Defiance Disrespect Anger

Sometimes it's difficult to recognize the difference between a strong-willed or emotional child and one with oppositional defiant disorder. But if your child or teenager has a frequent and persistent pattern of anger, irritability, arguing, defiance or vindictiveness toward you and other authority figures, he or she may have oppositional defiant disorder (ODD). Signs of ODD generally begin during preschool years. Sometimes ODD may develop later, but almost always before the early teen years. These behaviors cause significant impairment with family, social activities, school and work.

Symptoms of ODD

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists criteria for diagnosing ODD. The DSM-5 criteria include emotional and behavioral symptoms that last at least six months.

Angry and irritable mood:

Often and easily loses temper
Is frequently touchy and easily annoyed by others
Is often angry and resentful

Argumentative and defiant behavior:

Often argues with adults or people in authority
Often actively defies or refuses to comply with adults' requests or rules
Often deliberately annoys or upsets people
Often blames others for his or her mistakes or misbehavior

Vindictiveness:

Is often spiteful or vindictive
Has shown spiteful or vindictive behavior at least twice in the past six months

ODD can vary in severity:

Mild. Symptoms occur only in one setting, such as only at home, school, work or with peers.
Moderate. Some symptoms occur in at least two settings.
Severe. Some symptoms occur in three or more settings.
There's no guaranteed way to prevent oppositional defiant disorder. However, positive parenting and early treatment can help improve behavior and prevent the situation from getting worse. The earlier that ODD can be managed, the better. Treatment can help restore your child's self-esteem and rebuild a positive relationship between you and your child. Your child's relationships with other important adults in his or her life — such as teachers and care providers — also will benefit from early treatment. Behavioral treatment of ODD involves learning skills to help build positive family interactions and to manage problematic behaviors. Additional therapy, and possibly medications, may be needed to treat related mental health disorders.

Treatment of ODD

There's no guaranteed way to prevent oppositional defiant disorder. However, positive parenting and early treatment can help improve behavior and prevent the situation from getting worse. The earlier that ODD can be managed, the better. Treatment can help restore your child's self-esteem and rebuild a positive relationship between you and your child. Your child's relationships with other important adults in his or her life — such as teachers and care providers — also will benefit from early treatment. Behavioral treatment of ODD involves learning skills to help build positive family interactions and to manage problematic behaviors. Additional therapy, and possibly medications, may be needed to treat related mental health disorders.