Oppositional defiant disorder is a recurring pattern of negative, defiant, and disobedient behavior, often directed at authority figures.

Children with oppositional defiant disorder are stubborn, difficult, and disobedient without being physically aggressive or actually violating the rights of others. Many preschool and early adolescent children occasionally display oppositional behaviors, but oppositional defiant disorder is diagnosed only if behaviors persist for 6 months or more and are serious enough to interfere with social or academic functioning. Most often, children develop this disorder by age 8.

Typical behaviors of these children include the following:

• Arguing with adults
• Losing their temper easily and often
• Actively defying rules and instructions
• Deliberately annoying people
• Blaming others for their own mistakes
• Being angry, resentful, and easily annoyed

These children do know the difference between right and wrong and feel guilty if they do anything that is seriously wrong.

Oppositional defiant disorder is best treated through behavior management techniques, which include a consistent approach to discipline and appropriate reinforcement of desired behavior. Parents and teachers can be instructed in these techniques by the child's counselor or therapist.

From time to time, children who have depression are mistakenly diagnosed with oppositional defiant disorder. This misdiagnosis most commonly happens when irritability is the main symptom of depression. Thus, when oppositional defiant disorder is diagnosed, all children should be carefully assessed for signs of depression, such as sleep or appetite disturbances.

Last full review/revision February 2009 by Hugh F. Johnston, MD