Oppositional Defiant Disorder

Oppositional defiant disorder (ODD) is a behavior disorder, usually diagnosed in childhood, that is characterized by uncooperative, defiant, negativistic, irritable and annoying behaviors toward parents, peers, teachers and other authority figures.

Some experts believe that a developmental sequence of experiences occurs in oppositional defiant disorder. This sequence may start with ineffective parenting practices, followed by difficulty with other authority figures and poor peer interactions.

As these experiences compound and continue, oppositional and defiant behaviors develop into a pattern of behavior. Early detection and intervention into negative family and social experiences may be helpful in disrupting the sequence of experiences that leads to more oppositional and defiant behaviors.

Early detection and intervention with more effective communication, parenting, conflict resolution and anger management skills can disrupt the pattern of negative behaviors and decrease the interference of oppositional and defiant behaviors in interpersonal relationships with adults and peers, and school and social adjustment.

The goal of early intervention is to enhance the child's normal growth and developmental process, and improve the quality of life experienced by children with oppositional defiant disorder.

Behavior disorders, as a category, are by far the most common reason for referrals to mental health services for children and adolescents.

Oppositional defiant disorder is reported to affect between 2 percent and 16 percent of children and adolescents in the general population. ODD is more common in boys than in girls.

Most symptoms of ODD also occur at times in individuals without this disorder, especially during the teenage years. However, in children and adolescents with oppositional defiant disorder, these symptoms occur more frequently and interfere with learning, school adjustment and, sometimes, with the adolescent's relationships with others.

Symptoms of Oppositional Defiant Disorder 

  • Excessive arguments
  • Refusal to comply with appropriate requests
  • Always questioning rules; refusal to follow rules
  • Behavior intended to annoy or upset others
  • Blaming others for his / her misbehaviors or mistakes
  • Easily annoyed by others
  • Frequently has an angry attitude 

The symptoms of ODD may resemble other medical conditions or behavior problems. Always consult your adolescent's physician for an evaluation.

Parents, teachers and other authority figures in child settings often identify the individual with ODD. A detailed history of the child's behavior from parents and teachers, clinical observations of the child's behavior and, sometimes, psychological testing contribute to the diagnosis.

Parents who note symptoms of ODD in their child can help by seeking an evaluation and treatment early. Early treatment can often prevent future problems. Further, oppositional defiant disorder often coexists with other mental health disorders, including mood disorders, anxiety disorders, conduct disorder and attention deficit / hyperactivity disorder, increasing the need for early diagnosis and treatment. Consult your adolescent's physician for more information.

Specific treatment for the adolescent with oppositional defiant disorder will be determined by your child's physician or mental health professional based on:

  • Overall health and medical history
  • Extent of symptoms
  • Tolerance for specific medications, procedures or therapies
  • Expectations for the course of the condition

Types of Treatments

  • Individual psychotherapy: Uses cognitive-behavioral approaches to improve problem-solving skills, communication skills, impulse-control and anger-management skills.
  • Family therapy: Often focused on making changes within the family system, such as improving communication skills and family interactions. Parenting children with ODD can be very difficult and trying for parents. Parents need support and understanding as well as help with developing more effective parenting approaches.
  • Peer group therapy: Often focused on developing social skills and interpersonal skills.
  • Medication: While not considered effective in treating ODD, medication may be used if other symptoms or disorders are present and are responsive to medication.

For additional information on this Health Topic, call your pediatrician or the Psychiatric Intake Response Center (PIRC) at Cincinnati Children's Hospital Medical Center, 513-636-4124.


Last Updated 01/2014