What is oppositional defiant disorder?

Oppositional defiant disorder (ODD) is a behavior disorder. People with ODD act in a way that's uncooperative and annoying toward others. These behaviors may make it difficult for them to make friends or complete tasks. It affects up to 16% of school age children.

Causes of oppositional defiant disorder

Scientists don't know for sure what causes this disorder. According to one theory, children with ODD have a difficult time becoming independent from their parents and caregivers. As a result, they continue acting like they did as toddlers even when they start going to school. Another theory suggests that children with ODD act out to get attention. These children don't see the difference between positive and negative reinforcement. For them, getting in trouble feels the same as being praised.

Risk factors of oppositional defiant disorder

Certain groups of people are more likely to develop oppositional defiant disorder. Boys are more likely than girls to show ODD behaviors. Children and teenagers who live in an abusive household also have an increased risk. This is also true of those who have a parent who abuses drugs or alcohol. Other risk factors include:

Environment: Children who don't have much supervision have a higher risk for developing ODD.

Medical history: ODD shows up more often in those who have a mood or anxiety disorder.

Temperament: Children who have trouble dealing with their emotions are more likely to show signs of ODD.

Symptoms of oppositional defiant disorder

It's difficult to spot the symptoms of oppositional defiant disorder. The behaviors are normal in toddlers and teenagers. Most of them never develop ODD. The difference is how often the behaviors show up and how much they cause problems at school and with other children. This list of symptoms can be mild, moderate or severe:

  • Arguments with authority figures
  • Being easily annoyed by others
  • Being vindictive and seeking revenge
  • Blaming others for misbehaviors
  • Engaging in behavior solely to annoy other people
  • Frequent temper tantrums
  • Refusal to follow rules
  • Speaking to people in a harsh or unkind tone

Diagnosis of oppositional defiant disorder

A mental health professional diagnoses oppositional defiant disorder. This person talks to the child's parents and teachers to learn how the child acts. The child may also go to a medical doctor. The doctor will make sure the child does not have a mood disorder or anxiety. Some children with learning disabilities also act out. To confirm the diagnosis, the psychologist may refer to a guidebook called the Diagnostic and Statistical Manual of Mental Disorders (DSM). This book has a list of symptoms and tells the professional what to look for as they examine the child.

Treatments for oppositional defiant disorder

Treating oppositional defiant disorder involves therapy and counseling. The child must attend sessions to learn how to behave differently. Parents and family members may also seek counseling to learn how to help the child with ODD. In many cases, they need to find better ways to talk to each other. The following treatments are frequently used to treat ODD:

  • Cognitive behavioral therapy sessions: These teach the patient how to control their urges, solve problems and communicate their needs.
  • Family therapy: This helps the entire family manage symptoms.
  • Parent management training: This teaches parents how to support the child and manage behavior.
  • Peer group therapy: This gives the patient a place to develop social skills and improve their relationships.

Recovery from oppositional defiant disorder

If left untreated, children with oppositional defiant disorder can develop other behavior problems. As adults they may show signs of passive aggressive personality disorder or antisocial personality. Recovery is possible, though. It requires patience and commitment. Parents have to make time to take their children to their appointments. They may also need to change habits at home. This may include creating a predictable schedule and finding ways to have fun together as a family.