Oppositional Defiant Disorder
DefinitionOppositional defiant disorder (ODD) is a behavior disorder in children and teens. Those with this disorder show negative, angry, and defiant behaviors much more often than most people of the same age. These behaviors begin to adversely affect the person’s relationships and ability to perform successfully in school, work, and family situations.
CausesThe cause of ODD is unknown. Like other psychiatric disorders, ODD results from a combination of genetic, family, and social factors. Children with ODD may inherit chemical imbalances in the brain that make them more likely to have the disorder.
|A chemical imbalance in the brain may be responsible for ODD.|
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Risk FactorsFactors that increase a child's risk for ODD include:
- Sex: male
- Age: childhood and teen years
- A parent with a mood, conduct, attention deficit, or substance abuse disorder
- Marital conflict
- Child abuse
- Inconsistent parental attention
- Low socioeconomic status
SymptomsSymptoms usually begin around age 8 and increase over several months.Children with ODD often:
- Argue with adults
- Lose their tempers
- Refuse to follow adults' requests or rules
- Deliberately annoy others and are annoyed by others
- Are angry and resentful
- Are spiteful or vindictive
- Blame others for their own mistakes
- Have low self-esteem
DiagnosisThe doctor will ask about symptoms, medical history, and family history. A physical exam will be done. The doctor will also look for other conduct disorders.Diagnosis of ODD is based on these criteria:
- Child displays at least four common symptoms.
- Symptoms occur more often and have more serious consequences than is typical in children of a similar age.
- Symptoms lead to significant problems in school, work, or social life.
- Symptoms are continuously present for at least 6 months.
TreatmentTreatment may include the following:
Parent TrainingTraining is designed to help parents manage their child's behavior.
Child PsychotherapyThe purpose of the psychotherapy is to teach the child better ways to manage anger.
Family PsychotherapyFamily therapy helps to improve family communication skills.
Cognitive-Behavior TherapyThis type of therapy helps the child and family members learn problem-solving skills and decrease negativity.
Social Skills TrainingThis is training to help the child reduce frustration with peers.
PreventionThere are no guidelines for preventing ODD.
American Academy of Child and Adolescent Psychiatry
American Psychiatric Association
Canadian Psychiatric Association
Canadian Psychological Association
Children with oppositional defiant disorder. American Academy of Child and Adolescent Psychiatry website. Available at: http://www.aacap.org/AACAP/Families%5Fand%5FYouth/Facts%5Ffor%5FFamilies/Facts%5Ffor%5FFamilies%5FPages/Children%5FWith%5FOppositional%5FDefiant%5FDisorder%5F72.aspx. Accessed July 17, 2013.
Oppositional defiant disorder. Boston Children's Hospital website. Available at: http://www.childrenshospital.org/az/Site1385/mainpageS1385P1.html. Accessed July 17, 2013.
Oppositional defiant disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 7, 2012. Accessed July 17, 2013.
- Reviewer: Michael Woods, MD
- Review Date: 07/2013
- Update Date: 05/11/2013
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