Oppositional Defiance Disorder
(Odd)
Definition & Research
The essential feature of Oppositional Defiance Disorder is a frequent and persistent pattern of angry and irritable moods, argumentative and defiant behavior, or vindictiveness. It is not unusual for individuals with Oppositional Defiance Disorder to show the behaviourial features of the diagnosis without problems of negative mood. However, individuals with the disorder who show the angry/irritable mood symptoms typically show the behavioural features as well.
The symptoms of ODD may be confined to only one setting, and this is more frequently at home. Individuals who show enough symptoms to meet the diagnostic threshold, even if it is only at home, may be significantly impaired in their social functioning. However, in more severe cases, the symptoms of the disorder are present in multiple settings. Given the pervasiveness of symptoms is an indicator of the severity of the disorder, it is critical that the individual's behavior be assessed across multiple settings and relationships. Because these behaviors are common among siblings, they must be observed during interactions with persons other than siblings. Also, because symptoms of the disorder are typically more evident in interactions with adults or peers whom the individual knows well, they may not be apparent during a clinical examination.
The prevalence of ODD ranges from 1% to 11%, with an average of 3.3%. the rate of ODD may vary depending on the age and gender of the child. The disorder is more prevalent in males than in females (1.4:1) prior to adolescence.
The first symptoms of oppositional defiant disorder usually appear during the preschool years and rarely later than early adolescence. Oppositional defiant disorder often precedes the development of conduct disorder, especially for those with the childhood-onset type of conduct disorder. However, many children and adolescents with oppositional defiant disorder do not subsequently develop conduct disorder. Oppositional defiant disorder also conveys risk for the development of anxiety disorders and major depressive disorder, even in the absence of conduct disorder. The defiant, argumentative, and vindictive symptoms carry most of the risk for conduct disorder, whereas the angry-irritable mood symptoms carry most of the risk for emotional disorders.
Manifestations of the disorder across development appear consistent. Children and adolescents with oppositional defiant disorder are at increased risk for a number of problems in adjustment as adults, including antisocial behavior, impulse-control problems, substance abuse, anxiety, and depression.
Many of the behaviors associated with oppositional defiant disorder increase in frequency during the preschool period and in adolescence. Thus, it is especially critical during these development periods that the frequency and intensity of these behaviors be evaluated against normative levels before it is decided that they are symptoms of oppositional defiant disorder.
Rates of oppositional defiant disorder are much higher in samples of children, adolescents, and adults with ADHD, and this may be the result of shared temperamental risk factors. Also, oppositional defiant disorder often precedes conduct disorder, although this appears to be most common in children with the childhood-onset subtype. Individuals with oppositional defiant disorder are also at increased risk for anxiety disorders and major depressive disorder, and this seems largely attributable to the presence of the angry- irritable mood symptoms. Adolescents and adults with oppositional defiant disorder also show a higher rate of substance use disorders, although it is unclear if this association is in dependent of the comorbidity with conduct disorder. (taken from DSM-5)
The symptoms of ODD may be confined to only one setting, and this is more frequently at home. Individuals who show enough symptoms to meet the diagnostic threshold, even if it is only at home, may be significantly impaired in their social functioning. However, in more severe cases, the symptoms of the disorder are present in multiple settings. Given the pervasiveness of symptoms is an indicator of the severity of the disorder, it is critical that the individual's behavior be assessed across multiple settings and relationships. Because these behaviors are common among siblings, they must be observed during interactions with persons other than siblings. Also, because symptoms of the disorder are typically more evident in interactions with adults or peers whom the individual knows well, they may not be apparent during a clinical examination.
The prevalence of ODD ranges from 1% to 11%, with an average of 3.3%. the rate of ODD may vary depending on the age and gender of the child. The disorder is more prevalent in males than in females (1.4:1) prior to adolescence.
The first symptoms of oppositional defiant disorder usually appear during the preschool years and rarely later than early adolescence. Oppositional defiant disorder often precedes the development of conduct disorder, especially for those with the childhood-onset type of conduct disorder. However, many children and adolescents with oppositional defiant disorder do not subsequently develop conduct disorder. Oppositional defiant disorder also conveys risk for the development of anxiety disorders and major depressive disorder, even in the absence of conduct disorder. The defiant, argumentative, and vindictive symptoms carry most of the risk for conduct disorder, whereas the angry-irritable mood symptoms carry most of the risk for emotional disorders.
