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Kritikal
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Topic
#3516

Resolved: Oppositional Defiant Disorder should not be included within the DSM

Status
Finished

The debate is finished. The distribution of the voting points and the winner are presented below.

Winner & statistics
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0

After 1 vote and with 1 point ahead, the winner is...

Kritikal
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3
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Two weeks
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Two weeks
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Ehyeh's avatar
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Ehyeh
1487
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Description

Resolved: Oppositional Defiant Disorder should not be included within the DSM

---Summary---
This is a debate about the validity of ODD as a diagnosis within the DSM.
ODD is a supposed mental illness where people do not respect authority.
As Pro, I will argue that ODD is utter nonsense, and should be thrown out of the DSM.
Con will argue that this belongs within the DSM.

(The summary is meant as a brief description of the debate, however nothing within it is binding to either side)

---Rules---
1. 1 or more FFs merit a loss

2. No counter-plans, meaning con can not say we should include or exclude something from ODD, and then say it is ok for it to be in the DSM. This would create unlimited ground, as con can argue literally anything should be in the ODD diagnosis.

Furthermore, this is not in the spirit of the resolustion as we want to determine if the DSM is correct or not in regards to ODD, not create imaginative ways to fix it.

3. Anything aside from this can be decided with theory

---DEFENITIONS---

Oppositional Defiant Disorder (ODD):
ODD is listed in the DSM as 313.81 (F91.3), and its inclusion within the DSM is the subject of this debate.

https://cdn.website-editor.net/30f11123991548a0af708722d458e476/files/uploaded/DSM%2520V.pdf

Should:
The best defenition of should in the context of this debate is the second defention given by Merriam-Webster: "auxiliary function to express obligation, propriety, or expediency"

The word should also gives fiat, meaning that we are debating what would happen if this were to occur in the real world, but not the possiblity of it actually occuring.

https://www.merriam-webster.com/dictionary/should

Not:
Not negates the word should to suggest something should not happen, hopefully this does not become a subject of debate.

Be included within:
In the context of this debate, this simply applies to any diagnosis/mental illness/disorder/etc. that is considered valid by the DSM.

the DSM:
This is a book called "The Diagnostic and Statistical Manual of Mental Disorders." For this debate the fifth edition is the main area of debate, although it would also ovbiously have implications for other editions in the past and future. Therefore, it can be assumed that all arguments apply to any edition of the book along with past fiat (the assumption that something never occured).

This is how everyone is urged to view the resolustion, however Con is allowed to argue this as they see fit. With no arguments presented by Con, these defentions should be accepted by voters.

Round 1
Kritikal's avatar
Kritikal
Pro
#1
The DSM is a book that classifies supposed mental disorders, and is used by psychiatrists to diagnose people. As such, it stands to reason that only legitimate mental disorders should be included 

The diagnosis criteria are as follows: 

A. A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following categories, and exhibited during interaction with at least one individual who is not a sibling. 
Angry/Irritable Mood
1. Often loses temper.
2. Is often touchy or easily annoyed. 
3. Is often angry and resentful. 
Argumentative/Defiant Behavior 
4. Often argues with authority figures or, for children and adolescents, with adults. 
5. Often actively defies or refuses to comply with requests from authority figures or with rules. 
6. Often deliberately annoys others. 
7. Often blames others for his or her mistakes or misbehavior. 
Vindictiveness 
8. Has been spiteful or vindictive at least twice within the past 6 months.

B. The disturbance in behavior is associated with distress in the individual or others in his or her immediate social context (e.g., family, peer group, work colleagues), or it impacts negatively on social, educational, occupational, or other important areas of functioning. 

C. The behaviors do not occur exclusively during the course of a psychotic, substance use, depressive, or bipolar disorder. Also, the criteria are not met for disruptive mood dysregulation disorder. [1]

The problem is that the majority of these are perfectly normal. The first set which classifies anger would get a lot of people who simply have so called anger issues. A study found that 7.8 percent of Americans have anger issues, but this is far more common in young men. [2] There are also many reasons that it is good to be angry, for example an abused child would meet at least two of the first three criteria if they commonly lost their temper at their parents. It could also be argued that they are easily annoyed even if their annoyance is not justified, and it certainly would be by the psychiatric industry. 

The second set of classifications on defiance is even more problematic. Demonizing arguments with authority figures demonizes protests targeted at government officials for exampe, but the requirement for children is even more ridiculous, Children should not argue with adults? What if the child is right, or what if they just think they are right? An adult should be able to argue in this context, but the psychiatric industry does not want to hear the concerns of adults. This mirrors the attitude of the entire industry which exploits children for money with no care for their well being. [3] Indeed this creates circular power where psychiatrists define what something is and then lock children up with no due process for years at a time. [4] It is no surprise that the industry wants to silence children to keep its unlimited hegemony and unreasonable profit. 

