Oppositional defiant disorder (ODD) is defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a recurrent pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months. This behavioral disorder usually manifests before eight years of age and is more commonly seen in boys before puberty but is equally seen in boys and girls after puberty. ODD is more than just throwing a temper tantrum in the middle of a store or talking back to authoritative figures every once in a while. Children with ODD express negative and inappropriate emotions on a regular basis for at least six months in duration. From losing their temper and becoming easily annoyed to displaying feelings of anger and resentment many children with ODD have poor emotion regulation, high levels of emotional reactivity and have poor frustration tolerance.

Signs and symptoms of oppositional defiant disorder

  • Irrational temper
  • Easily annoyed
  • Angry and resentful
  • Argues with authority figures
  • Actively defies and refuses to comply with requests from authority figures
  • Deliberately annoys others
  • Blames others
  • Acts in spiteful or vindictive manners

Children and teenagers with ODD are more at risk of having other co-occurring disorders such as attention deficit hyperactive disorder, a learning disability, depression or anxiety.

Are there medications for oppositional defiant disorder?

ODD is best treated with psychotherapy and parent management training. In other words, the parents are the therapists for this disorder and parents can have a large powerful impact on their children. Parents are encouraged to enroll in a training class where they can learn about ODD and how to enforce healthy behavioral approaches at home with their children.

How should I treat my child’s ODD?

Traditional discipline doesn’t typically work for kids with ODD, who flout punishment and enjoy upsetting those around them.

  • Always build on the positives, give the child praise and positive reinforcement when he shows flexibility or cooperation. Recognize the “little victories.”
  • Learn to control yourself. Take a time-out or break if you are about to make the conflict with your child worse, not better.
  • Pick your battles. Since the child with ODD has trouble avoiding power struggles, prioritize the things you want your child to do.
  • Set up reasonable, age-appropriate limits with consequences that can be enforced consistently. Resist the temptation to rescue the child from naturally occurring consequences.
  • Don’t go it alone. Work with and get support from the other adults (teachers, coaches, and spouse) who deal with your child. Look for area support groups and/or parenting classes for parents of difficult children.
  • Avoid burnout. Maintain interests other than your child with ODD, so that managing your child doesn’t take all your time and energy. Manage your own stress with exercise and relaxation. Use respite care as needed.