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Oppositional defiant disorder (ODD)


Disease: Oppositional defiant disorder (ODD) Oppositional defiant disorder (ODD)
Category: Psychiatric diseases

Disease Definition:

Teens are usually moody and argumentative. Even sometimes children that are best-behaved could be challenging and hard to manage. But in case the child or teen has a relentless pattern of tantrums, arguing and angry or disruptive behaviors towards the person in question and other authority figures, this child or teen might have oppositional defiant disorder (ODD). Doctors, counselors and child development experts could help the parents managing a child with oppositional defiant disorder.
Therapy, special kinds of training to help build positive family interactions, and possibly medications to treat related mental health conditions are involved in the treatment of ODD. 

Work Group:

Symptoms, Causes


Although it is normal to display oppositional behaviors at certain levels of a child’s development, but sometimes it might be hard to distinguish between a strong-willed or emotional child and one with ODD. There certainly is a difference between oppositional defiant disorder and children’s common independence-seeking behavior.
A child may have ODD if his/her oppositional behaviors:


  • Are obviously disruptive to the family and home or school environment
  • Are persistent
  • Have went on at least six months


Some of the behaviors that are related to ODD include:


  • Defiance
  • Hostility directed toward authority figures
  • Negativity
  • Disobedience


The behaviors mentioned above might result in the child’s showing these signs and symptoms constantly and on regular basis:


  • Argumentativeness with adults
  • Temper tantrums
  • Acting touchy and easily annoyed
  • Anger and resentment
  • Refusal to follow rules and requests made by adults
  • Blaming others for mistakes or misbehaviors
  • Difficulty maintaining friendships
  • Academic problems
  • Spiteful or vindictive behavior
  • Aggressiveness toward peers
  • Deliberate annoyance of other people



Oppositional defiant disorder usually takes place along with other behavioral or mental health problems, including:


  • Anxiety
  • Depression
  • Attention-deficit/hyperactivity disorder (ADHD)


Symptoms of ODD might be hard to differentiate from those of other mental or behavioral health problems.


When left untreated, the illnesses that occur with ODD may create or worsen irritability and defiance. This means that diagnosis and treatment of those conditions are very important. Substance abuse and dependence in children or adolescents is usually related to irritability and changes in their common personality. In addition, identification and treatment for any related substance abuse and dependence is essential.


A child psychologist or child behavioral expert could be consulted when parents are concerned about their child’s challenging behavior. Early treatment could help improve the child’s relationship with other authority figures such as their teachers or clergy and care providers. In addition, treatment could help restore the child’s self-esteem and rebuild a positive relationship between the parent and their child.


The chances of reversing the effects of this disorder on the child and the family are better in case the disorder is managed early.


There isn’t any certain supporting cause for ODD. A combination of inherited and environmental factors lead to causes, such as:


  • Lack of supervision
  • A child’s natural disposition
  • Abuse or neglect
  • An imbalance of certain brain chemicals, like serotonin
  • Limitations or developmental delays in a child’s ability to process thoughts and feelings
  • Inconsistent or harsh discipline


ODD is a complex problem involving several different influences, genetic components and circumstances. There isn’t any single factor that causes ODD, instead there are many factors that play a role in the development of this disease.
Some of the factors that may increase a child’s risk of developing ODD include:


  • Being abused or neglected
  • Harsh or inconsistent discipline
  • Exposure to violence
  • Lack of positive parental involvement
  • Lack of supervision
  • Financial problems in the family
  • Having a parent with a mood or substance abuse disorder
  • Family instability that takes place in conditions such as divorce, multiple moves or changing schools or frequent child care providers.
  • Having parents with a history of ADHD, oppositional defiant disorder or conduct problems
  • Having parents with a severely troubled marriage


Stressful changes such as divorce or moving that breaks off a child’s sense of consistency leads to a higher risk of disruptive behavior. Nonetheless, these changes might help explain but not excuse disrespectful or oppositional behavior.



Other treatable conditions that occur along with oppositional defiant disorder in several children include:


  • Depression
  • Learning and communication disorders
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Anxiety


Children suffering from oppositional defiant disorder might struggle to make and keep friends, in addition to the trouble they’d encounter at school with teachers and other authority figures. ODD could give parents a tough time and frustration for the affected child. ODD might be a precursor to other, more severe problems such as conduct disorder, severe delinquency and substance abuse.


Usually, treatment for oppositional defiant disorder involves several kinds of psychotherapy and training for the children, as well as the child’s parents. Medications might help significantly improve symptoms of a child who has co-existing conditions, especially ADHD.
The treatment bases for ODD often include:

Cognitive problem solving training:

The goal of this therapy is helping the child identify and change through ways that contribute to behavior problems. Research demonstrates that ODD-related problems are improved effectively with the use of an approach named collaborative problem solving, in which the parent and their child work together to find suitable solutions for both of them.

Parent-child interaction therapy (PCIT):

Research has proved that as a result of PCIT, parents learn more-effective parenting methods, decreasing the behavior problems of children, and improving the quality of the parent-child relationship. Therapists coach parents while they interact with their children, throughout PCIT. In one approach, the therapist sits behind a one-way mirror and, using an “ear bug” audio device, guides parents through strategies reinforcing their children’s positive behavior.

Individual and family therapy:

Anger management and helping the children to be able to express themselves more healthfully could be done by individual counseling. Family counseling might help improve their communication and relationships, and help members of the family learn how to cope with one another.

Parent training:

Sometimes, the child might participate in this kind of training with their parent, so that everyone in the family builds up shared aims for how to deal with problems. An experienced mental health provider might help the parent develop skills permitting them to parent in a more positive and less frustrating way for both them and their child.

Social skills training:

The child might benefit from therapy that would help them learn how to act more positively and effectively with peers.


As a way of parent training, parents might learn how to:


  • Avoid power struggles
  • Offer acceptable choices to the child, giving him a certain amount of control
  • Give effective timeouts
  • Limit the outcomes to those that could be systematically reinforced and if possible, linger for a limited amount of time
  • Establish a schedule for the family that includes particular meals to be eaten together at home, and special activities one or both parents would do with the child
  • Remain calm and unemotional in the face of opposition.
  • Recognize and praise the child’s good behaviors and positive characteristics


While some parent management methods might appear as common sense, yet learning to use them in the face of opposition is hard, specifically if there are other stressors at home. Consistent practice and patience would be needed in learning these skills. The parents’ showing consistent, unconditional love and acceptance of the child, even during difficult and disruptive circumstances is the most important treatment. However, even for the most patient parents this process could be difficult.


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