Oppositional defiant disorder (ODD) is a disorder that occurs in childhood and is characterized by negative, defiant, disobedient, and often hostile behavior toward adults or other authority figures. Children with ODD often lose their temper, argue with adults, actively defy or refuse to comply with the rules set by adults, and deliberately annoy others. They may blame others for their mistakes or misbehavior, are touchy or easily annoyed, tend to be resentful, and are often spiteful or vindictive. Additionally, these children do not think nor care about the consequences that can potentially result from their behaviors.
Children with ODD will not only display these symptoms at home, but also at school and in the community. Their symptoms are usually more evident in interactions with adults or other individuals that the child knows well. It is common for children with this disorder to not think that they are being defiant and they justify their behavior as a response to perceived unreasonable demands or circumstances.
Oppositional defiant disorder is believed to be one of the most common behavioral disorders diagnosed in children. While its true prevalence is still under debate, it is estimated that 10.2% of children will develop ODD. However, approximately two thirds of children who are given a diagnosis of oppositional defiant disorder will overcome their symptoms, with studies showing that 70% of those previously diagnosed with ODD are no longer displaying symptoms by the time they reach the age of 18.
Causes and Risk Factors of Oppositional Defiant Disorder
To date researchers are unable to conclusively identify one exact cause for the development of oppositional defiant disorder. However, extensive studies have shown that this disorder is most likely the combination of biological, genetic, and environmental factors. The following are some examples of the different causes and factors that may be attributed to the development of ODD:
Genetic: It has been shown that ODD is likely a hereditary condition and that if an individual has a close relative with this mental illness, they have a predisposition to the development of oppositional defiant disorder.
Physical: The presence of oppositional defiant disorder is often associated with changes in the neurotransmitters in the brain. Higher or lower levels of neurotransmitters can cause sudden changes in mood and thinking processes due to the impaired transmission of nerve impulses. These chemical changes are what cause some of the symptoms of ODD like irritability, no fear of punishment, and engagement of hostile behaviors.
Environmental: Environmental factors at home and school play a crucial role in the development of oppositional defiant disorder. Certain situations such as domestic violence, sexual abuse, or poor quality of life can cause ODD in children who have unstable levels of or neurotransmitters or a genetic predisposition to the disorder.
- Dysfunctional home life
- Repeated exposure to violence
- Family history of mental illness
- Family history of substance abuse
- Lack of parental involvement / inconsistent parenting (e.g. inconsistent discipline)
- Experiencing abuse and/or neglect
Signs and Symptoms of Oppositional Defiant Disorder
At times it can be difficult to distinguish between a child who is just headstrong or disobedient at times and one who is experiencing oppositional defiant disorder. Additionally, the signs and symptoms of ODD will vary from child to child, with noted differences in how symptoms present in girls as opposed to how they present in boys. Some examples of the different signs and symptoms that may be present in a child that has oppositional defiant disorder include:
- Excessive arguing
- Behaving aggressively
- Refusing to follow rules
- Frequently throwing temper tantrums
- Acting hostile towards others
- Blaming others for their own negative behaviors
- Seeking revenge, even when unwarranted
- Blatant and repeated disobedience
- Intentionally irritating others
- Is unable to play with other children
- Easily and frequently frustrated
- Difficulty concentrating
- Not thinking before speaking
- Low self-esteem
- Persistent negativity
Effects of Oppositional Defiant Disorder
Children who do not receive treatment for their symptoms of ODD may end up suffering from long-term effects that follow them into adulthood. Some examples of these effects may include:
- Social isolation
- Difficulty making and keeping friends
- Substance abuse
- Development of conduct disorder
- Severe delinquency
- Suspension or expulsion from school
- Academic failure
- Development of anti-social personality disorder
Oppositional defiant disorder can occur alongside many different mental illnesses, some which have symptoms that overlap one another. Examples of the most common disorders that co-exist with ODD include:
- Anxiety disorders
- Learning and communication disorders
- Attention-deficit/hyperactivity disorder (ADHD)
- Bipolar disorder
- Autism spectrum disorders
- Intermittent explosive disorder
- Substance use disorders