Oppositional Defiant Disorder

Oppositional Defiant Disorder - Diagnostic Criteria, American Psychiatric Association

An individual diagnosed with oppositional defiant disorder needs to meet all of the following criteria:

• A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following categories, and exhibited during interaction with at least one individual who is not a sibling.


Angry/Irritable Mood


• Often loses temper.


• Is often touchy or easily annoyed.


• Is often angry and resentful.

Argumentative/Defiant Behavior


• Often argues with authority figures or, for children and adolescents, with adults.


• Often actively defies or refuses to comply with requests from authority figures or with rules.


• Often deliberately annoys others.


• Often blames others for his or her mistakes or misbehavior.

Vindictiveness


• Has been spiteful or vindictive at least twice within the past 6 months.
  
  Note: The persistence and frequency of these behaviors should be used to distinguish a behavior that is within normal limits from a behavior that is symptomatic. For children younger than 5 years, the behavior should occur on most days for a period of at least 6 months, unless otherwise noted. For individuals 5 years or older, the behavior should occur at least once per week for at least 6 months, unless otherwise noted. While these frequency criteria provide guidance on a minimal level of frequency to define symptoms, other factors should also be considered, such as whether the frequency and intensity of the behaviors are outside a range that is normative for the individual's developmental level, gender, and culture.
• The disturbance in behavior is associated with distress in the individual or others in his or her immediate social context (e.g., family, peer group, work colleagues), or it impacts negatively on social, educational, occupational, or other important areas of functioning.


• The behaviors do not occur exclusively during the course of a psychotic, substance use, depressive, or bipolar disorder. Also, the criteria are not met for disruptive mood dysregulation disorder.

Oppositional defiant disorder is a pattern of disobedient, hostile, and defiant behavior toward authority figures. This behavior typically starts by age 8, but it may start as early as the preschool years. The pattern of behaviors must be different from those of other children around the same age and developmental level. The behavior must lead to significant problems in school or social activities. Ten years after diagnosis, the majority of these children no longer have this disorder. If this disorder perisists and worsens, it develops into Conduct Disorder in adolescence, and Antisocial Personality Disorder in adulthood. 

Effective Therapies

Parent training and developing the child's skills in tolerating frustration, being flexible, and avoiding emotional overreaction has proven to be effective.