ODD stands for Oppositional Defiant Disorder. ODD is most often diagnosed in children or teens, and is considered part of “Disruptive, Impulse-Control, and Conduct Disorders.” Individuals with ODD often have difficulty managing and regulating their emotions and behavior.
Time Requirement and Symptoms
For a diagnosis of ODD to be made, the individual must have displayed a “pattern of angry or irritable mood, argumentative or defiant behavior, or vindictiveness for at least 6 months.” That seems pretty straight forward, except what indicates a “pattern” and what exactly does it mean to have an angry or irritable mood, argumentative or defiant behavior, or vindictiveness? Fortunately, this information is broken down further. A pattern is demonstrated by the presence of at least 4 of the following symptoms from any of the categories, demonstrated through interactions with others who are not siblings (because, come on, siblings get irritated and argumentative with each other).
Angry or Irritable Mood
- Often loses temper.
- Is often touchy or easily annoyed.
- Is often angry and resentful.
- 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.
- Has been spiteful or vindictive at least twice within the past 6 months.
The Requirement of Distress
In addition to fulfilling the time and symptom requirement for the diagnosis, there is also the requirement of distress. In order to qualify as a diagnosis, the behaviors demonstrated by the child must result in distress. This distress may be experienced within the child or by others in the immediate social context, such as family or friends. This requirement may also be met if there is not apparent distress within the individual or immediate social context, but there are negative effects socially, educationally, occupationally, or in other important areas of functioning. For example, maybe the child, family, and friends are not distressed by the child’s behavior, but their grades are suffering and the child has very few friends. That would then fulfill the distress requirement.
We know that the child must meet time, symptom, and distress requirements in order to fulfill the criteria for an ODD diagnosis. However, they must also meet some exclusion criteria. This means that in addition to meeting the above requirements, it must also be found that the child’s behaviors are not occurring due to other mental health or physical health issues (such as psychosis, substance use, or depression).
What Does That All Mean?
So now you know the technical requirements for an ODD diagnosis, but what does that actually mean? An individual with a diagnosis of ODD often has a short temper, is angry often, is argumentative and defiant, has difficulty accepting responsibility for their actions, and may react out of spite. These symptoms sometimes show themselves only in one setting, such as the home, but may also be present over many different settings, such as school and home. If your child has an ODD diagnosis, you may find it odd that your child appears well behaved when they are not familiar with the people they are interacting with, but this is normal. The behaviors often show themselves more with people the child knows well. When it comes to those people, though, the child with ODD may have conflictual relationships with parents, teachers, friends, and romantic partners. This makes it difficult to have emotional, social, or academic success.
Individuals diagnosed with ODD sometimes have other conditions that are occurring at the same time. Most common is ADHD (attention-deficit/hyperactivity disorder) or conduct disorder. In addition to those conditions frequently occurring with ODD, individuals diagnosed with ODD are at a higher risk for attempting suicide, developing anxiety disorders, or developing major depressive disorder.
It May Not be ODD
If you’re reading this blog and seeing some of these symptoms in your child, please don’t freak out. The simple fact of the matter is that the symptoms of ODD are relatively common and are often seen in children who do not have this diagnosis. To have this diagnosis, a child must demonstrate the behaviors in excess of what would be considered “normal” for the child’s age, gender, and culture. Young children “act out” and throw temper tantrums, and teens talk back and act defiant as part of normal, age-appropriate behavior and development. So when does this behavior shift from “normal” to something to be concerned about? There are some signs to help you determine this. If your child’s behavior result in significant distress and impairment, such as if a teenager’s behavior results in property damage or a young child is asked to leave their preschool, there is reason for concern.
I’m Concerned. What Now?
If you or others in your child’s life have noted concern about their ability to regulate emotions and behavior, an evaluation with a mental health professional may be in order. You can schedule HERE with me. This evaluation will help you determine if there is cause for concern and, if so, what steps to take next to help. Know that there is hope. Even if your child has a diagnosis of ODD, with your support and the help of a mental health professional, your child can be successful.
Stay tuned for next week, where I will talk about some strategies to help your child who is displaying signs of ODD or just engaging in these behaviors as part of “normal” development.