The PMHNP has diagnosed an 8-year-old boy with oppositional defiant disorder (ODD). Which of the following is the most effective treatment?
Family therapy with emphasis on child management skills
Structural family therapy with emphasis on multigenerational projections
Cognitive behavioral therapy for parents and child
Family systems therapy with integrated behavior modification training
The Correct Answer is A
Choice A reason: This is the correct answer. Family therapy focusing on parent management skills is evidence-based and targets the child’s disruptive behaviors through reinforcement, consistent discipline, and skill-building in the family context.
Choice B reason: Structural family therapy emphasizes family organization and multigenerational dynamics. While useful for broader family issues, it is less effective as a primary treatment for ODD behaviors.
Choice C reason: CBT can help children with emotional regulation, but for ODD, the primary evidence supports parent-focused behavioral interventions rather than individual CBT alone.
Choice D reason: Family systems therapy with integrated behavior modification has some merit but is more complex and less empirically supported than parent management training specifically for ODD.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Initiative vs. Guilt occurs in early childhood (3–5 years) and involves the development of purpose through goal-directed activities. At age 12, the child has passed this stage.
Choice B reason: Autonomy vs. Shame and Doubt occurs in toddlerhood (1–3 years) and focuses on developing independence and self-control. This stage is no longer relevant for a 12-year-old.
Choice C reason: Industry vs. Inferiority (ages 6–12) is characterized by children developing competence, pride in accomplishments, and perseverance in tasks. The child’s pride in his science project demonstrates mastery of this stage.
Choice D reason: Identity vs. Role Confusion occurs during adolescence (12–18 years) and involves forming personal identity and sense of self. While the child is entering this stage, his behavior reflects mastery of the prior stage.
Correct Answer is B
Explanation
Choice A reason: Family history about siblings may provide context for genetic predispositions but is not determinative for distinguishing RAD from ASD.
Choice B reason: History of language delay is important because language deficits are a core feature of ASD but not typically present in RAD, helping differentiate between the two conditions.
Choice C reason: Presence of selective attachment behaviors can help distinguish RAD, which is characterized by limited or absent attachment behaviors, from ASD, where children may form attachments but have social communication deficits.
Choice D reason: Indications of severe social neglect are critical for RAD diagnosis, as this disorder results from pathogenic caregiving environments, distinguishing it from neurodevelopmental conditions such as ASD.
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