Oppositional Defiant Disorder (ODD) is characterized by frequent and consistent periods of irritation or argumentation toward authority figures that typically begins in preschool years. The DSM-5 lists symptoms including angry/irritable mood, argumentative/defiant behavior, and vindictiveness that negatively impact various areas and last at least 6 months. While there is no single cause, potential factors include genetics, parenting styles, brain chemistry, and social environment. Treatment focuses on therapy that involves training for both the child and parents to improve relationships and behaviors.
2. More than just the occasional outburst
• All children sometimes have emotional moments. It is when it becomes
consistent that it’s a problem.
• Characterized by frequent and consistent periods of irritation or
argumentation toward and authority figure.
• Typically begins in preschool years.
• There are no clear estimates for how many have ODD. It may be around the
ballpark of 1-in-16 people.
3. Symptoms
• The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists
the following for the diagnosis of ODD:
• Includes 4 or more of: angry/irritable mood, argumentative/defiant
behavior, vindictiveness
• Occurs with at least 1 non-sibling
• Negatively impacts work/school/family
• Occurs independent of another mental health issue or substance abuse
• Lasts at least 6 months
4. Symptoms - Elaborated
• Angry/Irritable Mood – Often loses temper, easily
annoyed, often angry/resentful
• Argumentative/Defiant Behavior – often argues
with authority figures, often refuses compliance
with authority figures or rules, purposefully
annoys others, blames others for own mistakes
• Vindictiveness – “been spiteful or vindictive at
least twice within the past 6 months”
5. Causes
• No direct cause has been identified. ODD may be inherited through
genetic disposition or may be a result of parenting styles or consistent
problems with other authority figures.
• Biological factors which increase risk: parents with a history of ADHD, ODD, CD, or mood disorders;
parents with substance abuse problems; impairment in parts of the brain responsible for judgment
and impulse control; brain-chemical imbalance; toxin exposure; poor nutrition
• Psychological factors: poor relationship with parent(s), neglectful/absent parent(s), difficulty
forming social relationships or identifying social cues
• Social factors: poverty, abuse, neglect, lack of supervision, inconsistent discipline, family instability
Lists taken from the American Academy of Child and Adolescent Psychiatry
6. Complications
• Individuals with ODD may have difficulty forming or keeping
relationships or working with others. This can lead to poor
academic performance, antisocial tendencies, impulsive behavior,
substance reliance…
• The reflexive No – a child with ODD might refuse to comply with
an authority figure before they even know what they’re going to
ask
7. Seeking help
• An individual with ODD often won’t see themselves as having an
issue. Instead, they see themselves as being unreasonably
burdened or that their actions don’t matter.
• If a child’s behavior is seen as abnormal, it is then that the parent
is required to schedule an appointment
8. Treatment
• There is no medication targeted at ODD. However, ODD is often
accompanied by another behavior issue like ADHD, which may be
medicated.
• Therapy and training involves not only the child, but also the
parent(s). Treatment is typically long-lasting.
• Parent training – Parents are trained to more positively affect and
cause less frustration for their child.
9. Treatment - continued
• Parent-child Interaction Therapy – therapists guide parents while
they interact with their child. The therapist might sit behind a
one-way window and use wireless communication with parents.
• Individual therapy with the child
• Cognitive training – Helping the child identify negative thought
processes and find alternatives.
10. Citations
• ODD – Child Mind Institute
https://childmind.org/guide/oppositional-defiant-disorder/
• ODD – MayoClinic http://www.mayoclinic.org/diseases-
conditions/oppositional-defiant-disorder/basics/definition/con-
20024559
• American Academy of Child & Adolescent Psychiatry
https://www.aacap.org/App_Themes/AACAP/docs/resource_cent
ers/odd/odd_resource_center_odd_guide.pdf
