Oppositional defiant disorder refers to difficulty in controlling emotions and behaviors. It may involve persistent displays of irrationally rebellious behavior and anger at authority figures.

Health experts most commonlyTrusted Source diagnose oppositional defiant disorder (ODD) in children. They can often be disobedient and argumentative, but consistent patterns of these behaviors could indicate an underlying disorder.

This article will discuss what ODD is, how to recognize it, and methods of treating the disorder.

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Children and young people with ODD characteristically display ongoing patterns of defiant, vindictive, angry, and argumentative behavior toward authority figures. For a trained mental health professional to diagnose ODD, these patterns of behavior must continue for at least 6 monthsTrusted Source and significantly impair a person’s daily functioning.

Compared to other conduct disorders, ODD tends to present as disobedience or arguing with authority figures, such as teachers or parents, rather than antisocial behavior.

It is a formally recognized disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR). However, despite sharing some behavioral similarities, ODD is not the same as autism spectrum disorders.

Causes

The cause of ODD is unknown, but it is likely to develop due to multiple environmental, developmental, and genetic factors.

For example, a combination of environmental risk factors, such as childhood trauma or poverty and genetic factors, such as a predisposition for aggressive behavior, could cause ODD to develop.

The onset of the condition typically occurs before 8 years of ageTrusted Source.

Identifying the symptoms of ODD or any conduct disorder is challenging. These symptoms include:

  • anger
  • irritability
  • argumentative or defiant behavior
  • vindictiveness

Behaviors that persist for at least 6 months and seriously affect a child’s daily life may indicate ODD. These behaviors must be demonstrably more severe and frequent than those of their peers.

To help identify ODD, it can help to consult with others who regularly come into contact with the individual.

If it is not possible to reliably establish a pattern of symptoms, the behavior is unlikely to relate to a conduct disorder.

In such situations, it is best to avoid talking with the person about having a conduct disorder or insisting they seek unnecessary medical attention. This could cause them to feel alienated or resentful, possibly creating further issues.

A mental health professional, such as a psychiatrist, will diagnose all conduct disorders. They will use diagnostic questions and follow the guidance in the DSM-5-TR to assess whether a person has ODD.

Criteria for diagnosing ODD according to the DSM-5-TR include:

  • A pattern of angry or irritable mood, argumentative or defiant behavior, or vindictiveness over a period of at least 6 months, expressed through interacting with an individual who is not a sibling.
  • Behavior causes significant disruption to social, educational, occupational, or home functioning.
  • Behavior not due to a different mental health problem, such as attention deficit hyperactivity disorder (ADHD).

To help them make an assessment, a psychiatrist may require reports from those who regularly interact with the individual. They will examine the person’s medical and psychiatric history and may recommend further psychiatric testing if they suspect that another condition is causing the symptoms.

The symptoms of ODD can often overlap with different disorders, such as ADHD or bipolar disorder, which a mental health care professional must first rule out.

There is no singular treatment for ODD. Each person with the condition may present different symptoms, which may stem from different causes. Their specific familial and social situations will also differ. As a result, mental health care professionals must tailor treatment for ODD to an individual’s needs, and these approaches may require a number of individual treatment methods.

Psychotherapy

Psychotherapy is an effective treatment option, but the specific type of psychotherapy will depend on the individual. The main goal is to help the person find new ways of coping with stress, engaging with authority figures, and expressing emotion. Options include talk therapy and cognitive behavioral therapy.

A mental health care professional may also recommend treatments for any underlying conditions contributing to symptoms. For example, family therapy may be helpful if a problematic home life is influencing the disorder.

Environmental management

It is also important for caregivers and authority figures in the child’s life to understand ODD and plan accordingly. Parent management training and school-based management training can aid adults in supporting a child with ODD.

Oppositional defiant disorder (ODD) is often highly disruptive to daily functioning and can have some serious consequences, including substance misuse or incarceration. However, with early diagnosis, ODD can be effectively manageable.

That said, individuals who witness aggressive or unruly behavior must be cautious about labeling it as a conduct disorder.