Even the best-behaved children can act out or be challenging at times. However, children with oppositional defiant disorder have persistent patterns of tantrums, arguing, angry outbursts, and disruptive behavior toward people in authority. Oppositional defiant disorder (ODD) is a childhood disorder characterized by negative, defiant, disobedient, and often hostile behaviors most often directed at adults and people in authority. Defiant behaviors are often expressed as persistent stubbornness, refusal to follow directions, and unwillingness to seek common ground, compromise, or negotiate with others, including their peers. A boy or girl who has ODD may constantly test the limits by ignoring directions, arguing, or failing to accept blame for improper behaviors. The hostility they display may be directed at adults or peers and often involves deliberately annoying others with verbal aggression (generally without the physical aggression seen in conduct disorder).
Symptoms of ODD can be seen at home and may or may not be present in a school or community environment. Most children who have ODD don’t consider themselves to be defiant or oppositional toward others, in fact they believe their behavior is a response that is completely justified in reaction 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 the symptoms of ODD improve over time. In order to outgrow oppositional defiant behavior, it is important that your child realizes that his or her behavior is inappropriate and that they must make a conscious decision to change. A therapist who specializes in disruptive behaviors of childhood will help your child to understand the root cause of their behavior, learn new ways of handling negative emotions, and 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.
Causes of Oppositional Defiant Disorder
Oppositional defiant disorder is thought to be caused by a combination of risk factors working together. It is thought to be the result of a combination 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. Additionally, an imbalance of certain brain chemicals, such as serotonin, may exist.
Environment: There are a number of environmental factors that can put a child at risk for development of oppositional defiant disorder. For example, lack of structure or parental supervision, inconsistent discipline, and exposure to abuse or violence in the community all can play a part in the development of the disorder.
Psychological: Children who have ADHD are at greater risk for developing oppositional defiant disorder. Additionally, a child’s natural disposition can have a lot to do with the development of this disorder. Those children who are extremely aggressive and have troubles interpreting and identifying social cues from peers are more likely to develop ODD.
- Development delays
- Family instability
- Parents with marital problems or who have gone through divorce
- Financial problems in family
Symptoms of Oppositional Defiant Disorder
At times it may be difficult for parents to recognize the difference between a child who is just being stubborn or emotional and one who has oppositional defiant disorder. While it is normal for all children to display some defiant behavior during certain developmental stages, there is a difference between the usual independence-seeking behaviors and the highly disruptive behaviors of 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:
- 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
- Frequent temper tantrums
- Extreme arguing with adults (especially those in authority)
- Questioning rules
- Low self-esteem
- Social impairment
- Trouble maintaining friendships
- Spiteful attitude
Effects of Oppositional Defiant Disorder
If oppositional defiant disorder is not properly treated, not only can it cause the parents a large amount of unnecessary stress and frustration, but it can create a number of difficulties for the child as well. It’s vital for parents to seek help for their child before the problems become severe and lead to further complications in their lives. Long-term effects of ODD can include:
- Scholastic difficulties
- Suspension or expulsion
- Lack of self-esteem
- Substance abuse and addiction
- Severe delinquency
- Poor communication skills
- Lack of friendships
- Legal problems
- Conduct disorder
- Antisocial personality disorder
There are some disorders that frequently occur with oppositional defiant disorder that make this disorder that much more challenging to manage. It is important that all co-occurring disorders are treated simultaneously, as they can create or worsen the disorder if left untreated. These include:
- Anxiety disorders
- Attention-deficit hyperactivity disorder (ADHD)
- Mood disorders
- Learning disorders
- Communication disorders
- Substance abuse