Manifestations of the disorder across development appear consistent. Children and adolescents with oppositional defiant disorder are at increased risk for a number of problems in adjustment as adults, including antisocial behavior, impulse-control problems, substance abuse, anxiety, and depression.
Many of the behaviors associated with oppositional defiant disorder increase in frequency during the preschool period and in adolescence. Thus, it is especially critical during these development periods that the frequency and intensity of these behaviors be evaluated against normative levels before it is decided that they are symptoms of oppositional defiant disorder.
Rates of oppositional defiant disorder are much higher in samples of children, adolescents, and adults with ADHD, and this may be the result of shared temperamental risk factors. Also, oppositional defiant disorder often precedes conduct disorder, although this appears to be most common in children with the childhood-onset subtype. Individuals with oppositional defiant disorder are also at increased risk for anxiety disorders and major depressive disorder, and this seems largely attributable to the presence of the angry- irritable mood symptoms. Adolescents and adults with oppositional defiant disorder also show a higher rate of substance use disorders, although it is unclear if this association is in dependent of the comorbidity with conduct disorder. (taken from DSM-5)
Behaviour
A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four of the following symptoms from any category. They must also be exhibited during interaction with at least one individual (who is not a sibling). (*The persistence and frequency of the below behaviours should be used to determine a behavior that is within normal limits from a behavior that is symptomatic)
Angry/Irritable Mood
Argumentative/Defiant Behaviour
Vindictiveness
(taken from DSM-5) *
Angry/Irritable Mood
- Often loses temper
- Is often touchy or easily annoyed
- Is often angry and resentful
Argumentative/Defiant Behaviour
- Often argues with authority figures (ie 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/her mistakes or misbehaviours
Vindictiveness
- Has been spiteful or vindictive at least twice within the past 6 months.
(taken from DSM-5) *
Strategies
- Reduce the power struggle caused by, threatening the student, responding emotionally (getting angry or sarcastic), confronting the student near their peers, responding quickly, remaining in the interaction too long, bribes, trying to “convince”, and putting down the student.
- Provide the student with simple directives and choices.
- State pre-determined consequences clearly before punishment occurs.
- Listen to the student before reacting.
- Give brief and direct instructions in a calm tone.
- Discuss the problem privately with the student.
- Walk away before the situation gets too “hot”
- Don't threaten unless you are willing to carry the threats out. Threatening students with ODD allows them to test your ability to follow through.
- Clearly define the behaviors you expect. Students with ODD search for the "gray area" to justify their actions.
- Clearly define the consequences of compliant and non-compliant behavior. This provides a direct relationship between the desired or undesired behavior and the respective consequence and prevents "fueling" an argument.
- Always be firm and consistent. Students with ODD are constantly looking for an "open gate" and an opportunity to challenge your directives or justify their position.
- During confrontations, do not allow your emotions to rule. With students with ODD, your anger demonstrates that they are in control.
- Build on the positive!
Resources
Teacher Resources
Strategies to Work with Students with Oppositional Defiant Disorder
This resources provides teachers with a list of strategies (highlighted above) to helps students with ODD in their classrooms. It also provides a useful list of things not to do.
Oppositional Defiant Disorder (ODD)
This resources acts a hub for different strategies that teachers can utilize. The bottom resources bar is also full of useful information about ODD.
Effective Teaching Strategies
This resources provides a comprehensive look and ODD in the classroom and provides additional strategies.
Oppositional Defiant disorder: Recommendations for Teachers and for Parents
This resources is intended for teachers and parents. It provides additional strategies which are further explained.
Oppositional Defiant Disorder Resource Centre
This resource defines ODD and has a list of FAQs that are informative. It is also from a teacher and parent perspective.
Learn Alberta
This resources is provided by Learn Alberta, and is intended for teachers and students.
This resources provides teachers with a list of strategies (highlighted above) to helps students with ODD in their classrooms. It also provides a useful list of things not to do.
Oppositional Defiant Disorder (ODD)
This resources acts a hub for different strategies that teachers can utilize. The bottom resources bar is also full of useful information about ODD.
Effective Teaching Strategies
This resources provides a comprehensive look and ODD in the classroom and provides additional strategies.
Oppositional Defiant disorder: Recommendations for Teachers and for Parents
This resources is intended for teachers and parents. It provides additional strategies which are further explained.
Oppositional Defiant Disorder Resource Centre
This resource defines ODD and has a list of FAQs that are informative. It is also from a teacher and parent perspective.
Learn Alberta
This resources is provided by Learn Alberta, and is intended for teachers and students.