Oppositional Defiant Disorder

What is Oppositional Defiant Disorder?

Oppositional Defiant Disorder (ODD) is a childhood behavioural problem characterized by a recurrent pattern of negativistic, hostile, and defiant behaviour toward parents and other authority figures that seriously interferes with the child’s day to day normal functioning. While most children are oppositional from time to time, children with ODD present regular uncooperative and rebellious behaviour. They often lose their temper, argue with adults, deliberately annoy people, actively defy adults’ requests or rules, and blame others for their own mistakes or misbehaviour. These behaviours occur more consistently and frequently when compared to other children of the same age, and significantly impair their academic, family, and social life. ODD is the most common disorder found in a child’s early developmental stage, and is estimated to occur in 2-16% in the general population. ODD behaviours can be found in children as young as three years of age, but normally manifest when the child is at primary school.  Defiance that is allowed to continue almost always gets worse, and can progress into conduct disorder (CD), which is a more severe form of oppositional behaviour that often appears during adolescence. Therefore, early treatment and management is important.

 What are the Symptoms of Oppositional Defiant Disorder? 

For an individual to be diagnosed with ODD, four or more of the following behavioural symptoms must be present for at least six months:
  • Often loses temper
  • Often argues with adults
  • Often actively defies or refuses to comply with adult requests
  • Often deliberately annoys others
  • Often blames others for his or her mistakes or poor behaviour
  • Often angry or resentful
  • Often touchy or easily annoyed
  • Often spiteful or vindictive
   

 Treatment 

Parental training: to improve parents’ interaction with their child, and to help parents better manage the child’s behaviour. This involves teaching parents behavioural techniques that discourage bad behaviour and reinforce good behaviour. Parental training is the main treatment for ODD and is the most effective as well. Given that parenting skills for children and adolescents are different, separate parental trainings would be required for children and adolescents with ODD.
Family psychotherapy: To teach all family members to communicate more effectively and to improve mutual understanding.
Individual psychotherapy: To help children with ODD develop more effective anger management skills.
Social skills training: To help children with ODD improve frustration tolerance with peers and improve social skills.