Going to the last requirement in the list it has perhaps even worse effects. It demonizes blaming others for problems within your own life, but this is not a sign of a disorder in many cases. For example, anyone who has made the argument that systematic racism is responsible for a failure of theirs would fall under this category. For example, MLK dreamed of an equal world where black people would not be kept down — a clear sign of ODD.

The requirement on vindictiveness applies to 99% of the population I would suspect. I do not know a single person who has not done something in spite of it twice within the last two months. In fact, spite is in human nature and the reason we are spiteful is because in the long run this is what creates fairness in a society over the long run. [5] 

It is clear that ODD should not be included within the DSM because it is in no way abnormal, and in fact many of the characteristics of ODD actually serve vital purposes within society. The only potential benefit of including ODD within the DSM is enforcing compliance, but this is only good where compliance is good and forcing compliance to the psychiatric industry and other forms of power rarely is. 


Ehyeh's avatar
Ehyeh
Con
#2
Forfeited
Round 2
Kritikal's avatar
Kritikal
Pro
#3
Please refer to rule 1, 1 or more FFs merits a loss. 
Ehyeh's avatar
Ehyeh
Con
#4
Definition of mental disorder

DOES ODD EXIST?
Following the definition of a mental disorder, ODD can be said to be a mental disorder. ODD leads to impairment (usually very unnecessarily) with peers, work, and family. Pro has said that the behaviour characterized by those with ODD is perfectly normal for many children and that many tick many of the boxes for ODD. Even if we agreed on that point, it's also evident that most people tick many of the boxes for ADHD and other mental conditions such as narcissistic personality disorder. Will they claim that these conditions don't exist? Do narcissists and people with ADHD not exist? At best, all I can say and all pro can claim to prove is that ODD (like ADHD) is very likely over-diagnosed.
-
It seems apparent to most people that humans are not binary in terms of having a mental illness and not having one. People exist on a spectrum.  Everyone has narcissistic qualities yet these narcissistic tendencies aren't bad enough to be considered delusional or harmful to one's own functioning, therefore not a mental illness. ADHD likewise exists on a spectrum and not a binary on and off switch.
-
ODD and impulse control
Pro has previous said,


 ODD has nothing to do with a level of compulsion, and is not in the same range as OCD. Disorders such as OCD that deal with compulsion are classified as "Obsessive-Compulsive and Related Disorders." While ODD is classified as a conduct disorder.
This is objectively incorrect. Within the DSM, which PRO links, ODD is within the conduct disorders section, which states that the main sign of having one is the inability to control impulses and the capability to follow societal norms.

Poor impulse control is characteristic of all conduct disorders. "The chapter includes oppositional defiant disorder, intermittent explosive disorder, conduct disorder, antisocial personality disorder (which is described in the chapter ''Personality
Disorders"), pyromania, kleptomania, and other specified and unspecified disruptive, impulse-control, and conduct disorders. Although all the disorders in the chapter involve

the criteria for conduct disorder focus largely on poorly controlled behaviors that violate the
rights of others or that violate major societal norms. Many of the behavioral symptoms (e.g.,
aggression) can be a result of poorly controlled emotions such as anger. At the other extreme,
the criteria for intermittent explosive disorder focus largely on such poorly controlled emotion, outbursts of anger that are disproportionate to the interpersonal or other provocation
or to other psychosocial stressors. Intermediate in impact to these two disorders is oppositional defiant disorder, in which the criteria are more evenly distributed between emotions
(anger and irritation) and behaviors (argumentativeness and defiance)"
The addict analogy
A child with ODD may be able to stop lashing out at others, and they may be able to avoid being defiant if they try. I would have to concede on the merit that i haven't met every child and adult in the world with ODD. What pro fail to recognize is that just because someone can stop themselves from doing something doesn't mean they don't have a problem that they can't control in the long run. A porn addict might be able to stop himself from watching porn for a week and fight the temptation, yet the temptation never ceases until the addiction goes away. The same could be said for a child with ODD, although they may be able to control their reactions temporarily. The problem and anger are still there and one day it will come out. So no, a person with ODD has about as much control over their outbursts as someone does over their Tourette's (ticks). Someone with Tourette's can force their ticks away for a while, yet there comes a point where you cant keep it inside.

