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Introduction to Oppositional Defiant Disorder

Andrea Barkoukis, M.A., Natalie Staats Reiss, Ph.D., and Mark Dombeck, Ph.D. Updated: Feb 4th 2008

Children with Oppositional Defiant Disorder repeatedly engage in a pattern of defiant, disobedient, and hostile behavior toward authority figures. This behavior goes beyond acceptable misbehavior for the given child's age and the behavior has been continued for at least six months.

angry childChildren with Oppositional Defiant Disorder tend to display the following symptoms:

  • Persistent resistance towards taking direction from others
  • Stubbornness or non-compliant behavior
  • An unwillingness to compromise
  • Frequent arguing with, talking back to, or challenging of authority
  • Irritability, resentfulness, or negativity
  • Deliberate provocation of others which comes across as mean, spiteful, or rude
  • Temper tantrums or outbursts
  • Externalization of blame (it's always someone else's fault). Always blaming others or denying responsibility
  • Repeated testing of other people's limits (ignoring orders, arguing with directions)
  • Repeated trouble at school
  • Few or no friends

The symptoms of Oppositional Defiant Disorder are almost always evident at home. However, ODD children will sometimes compartmentalize their bad behavior so that it does not occur in other environments. Other children will display ODD symptoms across multiple environments including school, home and while out in the community.

Generally, ODD children are symptomatic when in the presence of adults or peers they know well. They may not display obvious symptoms in front of strangers. This tendency to reserve ODD behavior for family and friends (or home settings) can make diagnosing ODD difficult. Symptoms may simply not be displayed when ODD children are being interviewed by a strange therapist.

According to the DSM, Oppositional Defiant Disorder is fairly common, occurring in between 2 and 16% of children and adolescents. ODD usually begins prior to age 8 and is only rarely diagnosed after early adolescence has begun. Before puberty, males are more likely to develop ODD; following puberty this disorder occurs at the same rate across genders.

Diagnosis of Oppositional Defiant Disorder

Clinically diagnosable oppositional behavior must be distinguished from typical childhood misbehavior (e.g., occasionally talking back or hitting a sibling). The DSM lists 8 diagnostic criteria indicative of ODD. At least 4 of these behaviors must be present for at least 6 months in order to diagnose a child with ODD:

1) Frequently loses his/her temper
2) Frequently argues
3) Frequent defies or refuses to comply with rules and requests
4) Frequently annoys people on purpose
5) Frequently blames other people for mistakes or poor behavior
6) Is frequently very sensitive to other's comments, or is easily annoyed by others
7) Frequently angry or resentful
8) Frequently cruel or retaliative

Assessment of Oppositional Defiant Disorder takes place in much the same manner as the process used to diagnose Conduct Disorder. The assessing clinician will typically conduct interviews with the child, parents and family members and teachers, examine school records, and ask people familiar with the child to complete behavior rating forms similar or identical to those used for Conduct Disorder. To return to our section on Conduct Disorder, please click here.

Conduct Disorder and Oppositional Defiant Disorder share features in common. For instance, both conduct disordered and oppositional defiant children are highly irritable and have poor social skills. However, children with ODD simply do not show the serious behavioral problems that are present in Conduct Disorder (e.g., behaviors that violate the rights of others such as destruction of property). Children who meet criteria for both Conduct Disorder and Oppositional Defiant Disorder at the same time are diagnosed solely with Conduct Disorder, as the diagnosis of CD takes precedence over the diagnosis of ODD (due to its greater severity).

 

Reader Comments
Discuss this issue below or in our forums.

me - alex noack (brain smith on facebook) - Mar 21st 2011

i have odd, and lemme telll ya, im 13, i have adhd and bipolar and odd and multi personality disorder, and also, life is fu**in hard bcz of this

thanks'bye

Soap Opera Therapist - Old Mom - Feb 15th 2011

Mom of two with ODD. Husband and I aren't perfect we know. It was hard seeking help for our kids, one now grown. The first thing each of several professionals we saw wanted to focus on was divorce, drugs or disturbance. I understood, really. But we have been married 23 years in a sleepy little relationship where excitement was ice tea or cola on the front porch. No excitement just parents who gave their kids way too much but never a 'no'. I think their are some really good people to offer help as the lady who works with us today. My husband and I are learning love is no and a disappointed kid is a kid learning too. Just know, if you come across a therapist that has decided who your family is without actually listening then they aren't actually helping. Find someone new.

