Oppositional Defiant Disorder

Oppositional Defiant Disorder

Authored by Pin Ng PhD

Edited by Hugh Soames

Reviewed by Michael Por, MD

What is Oppositional Defiant Disorder?


Parents may experience living with a teenager that is defiant some of the time. It can put a strain on their relationship causing a wedge to be driven between them. Many parents can assume there is a problem with their child due to being oppositional.1https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3917664/ However, children who are defiant show a healthy sign of development in their relationships with their parents.

A parent not used to their child being suddenly defiant can be alarmed. It may send them searching for a reason for the new behavior. Parents may find that oppositional defiant disorder is very similar to what they experience from their child. There is a difference to oppositional defiant disorder and children just being merely defiant as they grow into their teen years.

Mental health specialists explain that oppositional defiant disorder involves issues relating to the control of emotions and behaviors. The disorder includes aggression, arguing, conflict, and the destruction of property.2https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5716335/

Teen challenges vs. Oppositional defiant disorder


Teenagers can often struggle to find the right fit at school, home, and in their personal lives. Individuals go through rapid changes during their teenage years as their bodies develop on the inside and outside. Many teens with new freedoms will push back against parents and challenge the established rules parents have set out.

Families may have to deal with a variety of issues as their children grow up. However, teens challenging their parents’ rules are different than in young people dealing with oppositional defiant disorder. The biggest differences between the two areas lies in the frequency, persistence, and prevalence of defiance through different situations.3https://journals.sagepub.com/doi/abs/10.1177/1048371317708326

Parents need to account for their teenager’s age, gender, and any cultural issues that may exist. In addition, defiance can occur due to trauma or delays in a person’s development. Oppositional defiant disorder is often diagnosed by mental health specialists when a child is of early elementary school age.4https://www.jaacap.org/article/S0890-8567(09)60838-8/abstract Diagnosis often end around adolescence.5https://medlineplus.gov/ency/article/001537.htm

Children suffering from oppositional defiant disorder often have an established pattern of problem behaviors. Oppositional defiant disorder symptoms may include:


  • Child is often angry and irritable
  • Quick and frequent losing of temper
  • Becoming easily annoyed
  • Verbally fighting with authority figures
  • Refusing to follow established rules
  • Deliberately harassing or annoying people
  • Blaming other people for mistakes
  • Being vindictive


Does oppositional defiance disorder only appear in boys?


Symptoms are different in boys and girls. Although the difference is small, boys can show more physical aggression. Boys can have explosive tempers and show acts of violence. This can lead to the destruction of property or fighting.6https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0159323

Girls can show similar signs of aggression and angry.7https://pubmed.ncbi.nlm.nih.gov/22047856/ Parents may find their daughters to be more manipulative, tell more lies, and refuse to cooperate. Minor disputes can escalate and self-harm threats can be made with the claim of committing suicide.

Parents can feel overwhelmed with a child displaying oppositional defiance disorder. A family therapist can help parents come to terms with their child’s mental health.8https://www.mayoclinic.org/diseases-conditions/oppositional-defiant-disorder/symptoms-causes/syc-20375831 A child will be referred to a residential center by a mental health professional to get the help they need.

References: Oppositional Defiant Disorder

  1. Burke JD, Hipwell AE, Loeber R. Dimensions of oppositional defiant disorder as predictors of depression and conduct problems in preadolescent girls. Journal of the American Academy of Child and Adolescent Psychiatry. 2010;49:484–492. [PubMed] []
  2. Matthys W, Vanderschuren LJMJ, Schutter DJLG, Lochman JE. Impaired neurocognitive functions affect social learning processes in oppositional defiant disorder and conduct disorder: Implications for interventions. Clinical Child and Family Psychology Review. 2012;15:234–246. [PubMed] []
  3. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders. 2nd ed. Arlington, VA: APA; 1972. []
  4. Rutter M, Shaffer D. DSM-III: a step forward or back in terms of the classification of child psychiatric disorders? J Am Acad Child Psychiatry. 1980;19(3):371–394. [PubMed] []
  5. Frick PJ, Lahey BB, Applegate B, et al. DSM-IV field trials for the disruptive behavior disorders: symptom utility estimates. J Am Acad Child Adolesc Psychiatry. 1994;33(4):529–539. [PubMed] []
  6. Rowe R, Maughan B, Pickles A, Costello EJ, Angold A. The relationship between DSM-IV oppositional defiant disorder and conduct disorder: findings from the Great Smoky Mountains Study. J Child Psychol Psychiatry. 2002;43(3):365–373. [PubMed] []
  7. Farrington DP, Loeber R, Stouthamer-Loeber M, Kammen WB, Schmidt L. Self-reported delinquency and a combined delinquency seriousness scale based on boys, mothers, and teachers: concurrent and predictive validity for African-Americans and Caucasians. Criminology. 1996;34(4):493–517. []
  8. Mayes SD, Waxmonsky JD, Calhoun SL, Bixler EO. Disruptive mood dysregulation disorder symptoms and association with oppositional defiant and other disorders in a general population child sample. J Child Adolesc Psychopharmacol. 2016;26(2):101–106. [PubMed] []
  9. Polderman TJ, Benyamin B, de Leeuw CA, et al. Meta-analysis of the heritability of human traits based on fifty years of twin studies. Nat Genet. 2015;47(7):702–709. [PubMed] []
  10. Ficks CA, Waldman ID. Candidate genes for aggression and antisocial behavior: a meta-analysis of association studies of the 5HTTLPR and MAOA-uVNTR. Behav Genet. 2014;44(5):427–444. [PubMed] []
  11. Blair RJ, Lee TM. The social cognitive neuroscience of aggression, violence, and psychopathy. Soc Neurosci. 2013;8(2):108–111. [PubMed] []
  12. Sarkar S, Craig MC, Catani M, et al. Frontotemporal white-matter microstructural abnormalities in adolescents with conduct disorder: a diffusion tensor imaging study. Psychol Med. 2013;43(2):401–411. [PubMed] []
  13. Zepf FD, Gaber TJ, Bubenzer S, et al. Reduced central nervous 5-HT neurotransmission in youth with ADHD influences ratings of a virtual opponents’ extraversion: effects of trait-aggression. J Pediatr Sci. 2011;3(2):e73. []
  14. Gavita OA, Celin A. Rational stories versus rational parenting program for the treatment of child psychopathology: efficacy of two formats of rational-emotive behavior therapy. J Cogn Behav Psychother. 2013;13(1):33–56. []
  15. Masi G, Milone A, Manfredi A, Brovedani P, Pisano S, Muratori P. Combined pharmacotherapy-multimodal psychotherapy in children with disruptive behavior disorders. Psychiatry Res. 2016;238:8–13. [PubMed] []
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