Learn More About Opposition Defiant Disorder

Diagnostic Criteria

A. A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present:

Angry/Irritable Mood

• often loses temper
• often argues with adults
• often actively defies or refuses to comply with adults' requests or rules

Argumentative/Defiant Behavior

• often deliberately annoys people
• often blames others for his or her mistakes or misbehavior
• is often touchy or easily annoyed by others
• is often angry and resentful

Vindictivenes

• is often spiteful or vindictive

Note: Consider a criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level.

B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.

C. The behaviors do not occur exclusively during the course of a Psychotic or Mood Disorder.

D. Criteria are not met for Conduct Disorder, and, if the individual is age 18 years or older, criteria are not met for Antisocial Personality Disorder

Specify current severity:

• Mild: Symptoms are confined to only one setting (e.g., at home, at work, at school, with peers).
• Moderate: Some symptoms are present in at least two settings
• Severe: Some symptoms are present in three or more settings

Oppositional defiant disorder (ODD) can be difficult to tell apart from other disorders such as attention deficit hyperactivity disorder, generalized anxiety disorder, or bi-polar disorder due to symptoms being very similar.

One key factor to identifying ODD is the vindictive behavior, which is not present in other disorders. While the other disorders cause disruptive behavior, the idea of “getting back” at parents, teachers or adults is a tell-tale sign of ODD.

A child suffering from ODD will have a great deal of difficulty following rules and behaving within the expected boundaries, and when prompted to follow the rules the vindictive behavior comes out in the form of angry and resentful behavior aimed at attacking or upsetting the person that is upsetting them.

ODD can have more than one cause, but primarily ODD is seen in children who have a lack of consistency in their lives, rules, and behavior expectations. Since this inconsistency is the largest factor for ODD, it is the only one covered in this section. For more information on what could have caused ODD in your child, consult with a professional guide.

Children learn appropriate behaviors in many ways, but the largest influence on behavior and emotion for children is environment. A child can pick up on very small signals about right and wrong and what is appropriate behavior from their environments, even when their parents are unaware of such signals. As a child begins to grow and learn, they attempt to incorporate these rules and expectations of their behavior into their personalities.

In children with ODD the rules and expectations in different areas of their lives are not consistent. In fact they are usually very different from one another. This might be different parenting styles or rules and household norms that differ from one parent to another parent in divorced families. This is also seen in differences between grandparents and parents where the grandparents play a large parental role. Major differences in school expectations can also cause ODD.

When a child doesn’t have consistent behavior expectations it makes them feel anxious, fearful and resentful. Happy and carefree children are those that get consistent parenting and rules – when they always know what to expect and what their roles or duties are, children are much more comfortable.

Anxious and resentful children act out their insecurities by being vindictive and taking their emotional stress out on their caretakers. However, this usually results in more strict rule enforcement or the creation of new rules, both of which are changes in expectations- this only makes the behavior symptoms worse.

ODD treatment is primarily psychotherapy. For the best therapy treatment, a combination of individual therapy with the child, and family therapy with the child’s parents and environment should be included.

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