Even the most placid of children are occasionally challenging to parents at times. Parents who have children with oppositional defiant disorder, however, deal with a pattern of tantrums, arguing, angry, and disruptive behavior toward people in authority. Oppositional defiant disorder (ODD) is a disorder of childhood characterized by negative, defiant, disobedient, often hostile behaviors most often directed at adults and people in authority for a period of six months or longer. Defiant behaviors are often expressed as persistent stubbornness, refusal to follow directions, unwillingness to seek common ground, compromise, or negotiate with others, including their peers. A child who has ODD may be persistent in testing limits, generally by ignoring directions, arguing, or failing to accept blame for improper behaviors. This hostility may be directed at adults or peers and often involves deliberately, persistently annoying others with verbal aggression (generally without physical aggression seen in conduct disorder). While all children display these symptoms some of the time, a child who has oppositional defiant disorder will have symptoms much more often than other children and have their overall functioning compromised by these challenging behaviors.
Symptoms of ODD will be seen in the home environment but may or may not be expressed at school or in the community. Manifestations of ODD are more commonly expressed through interactions with adults and peers that the child knows well, which can make a diagnosis of ODD very challenging for a medical professional. Most children who have ODD don’t consider themselves to be defiant or oppositional toward others; they believe their behavior is justified as a response to unreasonable demands and circumstances. While most children develop oppositional defiant disorder between the ages of 6 and 8, symptoms can emerge in younger children and persist throughout the teen years.
While living with a child who has oppositional defiant disorder can be a frustrating roller coaster, with the proper amounts of therapeutic intervention, ODD can be managed and overcome. For most children, ODD improves over time; follow-up studies show that 67% of children diagnosed with oppositional defiant disorder have symptoms that will abate within three years of diagnosis. In order to outgrow oppositional defiant behavior, your child must realize that his or her behavior is inappropriate and make a conscious decision to change. A therapist who specializes in disruptive behaviors of childhood such as ODD will help your child to understand the root cause, learn new ways of handling negative emotions, and help your child learn new strategies for appropriate and healthier behaviors.
Oppositional defiant disorder is among the most commonly diagnosed mental health conditions of childhood. Between 1 and 16% of children meet the criteria for ODD in the United States.
There are a few disorders that occur frequently with oppositional defiant disorder that can make the disorder more challenging to manage. It’s vital that all co-occurring disorders are treated, as they can create or worsen the irritability of ODD if left untreated. These include:
- Anxiety disorders
- Attention-deficit hyperactivity disorder (ADHD)
- Mood disorders
- Learning disorders
- Communication disorders
- Substance abuse
Causes of Oppositional Defiant Disorder
Oppositional defiant disorder is thought to be caused by a combination of risk factors working together. ODD is thought to be caused by the interplay of genetic, physical, social, and psychological factors. The risk factors for ODD may include:
Genetic: Oppositional defiant disorder tends to run in families; children who are born to parents who had ODD as a child are at greater risk for developing the disorder themselves. Additionally, parents who have a history of ADHD, substance abuse, depressive disorders, or bipolar disorder are at higher risk for having a child who develops ODD.
Physical: Brain imaging studies indicate that children who have ODD may have very subtle differences in the part of the brain that is responsible for reasoning, judgment, and impulse control.
Environment: Lack of structure or parental supervision, inconsistent discipline, and exposure to abuse or violence in the community may increase the risk a child develops ODD.
Psychological: Children who have ADHD are at greater risk for developing oppositional defiant disorder. Additionally, children who are extremely aggressive have troubles interpreting and identifying social cues from peers; these children often see hostile in very neutral settings.
Symptoms of Oppositional Defiant Disorder
It can be hard for even the most seasoned parent to recognize the difference between a willful, determined child and a child who has ODD. It’s absolutely normal for children to showcase oppositional behaviors at certain stages of development. However, there is a spectrum between normal independence-seeking behaviors and those of children who have ODD.
Symptoms of ODD generally appear before eight years of age, although some children do not display symptoms until the early teen years. Children who have oppositional defiant disorder will have a wide range of symptoms. Some of the most common symptoms of ODD include:
- Frequent temper tantrums
- Extreme arguing with adults (especially those in authority)
- Questioning rules
- Refusal to comply with adult requests or rules
- Deliberate attempts to annoy or upset others
- Blaming others for his or her mistakes or defiant behaviors
- Easily annoyed by others
- Mean, hateful talking while upset
- Revenge-seeking behaviors
- Spiteful attitude
- Low self-esteem
- Social impairment
- Trouble maintaining friendships
- Scholastic problems
Effects of Oppositional Defiant Disorder
If oppositional defiant disorder is left untreated, the affected child and his or her parents may become stressed and frustrated. It’s vital for parents to seek help for their child before the problems become severe and lead to complications in their lives.
Long-term effects of untreated ODD include:
- Scholastic difficulties
- Lack of self-esteem
- Substance abuse
- Severe delinquency
- Poor communication skills
- Lack of friendships
- Conduct disorder
- Antisocial personality disorder