Our 10-year-old son fits traits of ODD perfectly and began showing those signs almost from day 1. Extremely bright, imaginative and verbal. The usual behavior mod. "systems" (time out, credits, withdrawal of privileges) not effective. He has been increasingly violent/destructive at home, though not at school or elsewhere. Tried Risperdol but discontinued since improvement seemed minor in proportion to risks. Tried NHA (Howard Glasser), again only moderate and short-lived improvement. Am now exploring possible food triggers (wheat, sugar, dairy, chemical additives) but it's hard to get compliance with elimination of foods when he's at school (we send a good lunch, but he trades, gets treats, etc.).
He once gleefully spit over the balcony onto people's heads at the museum, right in front of his friends! We left immediately. As always, no remorse. Just sort of this calm satisfaction.
Son has exceptionally loving 5-year-old sister whom he takes great satisfaction in tormenting. We have taken pains to avoid showing anything that could be construed as preferential treatment toward her, but still he HATES her and has the verbal skills to tell her so in very illustrative terms, constantly, from the wakes up. Classically, he shows no remorse, never accepts blame, lies naturally, is selfish, "lazy" and is unmoved by the anguish or misfortunes of others. He sometimes remarks that he doesn't like his appearance, and is unwilling to try new things for fear he won't instantly be good at it. (Of course he won't admit to these feelings of insecurity.)
All along, I have take some consolation in the fact that his behavior is usually fine (or at least age-appropriate)at school and when at friends' homes. He seems to reserve all the horror for his parents. Also, I take some consolation in the fact that he seems genuinely sorry and loving when he accidentally bumps his pet bunny (as opposed to torturing animals, I mean). And I HAVE seen him be kind to his sister when he doesn't realize we are listening, although he still never DOES anything for someone else unless there's something in it for him.
So, here's the question: now that he's approaching adolescence (he's only 10 but shows some early signs of puberty), and he seems to also fit the characteristics of sociopathic personality disorder (TOTAL lack of conscience, NO empathy), what are our prospects for this child?
By the way, both his parents have had long-time struggles with dysthymia -- mine is helped enormously by Prozac, dad's is worse. My pregnancy with son was normal, no alcohol or drugs, and I'm pretty sure we did not fall into the pattern of "rewarding negative behaviors." We rarely caved in to tantrums, and gave lots of affirmation for good behaviors -- which he sometimes saw as trying to "trick" him. Thanks for ANY insight or direction you can offer. Thanks.