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Oppositional-Defiant Disorder (ODD)

Definition: Oppositional Defiant Disorder (ODD) often manifests itself through excessive stubbornness, revenge-seeking behavior, and an inability to compromise. Children with ODD may test limits by deliberately ignoring others, instigating arguments, and blaming others for their wrongdoing. These children rarely view themselves as being defiant. This disorder has both behavioral and emotional components. Although verbal aggression and outbursts are common, they do not include aggression toward people or animals, or destruction of property. First symptoms of ODD usually appear during preschool years and rarely later than early adolescence. Children are more likely to demonstrate defiant and hostile symptoms with their families or other familiar individuals than in other settings, although appearance in other settings may occur. The number of symptoms tends to increase as the child ages. Prior to adolescence, males are more likely than females (4:1) to be diagnosed with the disorder. Upon reaching puberty, however, this gender difference diminishes.

Symptoms: To be diagnosed with ODD, the negative, hostile and defiant behavior must include four or more of the following symptoms and last for at least six months. The symptoms are now grouped into three types (see below) and can cause significant impairment in social, academic or work settings.

Angry/Irritable Mood: Often loses temper, often touchy or easily annoyed by others, often angry and resentful.

Argumentative/Defiant Behavior: Often argues with adults, often actively defies or refuses to comply with adult’s requests or rules, often deliberately annoys people, often blames others for his/her mistakes or misbehavior.

Vindictiveness: Often spiteful or vindictive.

Causes: Although the exact causes of ODD are unknown, the disorder is often linked with inconsistent, neglectful, or overly harsh parenting methods. ODD is also more likely to develop when a child’s life is disrupted by frequent changes in caregivers or stress, such as divorce. Children with ODD often have a concurrent diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD). Individuals with ODD are also at an increased risk for anxiety, depressive, antisocial behavior, and substance use disorders.

Treatment: Treatment for Oppositional Defiant Disorder includes several types of psychotherapy and training for the child and parents, such as Individual and Family Therapy, Parent-Child Interactive Therapy, and Cognitive Problem-Solving training. Social Skills training to help the child interact more effectively with peers and Parent training to help parents lower their frustration and increase patience and consistency while handling the defiant behavior may also be useful. Medications are not generally used unless another condition co-exists, such as ADHD. The most important thing during treatment is to show unconditional love and acceptance of your child.