Conclusion
ODD exists as much as narcissistic personality disorder and ADHD do, although, as pro has rightly pointed out, it is rather vague and could be massively and unfairly diagnosed. That has nothing to do with whether it exists or not, or whether it belongs in the DSM-5. Based on the definition of a mental disorder, ODD definitely exists and is harmful to those who have this issue. Therefore, it belongs in the DSM. I imagine Pros' issue comes from over generalising, simply arguing or chatting back as being bad enough to be considered bad enough to be within the range of having ODD. This is incorrect. It has to cause great disturbance to your own personal life, psyche, and others.
Round 3
Kritikal's avatar
Kritikal
Pro
#5
Their Case

1. Definition of mental disorder

Two responses here. 

1. The word mental disorder is not in the resolution and has nothing to do with this debate. And even if something is a 'mental disorder' by a specific definition, semantics do not prove that it should be included within the DSM. Instead consider all things and weigh according to general net-benefit in order to view the round through an objective lens. 

2. The definition is not reliable because the psychiatric industry as a whole is coercive. (You can also cross apply my arguments from R1 here) [1]

2. Does ODD exist

Neg tells you that mental illness is a spectrum, but this point actually turns the entire contention. The way that the DSM would have you diagnose ODD is primarily through ticking boxes... boxes that I have already proved apply to the vast majority of normal people. 

Neg also says that all I can claim is an over diagnosis, but if ODD is defined by the DSM then it is logically impossible that these criteria are simply wrong. There is no magical etymological entity of ODD floating out in space somewhere, ODD is a list of abnormalities created by the DSM. We are not asking if the diagnosis of ODD exists, we are asking if the diagnosis of ODD should be written down in the DSM.

Also even if Neg is right, and some actually cross the threshold extreme symptoms are no longer considered ODD but instead they are closer to something called Disruptive Mood Dysregulation Disorder anyways. [2]

3. Impulse Control
This whole point deals with the classification of ODD, but it is not really relevant to the debate. It does not matter what we classify ODD as, it matters if it is a valid diagnosis, if the check marks indicate a serious problem.

On top of this Neg is just flat out wrong (along with the DSM). The DSM can not be a trusted source. They say that ODD is a impulse control issue, and yet you can read through the checks I posted in R1 and you will all see that impulsivity is not a diagnostic criteria of ODD. What this means is that even without impulsivity many are diagnosed with ODD. 

Again this point is completely irrelevant, and Neg offers up no explanation as to how this would prove the resolution false. I guess we are all just supposed to assume that anything that is impulsive is bad and should be called a disorder, but this is not true and neg does not meet the burden of proof to explain why it is. Without this assumption there is simply no link between this point and the resolution.

3. The addict analogy
First ODD is not an addiction, and neg provides no evidence saying that it is. Furthermore, ODD is not diagnosed based on addictive attributes, but based on behavioral ones (read the checklist again if you don't believe me). To make this point Neg would actually have to prove that I have somehow managed to use the wrong checklist, and that ODD is indeed something completely different than what the DSM which created the supposed illness in the first place says it is. 

Really all this point does is demonize anger and further points made by the psychiatric industry, although it is still completely unrelated from the resolution. The difference between an addiction and anger is that anger is often justified or at the very least rational, for example a child that has been abused by their parents or the psychiatric industry may be mad for very good reasons, yet the diagnosis never considers this and simply jumps to the conclusion that all anger is wrong.  

4. Conclusion 
Here Neg says ODD exists, but this is not the topic of the debate.

Then Neg goes onto say: "it is rather vague and could be massively and unfairly diagnosed."

This is basically a concession. For this debate, the definition which we both agreed to in the description said "ODD is listed in the DSM as 313.81 (F91.3), and its inclusion within the DSM is the subject of this debate." We are not debating about some concept of ODD that exists out in space somewhere, we are debating about ODD as it is within the DSM.

This was further clarified through the no counter-plans rule, which specifically says that we can not propose to change ODD. Saying:
That has nothing to do with whether it exists or not, or whether it belongs in the DSM-5
Is basically just a counter plan that redefines ODD as some etymological concept that broadly should be included within the DSM, but we are debating about the version of ODD that is real and within the DSM.

Now onto my case

My case was dropped. Maybe it is possible to cross apply a general point from Neg's case, but this is never done for one, and secondly my warrants are very specific to the individual diagnosis requirements of ODD, and Neg simply never grapples with these. 

1. Demonizing legitimate anger
7.8% of the population are consistently angry, and many for good reasons. This was never disputed, and we can see how massive over diagnosis can occur. This harms those with legitimate reasons to be angry such as abused children and labels them insane. 

