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Get emergency care if you or a loved one has serious thoughts of suicide or harming others.

OVERVIEW

What is oppositional defiant disorder?

Oppositional defiant (say: ah-puh-zish-uh-null dee-fie-ant) disorder, or ODD, is a behavior condition that affects children and teens. Those who have it are angry, argumentative and defiant much more often than others in their age group. The behaviors associated with ODD have a negative effect on the child’s or teen’s relationships and ability to do well in school and at home.

SYMPTOMS

What are the symptoms of ODD?

Every child or teen gets angry, throws tantrums and argues. But it can be hard to tell if a child or teen is just acting out, or if they have ODD. The symptoms of ODD are disruptive to home and family life, are almost constant and often last for at least 6 months.

Symptoms of ODD may include:

• Frequent temper tantrums
• Constant arguing with or defying adults
• Refusing to follow rules
• Annoying other people on purpose
• Blaming others for their own mistakes or bad behavior
• Acting touchy or easily annoyed by others
• Feelings of anger and resentment toward other people
• Wanting to get revenge on others
• Problems at school
• Trouble making or keeping friends

CAUSES & RISK FACTORS

What causes ODD?

Health care providers don’t know the exact cause of ODD. It may result from a combination of factors. The child’s general attitude and how the family reacts to their behavior may play a role in it. ODD may run in families. Other causes may be related to the nervous system or to brain chemicals that are out of balance.

Who is at risk for developing ODD?

A child is more likely to develop ODD if he or she has the following risk factors:

• A history of abuse or neglect
• A parent or caretaker who has a mood disorder, or who abuses alcohol or drugs
• Exposure to violence
• Inconsistent discipline
• Lack of supervision
• Instability in the family, such as divorce, multiple moves and changing schools frequently
• Financial problems in the family
• Parents who have or have had ODD, attention-deficit hyperactivity disorder (ADHD) or behavioral problems

DIAGNOSIS & TESTS

How is ODD diagnosed?

Your health care provider will ask about your child’s symptoms, medical history, family history and other emotional or behavioral problems. Your health care provider may want to refer your child to a health professional specializing in problem behavior for a more in-depth evaluation.

TREATMENT

How is ODD treated?

There are several treatment options for ODD. Some focus only on the child, while other treatments include the child’s family and school.

Your health care provider will probably work with another health professional who specializes in mental health or a psychologist to treat your child.

Treatment will focus on helping your child learn better ways to manage his or her anger. It will also help your child learn how to handle social situations so they will feel less frustrated with other people.

Treatment can also help families learn to communicate better with each other. And your health care provider can help you learn how to manage your child’s behavior and how to use discipline effectively.

In a treatment called cognitive behavior therapy, children and their families learn problem-solving skills and how to feel more positive.

What else can I do to help my child or teen who has ODD?

The following can help encourage good behavior:

• Praise your child’s or teen’s positive behaviors.
• Be consistent about rules.
• Model the behaviors you want your child to follow.
• Establish a daily routine for your child.
• Spend quality time with your child.

QUESTIONS TO ASK YOUR HEALTH CARE PROVIDER

• Why does my child have ODD?
• What can I do to help my child?
• What treatment will help my child?
• Do we need family counseling?
• Will medicines help?
• Are there any other treatments for my child?
• How can I stop from being so angry all the time?
• Does my child have ODD?
• My child seems to be a loner. How can I help them make friends?
• Are there any support groups in my area?

Sources

Oppositional Defiant Disorder by Sutton Hamilton, MD, and John Armando, LCSW (10/01/08, http://www.aafp.org/afp/20081001/861.html)