Oppositional Defiant Disorder (ODD): Symptoms & Treatment (2024)

What is oppositional defiant disorder (ODD)?

Oppositional defiant disorder (ODD) is a behavior condition in which your child displays a continuing pattern of uncooperative, defiant and sometimes hostile behavior toward people in authority. This behavior often disrupts your child’s normal daily functioning, including relationships and activities within their family and at school.

It’s common for children — especially those two to three years old and in their early teens — to be oppositional or defiant of authority once in a while. They might express their defiance by arguing, disobeying or talking back to adults, including their parents or teachers. When this behavior lasts longer than six months and goes beyond what’s usual for your child’s age, it might suggest that they have ODD.

The majority of children and teens who have ODD also have at least one other mental health condition, including:

• Attention-deficit hyperactivity/disorder (ADHD).
• Anxiety disorders, including obsessive-compulsive disorder (OCD).
• Learning differences.
• Mood disorders, such as depression.
• Impulse control disorders.

About 30% of children with ODD develop a more serious behavior condition called conduct disorder. ODD behaviors can continue into adulthood if ODD isn’t properly diagnosed and treated.

What is conduct disorder?

Conduct disorder (CD) is a condition in which your child or adolescent shows an ongoing pattern of aggression toward others. They also show serious violations of rules and social norms at home, in school and with peers.

These rule violations may involve breaking the law. Children with CD are more likely to get injured and may have difficulties getting along with peers.

Signs of conduct disorder include:

• Frequently breaking serious rules, such as running away from home, staying out at night when told not to or skipping school.
• Being aggressive in a way that causes harm, such as bullying, fighting or being cruel to animals.
• Lying, stealing or damaging other people’s property on purpose.

What’s the difference between ODD and ADHD?

Approximately 40% of children with attention-deficit/hyperactivity disorder (ADHD) also have oppositional defiant disorder or a related conduct disorder. While these two conditions commonly occur together, they’re distinct conditions.

ODD is related to a child’s conduct and how they interact with their parents, siblings, teachers and friends. ADHD is a neurodevelopmental disorder that causes a person to be easily distracted, disorganized and excessively restless.

Who does oppositional defiant disorder affect?

ODD most commonly affects children and teenagers, but it can also affect adults. It most commonly begins by age 8.

Some children outgrow ODD or receive proper treatment for it, while others continue to have symptoms through adulthood.

Children assigned male at birth (AMAB) are more likely to have ODD in their younger years than children assigned female at birth (AFAB). But teenagers who were AMAB and AFAB are affected equally.

Your child is more likely to develop ODD if they have the following risk factors:

• A history of child abuse or neglect.
• A parent or caregiver who has a mood disorder or who has substance or alcohol use disorders.
• Exposure to violence.
• Inconsistent discipline and lack of adult supervision.
• Instability in their family, such as divorce, moving to different houses often and changing schools frequently.
• Financial problems in their family.
• Parents who have or have had ODD, attention-deficit/hyperactivity disorder (ADHD) or behavioral problems.

How common is oppositional defiant disorder?

Researchers estimate that oppositional defiant disorder affects 2% to 11% of children. This range is so wide because some children may be misdiagnosed as having conduct disorder, and teenagers, as a population, are often underdiagnosed.

The prevalence of ODD declines with increasing age.