2. Defiance
I give a specific warrant that the set of classifications on defiance is are extremely problematic because of the way that it elevates authority, and yet this is never responded to. The impact here is psychiatric hegemony where powerless and innocent people are locked up without even having the right to a trial. 

3. Vindictiveness and demonizing human nature itself
The final requirement for ODD is vindictiveness or blaming others for your actions. This is normal and important in many cases, for example in the civil rights movement. And, vindictiveness is part of human nature itself which is actually a good thing because this is what tends to create fairness in the long run. 

Underview 
This round is very simple. Neg has three contentions, none of which are actually relevant to the resolution. They try to defend a concept of ODD that is not real nor is the subject of debate in all of these contentions rather than actual ODD as defined by the DSM and the debate itself. As such none of the contentions link to the resolution. Beyond this, there are simply no serious impacts to weigh on Negs side and my case has been conceded. Even if everyone buys every single one of Negs contentions, my case still outweighs on magnitude.

Ehyeh's avatar
Ehyeh
Con
#6
definition of  mental disorder
 Pro starts off his round by attacking my use of the scholarly definition of mental disorder and how, based on the current usage of what a mental disorder means, entails, and is, ODD ought to be in the DSM-5.
The word mental disorder is not in the resolution and has nothing to do with this debate. And even if something is a 'mental disorder' by a specific definition, semantics do not prove that it should be included within the DSM. Instead consider all things and weigh according to general net-benefit in order to view the round through an objective lens. 
 If we wish to have a discussion on whether something is a mental disorder or not, we must first agree on a commonly held view. If you disagree with the commonly held view, then you should state that view in comparison to the commonly held view. That means it makes a lot of sense for me to give the current definition of a mental disorder in this discussion in order to progress the discussion to a new resolution.

Does ODD exist?
Neg tells you that mental illness is a spectrum, but this point actually turns the entire contention. The way that the DSM would have you diagnose ODD is primarily through ticking boxes... boxes that I have already proved apply to the vast majority of normal people. 
Pro claims that the "vast majority" of normal people tick most of the boxes for ODD. In the previous round, I admitted with a superficial analysis that this could appear to be the case with some personal interpretation. Yet a quick Google search will soon let us know that he is objectively wrong about "the vast majority" of people fulfilling most of the criteria for ODD.


Neg also says that all I can claim is an over diagnosis, but if ODD is defined by the DSM then it is logically impossible that these criteria are simply wrong. There is no magical etymological entity of ODD floating out in space somewhere, ODD is a list of abnormalities created by the DSM. We are not asking if the diagnosis of ODD exists, we are asking if the diagnosis of ODD should be written down in the DSM
Pro's point is nullified based on the fact I've demonstrated mental illness exists on a spectrum, yet can only be claimed to be a mental illness when it reaches a boundary as to where it makes daily functioning and autonomy harder.

Neg also says that all I can claim is an over diagnosis, but if ODD is defined by the DSM then it is logically impossible that these criteria are simply wrong. There is no magical etymological entity of ODD floating out in space somewhere, ODD is a list of abnormalities created by the DSM. We are not asking if the diagnosis of ODD exists, we are asking if the diagnosis of ODD should be written down in the DSM.
False. Read the DSM, not articles which simplify the DSM for readability.

First ODD is not an addiction, and neg provides no evidence saying that it is. Furthermore, ODD is not diagnosed based on addictive attributes, but based on behavioral ones (read the checklist again if you don't believe me). To make this point Neg would actually have to prove that I have somehow managed to use the wrong checklist, and that ODD is indeed something completely different than what the DSM which created the supposed illness in the first place says it is. 
I'm unsure if we're reading the same DSM. Did you not see the quote i posted in the previous round? let me send it again. 

Poor impulse control is characteristic of all conduct disorders. "The chapter includes oppositional defiant disorder, intermittent explosive disorder, conduct disorder, antisocial personality disorder (which is described in the chapter ''Personality
Disorders"), pyromania, kleptomania, and other specified and unspecified disruptive, impulse-control, and conduct disorders. Although all the disorders in the chapter involve

the criteria for conduct disorder focus largely on poorly controlled behaviors that violate the
rights of others or that violate major societal norms. Many of the behavioral symptoms (e.g.,
aggression) can be a result of poorly controlled emotions such as anger. At the other extreme,
the criteria for intermittent explosive disorder focus largely on such poorly controlled emotion, outbursts of anger that are disproportionate to the interpersonal or other provocation
or to other psychosocial stressors. Intermediate in impact to these two disorders is oppositional defiant disorder, in which the criteria are more evenly distributed between emotions
(anger and irritation) and behaviors (argumentativeness and defiance)"
You know who else cannot control their impulses? people with porn and alcohol addictions. An impulse to get drunk or watch porn.

