Oppositional Defiant Disorder

Oppositional defiant disorder (ODD) is a pattern of disobedient, hostile, and defiant behavior toward authority figures. To fit this diagnosis, the pattern must persist for at least 6 months and must go beyond the bounds of normal childhood misbehavior.

This disorder is more prevalent in boys than girls. Some studies have shown that 20% of the school-age population is affected. However, most experts believe this figure is inflated due to changing cultural definitions of normal childhood behavior, and other possible biases including racial, cultural, and gender biases.

This behavior typically starts by age 8. Emotionally draining for the parents and distressing for the child, oppositional defiant disorder can add fuel to what may already be a turbulent and stressful family life.

While this is one of the most difficult of behavioral disorders, setting firm boundaries with consistent consequences plus a commitment to improving your relationship with your child can help your family overcome the dominating grip that oppositional defiant disorder may have on your household.

What are the signs and symptoms of Oppositional Defiant Disorder?

Three characteristics of the child who has ODD are: aggression, defiance and the constant need to irritate others. When documenting the child's behavior; characteristics or behavior patterns should be in place for at least 6 months. The behaviors will have a negative impact on social and academic functioning. It is important to look for the following characteristics:

  • The child often loses his/her temper

  • The child is defiant and doesn't obey rules/routines

  • The child argues often with adults and peers

  • The child seems to go out of his/her way to annoy others in very bothersome ways

  • The child is often lacking accountability and blames others for inappropriate behaviors

  • The child often seems angry, resentful, spiteful and vindictive

  • The child is often prone to tantrums and will be non-compliant

  • The child is constantly in trouble at school

DSM IV Criteria for Oppositional Defiant Disorder

Oppositional Defiant Disorder signs and symptoms, causes, diagnosis and treatment.A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present:

  • often loses temper

  • often argues with adults

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

  • 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

  • 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.

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

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

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.

What causes someone to develop Oppositional Defiant Disorder?

There's no clear cause underpinning oppositional defiant disorder. Contributing causes may include:

  • The child's inherent temperament

  • The family's response to the child's style

  • A genetic component that when coupled with certain environmental conditions, such as lack of supervision, poor quality daycare or family instability, increases the risk for ODD

  • A biochemical or neurological factor

  • The child's perception that he or she isn't getting enough of the parent's time and attention


Last Updated: 04 July 2016
Reviewed by Harry Croft, MD

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