Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2008;78(7):867-868

See related article on oppositional defiant disorder.

What is oppositional defiant disorder?

Oppositional defiant (ah-puh-ZISH-uh-null dee-FIE-ant) disorder is a behavior condition that affects children and teens. Those who have it act negative, angry, and defiant much more often than other people their age. These behaviors have a negative effect on the child's or teen's relationships and ability to do well in school and at home.

What are the symptoms?

Often, children and teens with this disorder:

  • Lose their temper

  • Argue with or defy adults

  • Refuse to follow rules

  • Annoy other people on purpose

  • Blame others for their own mistakes or bad behavior

  • Are touchy or easily annoyed by others

  • Are angry and resent other people

  • Want to get revenge on others

What causes it?

The exact cause is not known. It probably results from a combination of several causes. The child's general attitude and how the family reacts to his or her behavior may be part of the cause. The disorder may run in families. Other causes may be related to the nervous system or to brain chemicals that are out of balance.

How is it diagnosed?

Your doctor will ask about your child's symptoms, medical history, family history, and other emotional or behavioral problems. Your doctor may want to refer your child to a doctor specializing in problem behavior for a more in-depth evaluation.

How is it treated?

There are several treatment options. Some focus only on the child; others also include the child's family and school.

Children can learn better ways to manage their anger. They can also learn how to handle social situations so they will feel less frustrated with others their age.

Families can learn to communicate better with each other. Parents can also learn to manage their child's behavior and to use discipline effectively.

In a treatment called cognitive behavior therapy, children and their families learn problem-solving skills and how to feel more positive.

How can I prevent this disorder?

Even though there are no specific guidelines on how to prevent this disorder, there are some general resources that can be helpful if your child has risk factors. A few books for parents include:

  • The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children, by Ross W. Greene (Harper, 2005)

  • Transforming the Difficult Child: The Nurtured Heart Approach, by Howard Glasser and Jennifer Easley (Center for the Difficult Child Publications, 1998)

  • The Parent's Handbook: Systematic Training for Effective Parenting, by Don C. Dinkmeyer and Gary D. McKay (American Guidance Service, 1989)

  • Parent Effectiveness Training: The Proven Program for Raising Responsible Children, by Dr. Thomas Gordon (Three Rivers Press, 2000)

Where can I get more information?

Your doctor

The American Academy of Child and Adolescent Psychiatry (an online forum for parents with hard-to-parent children)

Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) in Children and Adolescents: Diagnosis and Treatment (an online pamphlet written by psychiatrist Jim Chandler, MD, FRCPC)

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