What are the other Names for this Condition? (Also known as/Synonyms)

• ODD (Oppositional Defiant Disorder)

What is Oppositional Defiant Disorder? (Definition/Background Information)

• Oppositional Defiant Disorder (ODD) is a disorder that is characterized by negative, defiant and hostile behavior toward authority figures including parents, teachers, peers, etc. It is usually seen in children and teens and is mostly directed at others
• Oppositional Defiant Disorder falls under the category of disruptive behavior disorders (DBDs), a group of disorders that are characterized by hostile and uncooperative behaviors toward people in positions of authority or power such as to one’s own family members, elders, or school teachers
• Oppositional Defiant Disorder is caused by a combination of biological and environmental factors such as neurological damage at birth, developmental issues, as well as due to other psychological issues in the family
• The treatment for Oppositional Defiant Disorder primarily involves behavioral therapy to help the affected individuals become aware of anger cues and practice strategies to cope with them
• Generally, the prognosis for Oppositional Defiant Disorder is good. However, it is important to detect and treat the condition in its early stages to prevent it from progressing into a more serious condition

Who gets Oppositional Defiant Disorder? (Age and Sex Distribution)

• Oppositional Defiant Disorder is most commonly observed in children, adolescents, and teenagers; even children as young as 2 to 3 years may exhibit signs of ODD
• The condition may be seen in individuals of any age group
• Males are more likely to be affected by this condition than females
• Worldwide, individuals of all racial and ethnic groups may be affected

What are the Risk Factors for Oppositional Defiant Disorder? (Predisposing Factors)

Some known risk factors for Oppositional Defiant Disorder include:

• Injuries to the child that occur during childbirth
• Personal history of anxiety and depression
• Attention-deficit hyperactivity disorder (ADHD): It is reported that about 33-50% of the children with ADHD may have ODD
• Family history of Oppositional Defiant Disorder (or any other types of disruptive behavior disorder), ADHD, anxiety, and depression
• Conduct disorder, a form of disruptive behavior disorder (DBD)
• Psychological stress caused due to family circumstances that include:
  • Divorce and separation
  • Substance abuse
  • Physical/emotional/sexual abuse
  • Criminal activity
  • Serious conflict

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Oppositional Defiant Disorder? (Etiology)

Oppositional Defiant Disorder may be caused by a combination of biological and environmental factors as given below:

• Biological factors:
  • Neurological damage due to birth injuries
  • Low birth weight
  • Having ADHD 
  • Anxiety and depression
• Environmental factors, due to psychological stress caused by family situations and dynamics
  • Separation and/or divorce of parents
  • Substance abuse
  • Physical/ emotional/sexual abuse
  • Criminal activity
  • Serious conflict

What are the Signs and Symptoms of Oppositional Defiant Disorder?

The signs and symptoms of Oppositional Defiant Disorder may include the following:

• Antisocial behavior
• Aggressive and intimidating behavior
• Short temper
• Consistent arguments and conflict with adults or people of authority
• Consistent defiance of rules, disobedience
• Not responding to requests by others
• Tendency to cause harm, vengeful
• Tendency to blame others for one’s own shortcomings
• Bullying among teens
• Tendency to lie
• Tendency to steal

How is Oppositional Defiant Disorder Diagnosed?

A diagnosis of Oppositional Defiant Disorder is made based on the basis of the following information:

• Complete physical evaluation
• Comprehensive analysis of personal and family medical history
• Thorough psychiatric assessment by a child psychiatrist; speaking to the child, his/her parents and teachers, etc.
• Assessment of symptoms based on the criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
• Differential diagnosis to rule out other disorders that may present similar signs and symptoms

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Oppositional Defiant Disorder?

The potential complications of Oppositional Defiant Disorder include one or more of the following:

• Inability to make friends
• Difficulty in academic and occupational life
• Feelings of isolation and loneliness
• Substance use and abuse
• Homelessness and poverty
• Perpetrating domestic violence and child abuse
• Involvement in criminal activity
• Suicidal thoughts and behaviors

How is Oppositional Defiant Disorder Treated?

The following methods may be employed alone or in combination thereof, for the treatment of Oppositional Defiant Disorder:

• Behavioral therapy is the primary method of treatment, which includes:
  • Collaborative problem solving (CPS) can teach affected individuals how to be aware of their frustration and handle it in a healthy manner 
  • School-wide positive behavioral support (SWPB): It is a program in place in many schools that fosters positive social behaviors and provides a service for extreme behavioral needs
  • Peer group therapy - in order to develop better social and interpersonal skills
• Parent training (PT) is an intervention-style training program set for parents of the affected individuals to help them be educated about the disorder and how to manage it at home and other social places
• Meditation and relaxing techniques including hypnosis
• Medication to treat simultaneously occurring ADHD and associated anxiety and depression

How can Oppositional Defiant Disorder be Prevented?

At the present time, no methods or guidelines are available for the prevention of Oppositional Defiant Disorder (ODD).

• Seeking medical treatment soon after symptoms begin appearing may help prevent progression of the condition into a more severe disorder
• It has been determined that psychological stress is an important risk factor. Hence, seeking professional help after a psychologically stressful event for the child may help prevent the onset of ODD and other such disorders

What is the Prognosis of Oppositional Defiant Disorder? (Outcomes/Resolutions)

• The prognosis for Oppositional Defiant Disorder is generally good and most affected individuals are reported to experience improvement in their symptoms following adequate treatment
• It is important to diagnose and treat Oppositional Defiant Disorder in its early stages to prevent it from progressing into a more severe disorder

Additions and Relevant Useful Information for Oppositional Defiant Disorder:

The other types of disruptive behavior disorder include conduct disorder and intermittent explosive disorder.