First defined in 1980 in the DSM-III, oppositional defiant disorder (ODD) is defined by the DSM-5 the Diagnostic and Statistical Manual of Mental Disorders 5th Edition:
“A pattern of angry, irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least six months. It is a developmental childhood disorder that is specifically differentiated from conduct disorder, which is another common mental disorder found in developing children.”
- Approximately 10.2% of children experience this disorder at any given time, with males slightly more likely to develop it than females
ODD has a variety of common symptoms that are associated with it. The most common symptoms are:
- A pattern of moodiness, anger, or resentfulness that regularly results in a loss of temper
- Near constant defiance of rules or authority figures
- A tendency to intentionally annoy others
- Regularly blaming others for misbehavior or mistakes
- Exceptionally high level of vindictiveness
In addition to these common signs of ODD, there are some contraindications as well.
- Children with oppositional defiant disorder take out their rage on people exclusively. If they are causing property damage or injuring pets, it may be a sign of conduct disorder, but not of ODD.
- ODD rarely expresses itself towards siblings, unless those siblings are placed in a significant position of authority over the child with ODD or there is a large age gap between the siblings.
- ODD is not associated with any use of drugs, either prescribed or illicit. If children show these symptoms while using any type of psychoactive drugs, the cause is likely not this disorder.
Parents often do not realize that their child may have oppositional defiant disorder at first, because almost all developing children have a penchant for stubbornness or testing limits. However, ODD is significantly more serious than a child “being a brat”.
- ODD is a persistent behavior causing distress in others impacting social, educational, and occupational growth
Mild cases can often be difficult to identify because this disorder usually only manifests in specific locations or social settings. Mild cases usually only manifest in one, while the most severe cases manifest in three or more settings. Since parents may not be present in any or all of the settings where it manifests and, similarly, doctors may not be present in those settings, diagnosis can be tricky because it may very well require second hand information.
In short, the cause of ODD is entirely unknown. Studies suggest that both genetic and environmental factors contribute, but no clear cause has been determined at this point. Other than some slight correlations between ODD and other disorders and between ODD and children that experience economic hardship, there is no good way to predict this disorder.
Treatment strategies for ODD usually involve training parents, or other authority figures, in how to effectively interact with the child. The most effective treatment strategies, by far, are those where authority figures provide consistent, measured responses to the child, and focus on positive reinforcement above negative. When treated this way, roughly 2 in 3 children are symptom free within 3 years.
In contrast, fear based treatment programs, especially short term programs, not only consistently fail to treat the disorder, but are likely to exacerbate problems in the long run. Additionally, while drugs may provide supplementary assistance for treatment, no drug options successfully treat ODD alone.