Really all this point does is demonize anger and further points made by the psychiatric industry, although it is still completely unrelated from the resolution. The difference between an addiction and anger is that anger is often justified or at the very least rational, for example a child that has been abused by their parents or the psychiatric industry may be mad for very good reasons, yet the diagnosis never considers this and simply jumps to the conclusion that all anger is wrong.  

"Anger is at least justified." Do you truly believe that porn addicts don't justify their porn addictions? People with anger issues recognise they have anger problems and try to control them, often to limited success (without assistance). Did you know that 90% of the world's prison population is men? Men account for the vast majority of those with anger issues. Clearly, there is an overlap between violence against others and anger issues. I wouldn't say anger issues are justified. Anger can be justified, yet not to the point where you have an anger issue. As this implies, your anger goes beyond reason and into areas that directly disable you and others. Thus, anger does not help you and is not justified if it does not solve your problems.
 
Concession?
Here Neg says ODD exists, but this is not the topic of the debate.

Then Neg goes onto say: "it is rather vague and could be massively and unfairly diagnosed."

This is basically a concession. For this debate, the definition which we both agreed to in the description said "ODD is listed in the DSM as 313.81 (F91.3), and its inclusion within the DSM is the subject of this debate." We are not debating about some concept of ODD that exists out in space somewhere, we are debating about ODD as it is within the DSM.
You have a massive leap in logic here. I believe many things are over diagnosed (ADHD), but that doesn't mean I don't think it exists or should be in the DSM.

This was further clarified through the no counter-plans rule, which specifically says that we can not propose to change ODD. Saying:
We're discussing right now whether it should be changed. You're yet to prove it should be. You're right with assumptions about my positions and reasoning.

DEMONISING LEGITIMATE ANGER?
1. Demonizing legitimate anger
7.8% of the population are consistently angry, and many for good reasons. This was never disputed, and we can see how massive over diagnosis can occur. This harms those with legitimate reasons to be angry such as abused children and labels them insane. 

I'm unsure what you mean by "legitimate" anger. Do you mean anger that the experiencer of the anger believed was justified? Based on the current DSM, anger cannot be justified if it doesn't solve anything, yet proposes nothing but self-destruction and destruction to others. Would you disagree with that? Whether the experiencer believes their anger is justified doesn't make it helpful or something we should embody if we wish to maintain a happy and productive life.

I give a specific warrant that the set of classifications on defiance is are extremely problematic because of the way that it elevates authority, and yet this is never responded to. The impact here is psychiatric hegemony where powerless and innocent people are locked up without even having the right to a trial. 
 What another wild set of assumptions based on a presumed axiom. The DSM-5 doesn't elevate authority in an unjust manner if it bases whether the authority is correct or not on the one who defies them is destructive to themselves and others. Once more, it is estimated only 1–16% of the population have ODD (mostly males). This is around the same as the proportion of those with anger issues. 

3. Vindictiveness and demonizing human nature itself
The final requirement for ODD is vindictiveness or blaming others for your actions. This is normal and important in many cases, for example in the civil rights movement. And, vindictiveness is part of human nature itself which is actually a good thing because this is what tends to create fairness in the long run. 

Something can be human nature whilst not being good, or healthy for the person. Schizophrenia is genetic, and thus "human nature," as is vindictiveness, but not to the extent that it is excessively maliciously destructive to self and others (as with the case of ODD).

This round is very simple. Neg has three contentions, none of which are actually relevant to the resolution. They try to defend a concept of ODD that is not real nor is the subject of debate in all of these contentions rather than actual ODD as defined by the DSM and the debate itself. As such none of the contentions link to the resolution. Beyond this, there are simply no serious impacts to weigh on Negs side and my case has been conceded. Even if everyone buys every single one of Negs contentions, my case still outweighs on magnitude.
A concept of ODD that is not real? I'm defending the current usage of the ODD and its place within the DSM, as I ought to as CON. All contentions link to the resolution that we ought to maintain the current status quo.

Conclusion
PRO has completely misunderstood my argument. He is wrong about the criteria for ODD, believing that most people tick the boxes. Objectively, as I demonstrated, only around 6% of people have ODD. Not the "majority" as he claims to believe. The Pro has offered no realistic alternative to what should constitute a mental disorder if the current one is incorrect. Instead, it feels more like he wants to throw the entire concept out the window and pretend no one has mental habits which negatively and persistently affect them.