Oppositional Defiant Disorder in Children and Adolescents

 ICD-10 Code: F91.3

Oppositional defiant disorder (ODD) is part of a cluster of diagnoses called the disruptive, impulse-control, and conduct disorders. Disruptive, impulse control and conduct disorders are a group of psychiatric conditions that include:

  • Oppositional Defiant Disorder
  • Intermittent Explosive Disorder
  • Conduct Disorder

These disorders are characterized by the presence of difficult, aggressive, or antisocial behavior. It is often associated with physical or verbal injury to the self, others, or objects or with violating the rights of others (e.g., destruction of property). These behaviors can appear in several forms and can be defensive, premeditated or impulsive. Individuals with disruptive, impulse control and conduct disorders may have an irritable temperament, be impulsive or inattentive, be defiant towards adults, be aggressive towards peers, and lack problem solving skills. They may also have a coercive interaction style and lack social skills.

Oppositional defiant disorder is defined as defiant, hostile, and disobedient behavior, usually directed at authority figures. Intermittent explosive disorder is explosive outbursts of anger, often to the point of rage, that are disproportionate to the situation at hand. Conduct disorder is repetitive and persistent aggression toward others in which the basic rights of others are violated. Disruptive, impulse control and conduct disorders appear to have addictive properties as they tend to have strong aspects of compulsion, craving, loss of control, and hedonistic release.

What is Oppositional Defiant Disorder?

ODD is a psychiatric disorder that affects approximately 3.3% of children. Although ODD affects both males and females, the disorder appears to be more prevalent in males prior to adolescence. ODD is characterized by three main symptoms:

  • Angry/Irritable Mood, which is often losing his/her temper, is touchy or easily annoyed, and is angry and resentful.
  • Argumentative/Defiant Behavior, which is frequent arguments with authority figures or adults, refusing to comply with requests from authority figures or with rules, deliberately annoys others, and often blames others for his or her mistakes or misbehavior.
  • Vindictiveness, which is spiteful or vindictive behavior.  
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Understanding Oppositional Defiant Disorder

Children who develop a stable pattern of oppositional behavior during their preschool years are at a greater risk to have oppositional defiant disorder during their elementary school years. The first symptoms of oppositional defiant disorder usually appear during the preschool years and rarely later than early adolescence. Children with oppositional defiant disorder are at greater risk of developing conduct disorder and antisocial personality disorder during adulthood.

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How is oppositional defiant disorder treated?

ODD is treatable.  Published treatment guidelines for OCD include those from the Society of Clinical Child and Adolescent Psychology, the American Academy of Child and Adolescent Psychiatry, and the National Institute for Clinical Excellence.

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