Oppositional defiant disorder

Oppositional defiant disorder is a controversial psychiatric category listed in the Diagnostic and Statistical Manual of Mental Disorders where it is described as an ongoing pattern of disobedient, hostile, and defiant behavior toward authority figures which supposedly goes beyond the bounds of normal childhood behavior.

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DSM criteria

To meet DSM-IV-TR criteria, certain factors must be taken into account. First, the defiance must interfere with the child’s ability to function in school, home, or the community. Second, the defiance cannot be the result of another disorder, such as depression, anxiety, or the more serious Conduct disorder. Third, the child's problem behaviors have been happening for at least six months. The diagnostic criteria for this disorder are as follows:

• Deliberately annoying people
• Blaming others for own mistakes
• Easily annoyed
• Angry and resentful
• Spiteful or even vengeful

If the child meets at least four of these criteria, and they are interfering with the child’s ability to function, then he or she technically meets the definition of Oppositionally defiant.^[1]

Prevalence

The DSM-IV cites a prevalence of between 2 & 16% for ODD.

Prognosis

Childhood Oppositional Defiant Disorder is strongly associated with later developing Conduct disorder.^[2] Untreated, about 52% of children with ODD will continue to meet the DSM-IV criteria up to three years later and about half of those 52% will progress into Conduct Disorder.^[3]

Treatment

There are a variety of approaches to the treatment of Oppositional Defiant Disorder (ODD). One evidence-based approach with empirical support is an approach developed by Russell A. Barkley, Ph.D.^[4][5][6] This approach uses a parent training model and begins by focusing on positive approaches to increase compliant behaviours. Only later in the program are methods introduced to extinguish negative or noncompliant behaviours.

References

See also

• Controversy about ADHD (details arguments similar to those that surround Oppositional Defiance Disorder)
• Conduct disorder
• ADHD
• Bipolar disorder