• Oppositional Defiant Disorder



    Oppositional defiant disorder (ODD) is a behavior disorder in children and teens. Those with this disorder show negative, angry, and defiant behaviors much more often than most people of the same age. So much so that these behaviors begin to adversely affect the person’s relationships and ability to perform successfully in school, work, and family situations.


    The cause of ODD is unknown. Like other psychiatric disorders, ODD results from a combination of genetic, family, and social factors. Children with ODD may inherit chemical imbalances in the brain that predispose them to the disorder.
    Child's Brain
    Child Brain
    A chemical imbalance in the brain may be responsible for ODD.
    Copyright © Nucleus Medical Media, Inc.

    Risk Factors

    A risk factor is something that increases your chance of getting a disease or condition. Risk factors for ODD include:
    • Sex: male
    • Age: childhood and teen years
    • A parent with a mood, conduct, attention deficit, or substance abuse disorder
    • Marital conflict
    • Child abuse
    • Inconsistent parental attention
    • Low socioeconomic status


    Symptoms usually begin around age 8 and increase over several months.
    Children with ODD often:
    • Argue with adults
    • Lose their tempers
    • Refuse to follow adults' requests or rules
    • Deliberately annoy others and are annoyed by others
    • Are angry and resentful
    • Are spiteful or vindictive
    • Blame others for their own mistakes
    • Have low self-esteem


    The doctor will ask about symptoms, medical history, and family history, and perform a physical exam. The doctor will also look for other conduct disorders.
    Diagnosis of ODD is based on these criteria:
    • Child displays at least four common symptoms (see symptoms above).
    • Symptoms occur more often and have more serious consequences than is typical in children of a similar age.
    • Symptoms lead to significant problems in school, work, or social life.
    • Symptoms are continuously present for at least 6 months.


    Treatment may include the following:

    Parent Training

    Training is designed to help parents manage their child's behavior.

    Child Psychotherapy

    The purpose of the psychotherapy is to teach the child better ways to manage anger.

    Family Psychotherapy

    Family therapy helps to improve family communication skills.

    Cognitive-Behavior Therapy

    This type of therapy helps the child and family members learn problem-solving skills and decrease negativity.

    Social Skills Training

    This is training to help the child reduce frustration with peers.


    There are no guidelines for preventing ODD.


    American Academy of Child and Adolescent Psychiatry http://www.aacap.org

    American Psychiatric Association http://www.psych.org


    Canadian Psychiatric Association http://www.cpa-apc.org

    Canadian Psychological Association http://www.cpa.ca


    American Psychiatry Association. Available at: http://www.psych.org.

    Children with oppositional defiant disorder. American Academy of Child and Adolescent Psychiatry website. Available at: http://www.aacap.org/publications/factsfam/72.htm. Accessed July 2003.

    The Merck Manual of Medical Information—Home Edition. Simon and Schuster, Inc.; 2000.

    Revision Information

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