations of Oppositional Defiant Disorder and Conduct Disorder: Introduction to the Special Section. Journal of Abnormal Psychology.2000; 119(4): 683-88 Children with oppositional deviant disorder. American academy of child and adolescent psychiatry. March 2011 .Available from: http://www.aacp.org 3. Available from http://www.webmd.com/mental-health/oppositional-defiant-disorder. 4. Oppositional defiant disorder (ODD)-Child has Aversion to Authority; July 2010.Availbel from http://www.disabled-orld.com/disability/types/psychological/odd.php

5. Nock M K, Kazdin AE. Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: results from the National Co morbidity psycho psychiatry. July 2007; 6. Hills k, Dowell k .The gender appropriateness of Current Oppositional Defiant Disorder Diagnostic Criteria 7. Gomez R, Hafetz R.Oppositional defiant disorder: prevalence based on parent and Teacher ratings of Malaysian primary School children. Asian Journal of Psychiatry; March 2013; vol (7) 8. Sarkel S, Sinha V K. Prevalence of conduct disorder in school children of Kanke.Indian Journal of Psychiatry, 2006; vol 48(3) 9. Kessler R C Berglund P Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Co morbidity Survey Replication .Achieves of Psychiatry. June 2005: vol 62(6) Survey Replication. Journal of child

External stressors Family factors such as children of alcoholic parents, Anti social behaviors Mood disorders

Dependency Sub System Lack of peer support. Lack of approval in the family and society

Affiliation/Attachm ent subsystem Lack of attachment Insecurity Dysfunctional Family system

Achievement sub system. Poor role performance. Poor work accomplishment. Decreased success

Stress in tolerance

School Children

Illness/odd

Mood disorder Internal Stressors Learning by imitation Previous experience Experimentalism Aggressive Disobeying Talking back to their parents Arguing Impaired defecation and urination Painful micturation and defecation Ingestive system Decreased food Intake. Loss of appetite Poor health Ulcer