Oppositional Defiant Disorder

Oppositional Defiant disorder (ODD) is a behavioral disorder, commonly found in children and adolescents. It is seen as a pattern of hostile and disobedient behavior. Normally this behavior is directed at adults and figures of authority.  Sufferers argue with adults and have a hard time controlling their behavior.  The most common behaviors are negativity, hostility, defiance and aggression.

There is no single test that can diagnose ODD, but typically, a medical professional can determine if a child has the disorder by looking at their pattern of behavior.

Children with ODD show an ongoing pattern of extreme negativity, hostility, and defiance that:

  • Disrupts family and school
  • Is aimed at adult family members and of figures of authority
  • Is extreme when compared to other children

Symptoms that are associated with ODD

  • Questioning and not following rules
  • Purposefully annoying and upsetting others
  • Sudden outbursts of anger

Types of Treatment

Treatment usually consists of a combination of:

  • Parent-Management Training Programs and Family Therapy to teach parents and other family members how to manage the child’s behavior. Parents, family members, and other caregivers are taught techniques in positive reinforcement and ways to discipline more effectively.
  • Cognitive Problem-Solving Skills Training to reduce inappropriate behaviors by teaching the child positive ways of responding to stressful situations. Children with ODD often only know of negative ways of interpreting and responding to real-life situations. Cognitive problem solving skills training teaches them how to see situations and respond appropriately.
  • Social-Skills Programs and School-Based Programs to teach children and adolescents how to relate more positively to peers and ways to improve their school work. These therapies are most successful when they are conducted in a natural environment, such as at the school or in a social group.
  • Medication may be necessary to help control some of the more distressing symptoms of ODD as well as the symptoms of coexisting conditions, such as ADHD, anxiety, and mood disorders. However, medication alone is not a treatment for ODD.

More about Medication

However, medication may be a useful part of a comprehensive treatment plan to help control specific behaviors and to treat coexisting conditions, such as ADHD, anxiety, and mood disorders. Successful treatment of coexisting conditions often makes ODD treatment more effective. For example, medication used to treat children with ADHD has been shown to lessen behavioral symptoms when ODD and ADHD coexist. When children and adolescents with ODD also have a mood disorder or anxiety, treatment with antidepressants and anti-anxiety medications has been show to help lessen the behavioral symptoms of ODD. (1)


It was once thought that most children would outgrow ODD by adulthood. We now know this is not always true. While some of the symptoms of ODD can go away over time, and many children outgrow the disorder, some children with ODD will continue to experience the consequences of ODD during their later years.

For those who do not receive treatment, ODD can develop into Conduct Disorder (CD), a more serious behavioral disorder. Of those with CD, almost 40 percent will develop antisocial personality disorder in adulthood.(2)

Early diagnosis and treatment can help these individuals learn how to cope with stressful situations and manage their behavioral symptoms.

Psychotherapy, parent-management training, skills training, and family therapy work. Research shows that children and adolescents respond well to therapy for ODD. In fact, for those who receive treatment, many are symptom-free once therapy has concluded and will go on to lead rewarding and happy lives.

If your child or someone you loves need help for Oppositional Defiance Disorder, call us now.

1.Connor DF, Glatt SJ, Lopez ID, Jackson D, Melloni RH (2002), Psychopharmacology and aggression: I. A meta-analysis of stimulant effects on overt/covert aggression-related behaviors in ADHD. J Am Acad Child Adolesc Psychiatry 41:253-261.

2.Zoccolillo M, Pickles A, Quinton D, Rutter M (1992), The outcome of conduct disorder. Psychol Med 22:971-986.

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