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Oppositional Defiant Disorder

(ODD)

Definition

Oppositional defiant disorder (ODD) is when children and teens show angry and defiant behaviors more than their peers. This impacts school, work, and family situations.

Causes

The cause is not known. It 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

This problem is more common in males. Other things that may raise a child's risk are:

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

Symptoms

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

Children with ODD often:

  • Argue with adults
  • Lose their tempers
  • Do not follow what an adult tells them to do
  • Annoy others on purpose
  • Are annoyed by others
  • Are angry and bitter
  • Are spiteful or want to get back at others
  • Blame others for their own mistakes
  • Have low self-esteem

Diagnosis

The doctor will ask about your child's symptoms and health history. You, your child's teachers, and relatives may be asked about the problems your child is having. A physical exam will be done. This is often enough to make the diagnosis.

Treatment

The goal is to stop problem behaviors. Choices are:

  • Parent training
  • Individual or group counseling to help children learn to express and control anger
  • Social skills training to help a child get along better with peers
  • Medicines may be used with other treatments to help ease certain symptoms, such as mood swings

Prevention

Early treatment for behavioral problems may lower the risk of ODD.

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:

Gorman DA, Gardner DM, et al. Canadian guidelines on pharmacotherapy for disruptive and aggressive behaviour in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, or conduct disorder. Can J Psychiatry. 2015 Feb;60(2):62-76.

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 November 19, 2020.

Oppositional defiant disorder. Boston Children's Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/o/oppositional-defiant-disorder. Accessed November 19, 2020.

Oppositional defiant disorder. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/oppositional-defiant-disorder. Accessed November 19, 2020.

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. Accessed November 19, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board Adrian Preda, MD  Last Updated: 04/16/2021