What is oppositional defiant disorder?

It is not unusual for children—especially those in their “terrible twos” and early teens—to be oppositional, or defiant of authority, once in a while. They might express their defiance by arguing, disobeying, or talking back to adults, including their parents or teachers. When this behavior lasts longer than six months and is excessive compared to what is usual for the child’s age, it might suggest a behavior disorder called oppositional defiant disorder (ODD).

ODD is a condition in which a child displays an ongoing pattern of uncooperative, defiant, hostile, and annoying behavior toward people in authority. This behavior often disrupts the child’s normal daily functioning, including relationships and activities within the family and at school.

Many children and teens with ODD also have other disorders, such as:

  • Attention deficit hyperactivity disorder (ADHD)
  • Learning disabilities
  • Mood disorders (such as depression)
  • Anxiety disorders

Some children with ODD go on to develop a more serious behavior disorder called conduct disorder.

How common is oppositional defiant disorder?

Estimates suggest that 2 percent to 16 percent of children and teens have ODD. In younger children, ODD is more common in boys. In older children, it occurs about equally in boys and in girls. It typically begins by age 8.

What are the symptoms of oppositional defiant disorder?

Symptoms of ODD can be clustered into three categories:

  • Angry/irritable mood:
    • Loses temper easily
    • Having frequent outbursts of anger and resentment
    • Touchy and/or easily annoyed
    • Angry and/or disrespectful
  • Argumentative/defiant behavior
    • Excessively arguing with adults
    • Actively refusing to comply with requests and rules
    • Blaming others for the child’s own mistakes
    • Deliberately trying to annoy or upset others, or being easily annoyed by others
  • Vindictiveness
    • Being spiteful and seeking revenge
    • Saying mean and hateful things when upset

In addition, many children with ODD are moody, easily frustrated, and have low self-esteem. They also might abuse drugs and alcohol.

What causes oppositional defiant disorder?

The exact cause of ODD is not known, but it is believed that a combination of biological, genetic, and environmental factors might play a role.

  • Biological: Some studies suggest that defects in or injuries to certain areas of the brain can lead to behavior disorders. In addition, ODD has been linked to special chemicals in the brain called neurotransmitters. Neurotransmitters help nerve cells in the brain communicate with each other. If these chemicals are out of balance or not working properly, messages might not make it through the brain correctly, leading to symptoms. Further, many children and teens with ODD also have other mental disorders, such as:
    • ADHD
    • Learning disorders
    • Depression
    • Anxiety disorder

This might contribute to their behavior problems.

  • Genetic: Many children and teens with ODD have close family members with mental disorders, including:
    • Mood disorders
    • Anxiety disorders
    • Personality disorders

This suggests that at least a vulnerability to ODD may be inherited.

  • Environmental: Factors such as
    • A dysfunctional family life
    • A family history of mental disorders and/or substance abuse, and
    • Inconsistent discipline by parents

This might contribute to the development of behavior disorders.

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