title: Mary, a 4-year-old with oppositional defiant disorder.
abstract: OBJECTIVE
  Examine the treatment course of a 4-year-old girl with oppositional defiant disorder, which developed in the context of her father's deployment to Bosnia.
  
  
  METHODS
  A case report of the interventions made with this patient and her clinical outcomes.
  
  
  RESULTS
  The patient's behavior improved substantially with regular therapy sessions and with a designated playtime with her mother.
  
  
  CONCLUSIONS
  One possible cause of oppositional defiant disorder is a parent-child attachment deficit. In this case, the child's parents are both active duty service members and her father was deployed overseas. Young children have difficulty verbalizing feelings of loss and may respond behaviorally by exerting control over their immediate environment. Some children may respond to unstructured play sessions in which they are able to express feelings and gain some control in their interactions with adults.
authors.affiliation: Walter Reed Army Medical Center, Department of Psychiatry, 6900 Georgia Avenue, NW, Washington, DC 20307, USA.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Daly
authors.forename: Thomas
authors.initials: T
authors.lastname: Grieger
mesh_terms: D019958:Attention Deficit and Disruptive Behavior Disorders / Q000209:etiology / Q000628:therapy*; D002653:Child Behavior Disorders / Q000209:etiology; D002675:Child, Preschool; D003248:Constipation / Q000523:psychology*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008889:Military Personnel; D009034:Mother-Child Relations