Carl R. Darnall Army Medical Center - Health Library

Oppositional Defiant Disorder

(ODD)

Definition

Oppositional defiant disorder (ODD) is a behavior disorder in children and teens. They show angry and defiant behaviors much more than most people of the same age. These behaviors interfere with the person’s relationships. It also has an impact on their ability to do well in school, work, and family situations.

Causes ^

The cause of ODD is unknown. ODD may be a mix of genes, family, and social factors.

Child's Brain
Child Brain

A chemical imbalance in the brain may be responsible for ODD.

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Risk Factors ^

ODD is more common in males. Your child's chances for ODD are higher for:

  • Having other people in your family who have the same problems
  • A parent with a mood disorder, or learning or substance misuse problems
  • A mother who used alcohol, smoked, or had a poor diet while pregnant
  • Problems with how the family works at home
  • Prior child abuse
  • Parental inattention

Symptoms ^

A child's problems start around 8 years old. They tend to get worse as time goes on.

Children with ODD often:

  • Argue with adults
  • Lose their tempers
  • Don’t follow what an adult tells them to do
  • Annoy others on purpose
  • Are annoyed by others
  • Are angry and resentful
  • Are spiteful or vindictive
  • Blame others for their own mistakes
  • Have low self-esteem

Diagnosis ^

You will be asked about your child's symptoms and health history. A physical exam will be done. Your child be asked certain questions. They will be rated on how they answer them.

ODD's pattern of behavior must last 6 months or longer. ODD is also based on:

  • How often anger or moody symptoms happen
  • How often defiance happens
  • How often vindictiveness happens
  • How much their behavior affects people around them
  • How much this impacts school or work

Treatment ^

Care involves one or more of these:

  • Parent training—Experts can help parents learn to control their child’s problems.
  • Counseling—Children learn how to express and control their anger. It may be alone, with family, or in a support groups. Many types may be used.
  • Social skills training—Helps your child work with and control frustration with their peers.
  • Medicines may not be used right away. They are more useful if your child has another condition such as such as attention deficit hyperactivity disorder (ADHD). Medicines may treat:
    • Aggressive behavior
    • Restlessness
    • Mood swings
    • Inattentiveness

Prevention ^

If you think your child has problems, talk to their doctor. Finding and treating them early will help lower the chances of problems getting worse as they get older.

RESOURCES:

American Academy of Child & Adolescent Psychiatry
https://www.aacap.org

Mental Health America
http://www.mentalhealthamerica.net

CANADIAN RESOURCES:

Canadian Academy of Child & Adolescent Psychiatry
http://www.cacap-acpea.org

Canadian Mental Health Association
https://cmha.ca

REFERENCES:

Oppositional defiant disorder. American Academy of Child & Adolescent Psychiatry website. Available at: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-With-Oppositional-Defiant-Disorder-072.aspx. Accessed August 28, 2018.

Oppositional defiant disorder. Boston Children's Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/o/oppositional-defiant-disorder. Accessed August 28, 2018..

Oppositional defiant disorder. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114094/Oppositional-defiant-disorder. Updated March , 2017. Accessed August 28, 2018.

Oppositional defiant disorder (ODD). Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/pediatrics/mental-disorders-in-children-and-adolescents/oppositional-defiant-disorder-odd. Updated February 2017. Accessed August 28, 2018.

Last reviewed June 2018 by EBSCO Medical Review Board Adrian Preda, MD  Last Updated: 8/28/2018