What is oppositional defiant disorder (ODD)?

Oppositional defiant disorder (ODD) is a behavior disorder, usually diagnosed in childhood, that is characterized by uncooperative, defiant, negativistic, irritable, and annoying behaviors toward parents, peers, teachers, and other authority figures. Children and adolescents with ODD are more distressing or troubling to others than they are distressed or troubled themselves.

What causes oppositional defiant disorder?

While the cause of ODD is not known, there are two primary theories offered to explain the development of ODD. A developmental theory suggests that the problems begin when children are toddlers. Children and adolescents who develop ODD may have had a difficult time learning to separate and become autonomous from the primary person to whom they were emotionally attached. The "bad attitudes" characteristic of ODD are viewed as a continuation of the normal developmental issues that were not adequately resolved during the toddler years. Learning theory suggests, however, that the negativistic characteristics of ODD are learned attitudes, reflecting the effects of negative reinforcement techniques used by parents and authority figures. The use of negative reinforcement by parents is viewed as increasing the rate and intensity of oppositional behaviors in the child as it achieves the desired attention, time, concern, and interaction with parents or authority figures.

Who is affected by oppositional defiant disorder?

Behavior disorders, as a category, are, by far, the most common reason for referrals to mental health services for children and adolescents. Oppositional defiant disorder is reported to affect 1 to 16 percent of the school-age population. ODD is more common in boys than in girls.

What are the symptoms of oppositional defiant disorder?

Most symptoms seen in children and adolescents with oppositional defiant disorder also occur at times in children without this disorder, especially around the ages or two or three, or during the teenage years. Many children, especially when they are tired, hungry, or upset, tend to disobey, argue with parents, or defy authority. However, in children and adolescents with oppositional defiant disorder, these symptoms occur more frequently and interfere with learning, school adjustment, and, sometimes, with the child's relationships with others.

Symptoms of oppositional defiant disorder may include:

  • Frequent temper tantrums

  • Excessive arguments with adults

  • Refusal to comply with adult requests

  • Always questioning rules; refusal to follow rules

  • Behavior intended to annoy or upset others, including adults

  • Blaming others for his/her misbehaviors or mistakes

  • Easily annoyed by others

  • Frequently has an angry attitude

  • Speaking harshly, or unkindly

  • Seeking revenge

The symptoms of ODD may resemble other medical conditions or behavior problems. Always consult your child's doctor for a diagnosis.

How is oppositional defiant disorder diagnosed?

Parents, teachers, and other authority figures in child and adolescent settings often identify the child or adolescent with ODD. However, a child psychiatrist or a qualified mental health professional usually diagnoses ODD in children and adolescents. A detailed history of the child's behavior from parents and teachers, clinical observations of the child's behavior, and, sometimes, psychological testing contribute to the diagnosis. Parents who note symptoms of ODD in their child or teen can help by seeking an evaluation and treatment early. Early treatment can often prevent future problems.

Further, oppositional defiant disorder often coexists with other mental health disorders, including mood disorders, anxiety disorders, conduct disorder, and attention-deficit/hyperactivity disorder, increasing the need for early diagnosis and treatment. Consult your child's doctor for more information.

Treatment for oppositional defiant disorder

Specific treatment for children with oppositional defiant disorder will be determined by your child's doctor based on:

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