Episode Transcript
Announcer: 来自犹他大学医生和专家的医学新闻和研究，你可以用它来过上更快乐、更健康的生活. You're listening to The Scope.
Interviewer: We're here with Dr. Matthew Woolley, 临床心理学家，犹他大学精神病学助理教授. Thank you for being on the show today.
Dr. Matthew Woolley: Thanks for having me.
Interviewer: Kathy from Sandy, Utah has sent us a question. 她想知道她的一个学生是否患有ODD，即对立违抗性障碍. She's a private piano teacher. She has a young student of hers that she calls impossible. 她说，大约有一半的时间他是可以合作的，但另一半时间他很容易分心. 如果被要求做某事，他经常拒绝说：“我不想做。.当有人问他为什么做某事时，他会回答说：“因为我笨。." He also mocks and mimics me at times. 旁听他上课的妈妈似乎知道他是不可思议的. 她没有用语言向我承认，但从不做任何事情来纠正他的行为. She's at her wits end and wants to know if he has ODD. While surfing she came across this disorder. Let's talk about what is operational defiant disorder.
Dr. Matthew Woolley: It's oppositional defiant disorder. That means that kids who have this, 这是一种破坏性行为障碍，意思是这是一种行为模式，破坏了他们正常的功能和与他人互动的能力.
Interviewer: To some extent all kids have that though, don't they really?
Dr. Matthew Woolley: Yeah, I might still have a little of it, you know. 事实上，每个人都有反对的时候. Children certainly can be oppositional, 但这是一种一致的行为模式，它不仅仅是反对你被要求做的事情. There's a pattern of being angry, upset, 容易易怒，并且在你的环境中反对规则. These kids are not necessarily law breaker kids. They may follow the rules of society, 但是像坐下来弹钢琴之类的规则. They often say no. In fact, 有趣的是，有时这些孩子会经常表现出不合逻辑的对立行为模式. 这实际上是一个关键的标志，意思是要求他们做一些他们通常想做的事情，他们会和你争论这件事或者怎么做. 而不是典型的孩子说，“是的，我想去看电影." they might argue with you about the time. 他们正在寻找机会来建立一点控制.
Interviewer: 是大脑中的化学物质失衡导致的，还是究竟发生了什么?
Dr. Matthew Woolley: 有一些遗传因素，但是很多行为在早期就被强化了. What will happen is a child will be fairly difficult, forceful and oppositional from a very early age, 父母很早就屈服了，因为他们更容易屈服于这些坚强的孩子. That dramatically reinforces this behavior, so later on by the time they hit even kindergarten, they're at the ripe old age of five, people are saying things like, "Well, they've always been this way." It's a combination of both heritable genetic factors, but early learning that, “当我感到威胁时，我通过反对来满足我的需求."
Interviewer: What are some of the symptoms?
Dr. Matthew Woolley: 当然是反对成年人和父母的正常要求. There is a consistent pattern here. 这几乎是大发娱乐争论的全部时间. That's probably the hallmark behavior. Defying rules, but not necessarily breaking laws, 意思是这些孩子不一定是出去偷东西的, 但这些孩子觉得在学校或家里这样的特定环境下，他们不必听从大人的命令. They tend to be more irritable, angry outbursts, 情绪崩溃发生得更频繁，而且经常与多动症同时发生. If you have a child who has been diagnosed with ADHD, 哪一种是注意力不集中型还是多动症和注意力不集中的混合型, 这些孩子也有更高的风险有这种行为.
Interviewer: When does this type of disorder start to develop, how old?
Dr. Matthew Woolley: 大发娱乐经常看到父母在小学早期就把孩子带进来. They've usually been able to handle this kid's behavior, 但是当他们上幼儿园、一年级或二年级的时候，这就开始成为一个问题了，因为他们也和老师和其他类似的人产生了对立. 然而，如果你回头看，通常这种行为在蹒跚学步的时候就开始萌芽了.
Interviewer: Do boys get it more than girls?
Dr. Matthew Woolley: 这在男孩中比女孩更常见，但女孩当然也不能幸免.
Interviewer: What's the takeaway that you would have for Kathy? 听起来你是在建议也许她应该和家长谈谈.
Dr. Matthew Woolley: 父母通常不喜欢别人说他们的孩子很难相处. 也许不那么危险的事情是去看儿科医生.
Interviewer: Go with the pediatrician.
Dr. Matthew Woolley: Yeah, I'm a psychologist, 我也意识到父母在找心理学家的时候会有一点犹豫，尽管儿科医生可能会推荐他们去找心理学家.
Interviewer: 从儿科医生那里比从音乐老师那里更容易.
Dr. Matthew Woolley: Yea, definitely. I often tell parents it's easy to get into a pediatrician. 通常你可以在24到48小时内到大多数儿科医生的办公室预约. 也许你可以随身携带一些简短的描述，这样你就可以向儿科医生描述你所看到的, 他或她可能会大发娱乐你更好地理解它，也许会把你介绍给心理学家，在那里你可以得到适当的评估.
Announcer: We're your daily dose of science, conversation and medicine. This is The Scope University of Utah Health Sciences Radio.