Oppositional-Defiant Disorder - Criteria for diagnosis
A form of antisocial behavior disorder characterized by opposition to authority figures such as parents and teachers, and by excessive anger and hostility.
Depending on the population, 2-6% of children have oppositional-defiant disorder. Oppositional-defiant disorder is similar to conduct disorder, without the more severe behavior components of aggression, property destruction, deceit, and theft. Oppositional-defiant children often go on to develop conduct disorder. Many children, especially during transitional periods such as preschool and adolescence, exhibit transient oppositional behavior towards parents and peers that will decline as they mature. If oppositional behavior is initiated during adolescence in particular it is probably part of the child's process of individuation, and should not be mistaken for a disorder. Children with oppositional-defiant disorder (1) are oppositional much more frequently than other children of their age and (2) increase their oppositional behaviors rather than decrease them with age. Disobedience and hostility usually appear first in the home environment, and may or may not ever emerge in school settings. Oppositional-defiant disorder is more common in families where there is marital discord, where a parent has a history of an antisocial, mood, or attention disorder, and where child rearing practices are either harsh (punishing), inconsistent (a succession of different caregivers), or neglectful.
Criteria for diagnosis
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), oppositional-defiant disorder is diagnosed when (1) there is a pattern of defiant, disobedient, and hostile behavior towards authority figures lasting for at least six months, including frequent occurrence of at least four of the following behaviors;(2) the child exhibits the behaviors more frequently than other individuals of the same age or developmental level.
The child with oppositional-defiant disorder will:
- often lose his or her temper
- often argue with adults
- defy or refuse to comply with requests or rules
- deliberately do things that annoy other people
- blame others for his or her own mistakes
- be touchy or easily annoyed
- be angry and resentful
- be spiteful or vindictive.
Care should be taken to distinguish oppositional-defiant behavior that results from other problems, such as mood or psychotic disorders, attention deficit/hyperactivity disorder, mental retardation, and language disorders.
Bernstein, Neil I. Treating the Unmanageable Adolescent: A Guide to Oppositional Defiant and Conduct Disorders. Northvale, NJ: Jason Aronson, 1997.
Price, Jerome A. Power and Compassion: Working with Difficult Adolescents and Abused Parents. New York: Guilford Press, 1996.
Wenning, Kenneth. Winning Cooperation from Your Child!: A Comprehensive Method to Stop Defiant and Aggressive Behavior in Children. Northvale, NJ: J. Aronson, 1996.