Oppositional Defiant Disorder (ODD) Causes, Symptoms, Diagnosis and Treatment

What is Oppositional Defiant Disorder?

Oppositional defiant disorder (ODD) is defined by the DSM-5 as “a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least six months as evidenced by at least four symptoms from any of the [defined] categories and exhibited during interaction with at least one individual who is not a sibling”.

Many children and teens with ODD also have other behavioral problems, such as:

Attention-deficit/hyperactivity disorder
Learning disabilities
Mood disorders (such as depression)
Anxiety disorders.

Some children with Oppositional Defiant Disorder go on to develop a more serious behavior disorder called conduct disorder.

Oppositional Defiant Disorder can vary in severity:

Mild. Symptoms occur only in one setting, such as only at home, school, work or with peers.
Moderate. Some symptoms occur in at least two settings.
Severe. Some symptoms occur in three or more settings.

Causes of Oppositional Defiant Disorder:

There is no known cause for the development of Oppositional Defiant Disorder.

However, a combination of the following factors may play an integral role:

Genetics — a child’s natural disposition or temperament
Environment — problems with parenting that may involve a lack of supervision, inconsistent or harsh discipline, or abuse or neglect
Prenatal factors and birth complications

Malnutrition
Protein deficiency
Lead poisoning
Mother’s use of alcohol or other substances during pregnancy

Neurobiological factors

Overactive behavioral activation system (BAS)
Underactive behavioral inhibition system (BIS)

Social cognitive factors

Immature forms of thinking (such as egocentrism),
Failure to use verbal mediators to regulate his or her behavior
Cognitive distortions, such as:

Interpreting a neutral event as an intentional hostile act

The following factors increase the risk of developing Oppositional Defiant Disorder:

Temperament — a child who has a temperament that includes difficulty regulating emotions, such as being highly emotionally reactive to situations or having trouble tolerating frustration
Parenting issues — a child who experiences abuse or neglect, harsh or inconsistent discipline, or a lack of parental supervision
Other family issues — a child who lives with parent or family discord or has a parent with a mental health or substance use disorder

Symptoms of Oppositional Defiant Disorder:

The following symptoms may be exhibited by those suffering from ODD:

Throwing repeated temper tantrums
Excessively arguing with adults
Actively refusing to comply with requests and rules
Deliberately trying to annoy or upset others, or being easily annoyed by others
Blaming others for one’s own mistakes
Having frequent outbursts of anger and resentment
Being spiteful and seeking revenge
Swearing or using obscene language
Saying mean and hateful things when upset
Low self esteem
Easily frustrated or annoyed
Abuse drugs or alcohol

Diagnosis of Oppositional Defiant Disorder:

Oppositional Defiant Disorder is professionally diagnosed by a child psychologist, child psychiatrist or pediatrician specializing in behavioral disorders.

Diagnosis involves detailed interviews with the child (if they are old enough), parents and teachers, and comparing the child’s behavior with the checklist for Oppositional Defiant Disorder contained in the Diagnostic and Statistical Manual of

Mental Disorders from the American Psychiatric Association.

For a child or adolescent to qualify for a diagnosis of ODD:

Behaviors must cause considerable distress for the family or interfere significantly with academic or social functioning.
Interference might take the form of preventing the child or adolescent from learning at school or making friends, or placing him or her in harmful situations.
These behaviors must also persist for at least six months.