Related Articles
Oppositional defiant disorder (ODD) is thought to be influenced by a combination of biological, psychological, and social factors
Oppositional defiant disorder (ODD) is seen in children and teenagers and characterized by frequent and persistent patterns of anger, irritability, vindictiveness, arguing, and defiance toward authority figures.
While there is no known cause of ODD, it is thought to be influenced by a combination of biological, psychological, and social factors.
8 factors that can contribute to ODD
- Genetics: Studies have shown that genes may play a role in the development of ODD, causing neurological differences in nerve and brain functions. ODD may be inherited from family members who have mental illnesses such as depression, anxiety, or personality disorders. Many children with ODD come from families with a history of attention-deficit/hyperactivity disorder (ADHD), mood disorders such as bipolar disorder, or depression and substance abuse.
- Environment: Parenting issues may lead to ODD, such as a lack of supervision, inconsistent or harsh discipline, or abuse or neglect. A child who lives with parental or family conflict or who has a parent who has a mental health or substance use disorder is more likely to develop the disorder.
- Injury: ODD can be caused by brain injuries or defects, as well as an imbalance of chemicals in the brain.
- Developmental theory: According to this theory, developmental problems may begin when children are toddlers. Children and teenagers with ODD may have struggled to learn to be independent from a parent or other significant figure to whom they were emotionally attached. Their behavior could be caused by developmental issues that last beyond the toddler years.
- Learning theory: According to this theory, negative symptoms of ODD are learned attitudes. They mimic the effects of negative reinforcement techniques used by parents and others in positions of authority. Negative reinforcement increases ODD behaviors because they allow the child to obtain what they want: attention and reaction from parents or others.
- Gender and age: The disorder affects boys more than girls. According to some studies, it affects 20% of school-aged children. However, most experts believe that this figure is exaggerated because of shifting definitions of normal childhood behavior. It may also have roots in racial, cultural, and gender biases. This behavior typically begins about when the child is eight years old although it can start as early as preschool age.
- Temperament: A child with a temperament that includes difficulty regulating emotions such as being overly emotional in situations or having difficulty tolerating frustration is more likely to develop the disorder.
- Mental health problems: Many children and adolescents who have ODD also have other mental health problems, such as:
- Depression or anxiety
- ADHD
- Behavioral disorders
- Learning and communication disorders
When to consult a doctor
If you suspect your child has ODD, talk to a doctor. There may be coexisting illnesses that, if left untreated, can exacerbate symptoms. Teens with ODD are also more likely to abuse alcohol and drugs.
Your family doctor will be able to refer you to the right doctors and therapists.
What are the signs and symptoms of ODD?
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) includes criteria for diagnosing ODD. Emotional and behavioral symptoms that last at least 6 months are included in the DSM-5 criteria.
- Angry and irritable mood
- Easily loses temper
- Frequently irritated by others
- Frequently enraged or resentful
- Argumentative and defiant behavior
- Argues with adults or authority figures
- Frequently actively defies or refuses to comply with adult requests or rules
- Annoys or upsets people on purpose
- Blames others for their mistakes or misbehavior
- Vindictiveness
- Spiteful or vindictive
- Shown this behavior at least 2 times in the past 6 months
ODD can vary in severity. Some children’s symptoms may begin at home and gradually spread to other settings such as school and with friends:
- Mild: Symptoms occur only in one setting such as only at home, school, work, or with peers
- Moderate: Some symptoms occur in at least 2 settings
- Severe: Some symptoms occur in 3 or more settings
How to treat ODD in a child
Early treatment can prevent future issues. Treatment will be determined by your child's symptoms, age, overall health, and severity of the disorder. Children with ODD may need to try various therapists and therapies before discovering what works best for them.
Treatment options may include
- Cognitive-behavioral therapy: The child learns to solve problems, control their emotions, and communicate more effectively.
- Family therapy: ODD in the family can be extremely difficult for parents and become a source of contention between siblings. Family therapy aims to improve family communication and interaction and promote understanding and support.
- Peer group therapy: The child learns to improve their social skills.
- Medications: While rarely used to treat ODD, a child may require them for other symptoms or disorders such as ADHD or anxiety disorders.
It is critical that parents actively participate in their child's battle to control inappropriate and troubling behaviors. Parents can learn and practice stress management techniques, which will not only help them deal with the stresses of raising a child with ODD but also set a good example for their children.
Can ODD be prevented?
Certain approaches can help prevent ODD:
- Early intervention programs may be beneficial for young children, teaching them social skills and how to deal with anger.
- Psychotherapy, learning social skills, and getting help with schoolwork can help reduce problematic behaviors in teenagers.
- School-based programs can help limit bullying and improve teen relationships.
- Parent-management education programs can educate parents on how to manage their child's behavior. Parents are taught positive reinforcement techniques and how to discipline their child.