CONFIRMS MY GUT FEELING - John Katal (Johnny) - Nov 11th 2010

Because of your information, we are hope to direct our energy towards a posible outcome. I wish to thank a father of one of our student for his firm and honest input during our meeting today (11/11/2010). After our discussion, he e-mailed me information on ODD which he got from this very site. All symptoms and conditions of this student fitted perfectly under ODD. Peace and thank kindly.

ODD in a five year old - Linda - Apr 27th 2010

My daughter who has just turned five has nearly all of the symptom of ODD, except for the fact she is very popuar in prep and socialises very well. The symptoms are only present at home and at close families homes. She is a perfect angel at others gouses, (as I have been told, cause I am not there). At home she literally brings myself to tears on a regular basis. My elder child who is very quite and sensitive bears the brunt of her sisters behaviour. Not matter what she is doing or what she has her younger sister will scream and throw a tamtrum until her sister gives in. Please I am at the end of my tether and need some advice on how to handle this situation as it is putting so much strain on our family life. Because this behaviour only comes out in front of close family people don't beleive her behaviour. I makes me feel like a bad parent.

SOUNDS LIKE MY DAUGHTER - ALBERTA PATTERSON - May 18th 2009

MY DAUGHTER HAS BEEN DOING A LOT OF THINGS THAT WAS CONCERNING ME I ARRANGED FOR HER TO SEE DR'S MEDICINE WAS GIVEN AND THINGS GOT WORSE I PRAYED ASKING GOD WHAT WAS WRONG WITH HER AND STARTING LOOKING INFORMATION UP ON THE COMPUTER AND FOUND THE INFORMATION ON OPPOISITIONAL DEFIANT DISORDER  AS I READ THE INFORMATION I REALIZE THAT IS WHAT MY DAUGHTER MUST HAVE SO NOW IM LOOKING FOR SOMEONE IN THIS FIELD TO SEE HER THANK YOU FOR THE INFORMATION.

A New Starting Point - Sonya - Mar 11th 2009

Having dealt with our eldest childs' behavior for so long we were exhausted as a family. Constant school meetings from preschool age-8th grade, constant rotation of his friends, extended family frustration and arguements & battles with us and his siblings. We were told he was spoiled as a child, that this was all just a stage and he would grow out of it, that he suffered from ADHD, meds. dealing with that, costly sessions with psychiatrists & psychologists and just an overall sense of failure and sadness. How come the symptoms that he has displayed since a toddler, at home and at school, are so obviously ODD? That no one "helping" us was able to recognize this? I appreciate all of this "new-to-me" information.

When it'a a Parent - Thressa - Oct 12th 2008

Thanks so much for your comments. I too had a mothjer like yours. Her mother, my grandmother was the same way. I beleive they were badly parented themselves, at least I know my mother was. Thankfully none of my siblings have had this problem, but our children or grandchildren have it at an alarming rate. Possibly because we were parented right by one parent but the primary caregiver our mother was not always fair or just. She also had an alcohol problem which made her horribly worse. I have parented my second child much better than the first because I didn't question my upbringing enough and repeated the same mistakes my momm did. My grandson has adhd and odd. It is very sad. Thressa

Response to your article about Oppositional Deviant Disorder - Karen - Jul 3rd 2008

I have a parent that displays the kind of symptoms you are explaining in your article.  I am in a very painful place right now because that person is terminally ill and making all the incorrect decisions.  Cancer treatment was refused for about 4 years and thus caused so many more problems and suffering.

 This person was born in 1927 one of 6 children.  The two sisters  could be quite difficult but the brothers seemed to be more placid.

 Being in the presence of this person is really like swimming aginst the tide and the normal perceptions of life seem to be continually distorted. 

 This is a person I love very much and I have beens so distressed by some of the actions i.e.

Screaming out of a car window for help while being driven along

Taking an overdose at Christmas because she was worried about my sore throat and having to have a stomach pump

Screaming and getting in rages

Constantly reliving sad stories

Always being a victim

Turning acts of kindness into kinds of ill

Focusing entirely on illness

Now this person has refused to let any of the support nurses from the hospice to administer the drugs.  Carers have been sent out and so it goes on. 

The condition you describe sounds like that kind of behaviour

 

 

THANK YOU! - Jane - Mar 2nd 2008
Thank you for this website. It has given me so much information that I have tried to find for so long on ODD and Conduct Disorder and ADHD. Thank you for making the problem and the treatments so easy to understand.

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