Diagnostic Guidelines
The essential feature of this disorder is a pattern of persistently negativistic, hostile, defiant, provocative, and disruptive behavior, which is clearly outside the normal range of behavior for a child of the same age in the same social cultural context, and which does not include the more serious violations of the rights of others as reflected in the aggressive and dissocial behavior specified for categories F91.0 and F91.2. Children with this disorder tend frequently and actively to defy adult requests or rules and deliberately to annoy other people. Usually they tend to be angry, resentful, and easily annoyed by other people whom they blame for their own mistakes or difficulties. They generally have a low frustration tolerance and readily lose their temper. Typically, their defiance has a provocative quality, so that they initiate confrontations and generally exhibit excessive levels of rudeness, uncooperativeness, and resistance to authority.

Frequently, this behavior is most evident in interactions with adults or peers whom the child knows well, and signs of the disorder may not be evident during a clinical interview.

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The key distinction from other types of conduct disorder is the absence of behavior that violates the law and the basic rights of others, such as theft, cruelty, bullying, assault, and destructiveness. The definite presence of any of the above would exclude the diagnosis. However, oppositional defiant behavior, as outlined in the paragraph above, is often found in other types of conduct disorder. If another type (F91.0-F91.2) is present, it should be coded in preference to oppositional defiant disorder.

Excludes: * conduct disorders including overtly dissocial or aggressive behavior (F91.0-F91.2)