Oppositional Defiant Disorder: Symptoms & Diagnosis

Do you suspect that your child’s outbursts and defiance could be above and beyond the norm? Here is everything you need to know.

Symptoms of oppositional defiant disorder (ODD) include regular temper tantrums, excessive arguments with adults, and uncooperative, deliberately annoying, or mean and spiteful behavior.

Signs and Symptoms of ODD in Children

Children with oppositional defiant disorder (ODD) are usually not physically aggressive but rather thwart, obstruct, frustrate, demean, and resist anyone in a position of authority (parents, teachers, coaches, police, etc.). They purposefully bother and irritate others. Almost anybody can be aggressive and irritating from time to time; to be diagnosed with ODD, a person must display a pattern of negative, hostile, and defiant behavior lasting at least six months, during which four (or more) of the following symptoms are present:

• Often loses temper

• Often argues with adults

• Actively defies or refuses to comply with adults’ requests or rules

• Deliberately annoys people

• Blames others for his or her mistakes or misbehavior

• Easily annoyed by others

• Angry and resentful

• Spiteful or vindictive

There are two types of ODD. The childhood version is present from an early age, making these children very difficult to raise. About 40 percent of these children will outgrow ODD by age eight. The second type is adolescent-onset ODD. Once-normal and loving children become impossible to live with. Home and school become places of almost constant conflict.

Signs and Symptoms of ODD and CD in Adults

ODD is thought to be genetic and can last into adulthood, or worsen into a condition like antisocial personality disorder. ODD adults additionally feel mad at the world, and lose their tempter regularly. This may manifest as spousal abuse or road rage. Adults with ODD defend themselves relentlessly when someone says they’ve done something wrong. They feel misunderstood and disliked, hemmed in, and pushed around. Constant opposition to people in authority roles makes it very hard for adults with ODD to keep jobs and to maintain relationships and marriages.

Diagnosis

There is no single test that can diagnose ODD. To diagnose ODD accurately, physicians usually screen you or your child to rule out anxiety, depression, and bipolar disorder, which can all cause ODD-like behaviors. ADHD commonly co-occurs with ODD, and children with both conditions tend to be even more disruptive and aggressive. These behaviors are only “symptoms” if they occur more frequently than is typically observed in individuals of comparable age and developmental level, and if they cause clinically significant impairment in social, academic, or occupational functioning. The physician will use clinical experience to make a decision. Diagnosis is time consuming because multiple sources of information must be assessed.

A primary care physician may refer you to a mental health professional who has experience with the condition. The professional will collect reports from parents, teachers, the child, and anyone else who has significant exposure to the child’s behavior. Talking to as many people as possible about how and where the behavior occurs can help the doctor determine which behaviors are impacting different areas of the child’s life. It will also help to determine if the child is responding to a stressful situation, or if you’re dealing with an ongoing behavioral issue.

People with ODD never take responsibility for their behavior and the effect it has on everyone around them. They blame anyone but themselves. It usually takes a highly qualified physician to determine whether problems at school, work, or home are being caused by ODD. The physician may use rating scales and questionnaires to make a complete assessment.

The strain of dealing with ODD affects the entire family, especially marital relationships. Fortunately, effective therapies exist for reigning in even the most defiant child or adult. It won’t be easy, but it can be done – typically with the help of specialized psychotherapy, family training programs, and a physician to supervise treatment.

TAGS: Comorbid Conditions with ADD, Oppositional Defiant Disorder

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