Oppositional Defiant Disorder

About Oppositional Defiant Disorder

DSM-V criteria for Oppositional Defiant Disorder

Oppositional Defiant Disorder is a psychological disorder where the individual, usually a child, exhibits angry mood, defiant behaviour, and/or vindictiveness. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), oppositional defiant disorder is characterised by at least four symptoms belonging to one or more of the angry/irritable mood, argumentative/defiant behaviour, and the vindictiveness categories.

Symptoms of angry/irritable mood:

  • Loses their temper easily
  • Easily becomes touchy or annoyed
  • Feels angry and resentful

Symptoms of argumentative/defiant behaviour:

  • Frequent arguments with authoritative figures (in children) or adolescents (in adults)
  • Refusing to obey orders and rules from authoritative figures
  • Deliberately irritating others
  • Blaming others for their mistakes

Vindictiveness:

  • Feelings of spitefulness or wanting to take revenge

These symptoms must have persisted for at least six months and be exhibited in at least two different settings (eg. School and home) to at least one other individual (eg. A sibling or a classmate).

In many cases, a child suspected of having oppositional defiant disorder may not display these symptoms during a psychologist’s examination. Hence diagnosis of the disorder usually requires self-reporting of symptoms from individuals the child interacts with often, such as their parents or schoolteachers.

Prevalence of ODD

The prevalence of oppositional defiant disorder is about 3.3%, with a slightly higher prevalence rate in males.

Comorbidity with ODD

Oppositional defiant disorder is most commonly comorbid with Attention Deficit Hyperactivity Disorder (ADHD) and may develop into Conduct Disorder at a later age. As adults, they are more at risk of developing substance use disorders, antisocial personality disorders, and mood disorders.

Cognitive issues that may be associated with Oppositional Defiant Disorder

Children with oppositional defiant disorder have been found to display poorer performance on tasks requiring them to infer others’ emotions, indicating deficits in their social cognition abilities and theory of mind (ToM). They made more errors when interpreting social situations and, when faced with social problems they had to solve, often proposed solutions that required the use of violence. In addition, more profound deficits in inferring others’ emotional mental states is related to a higher likelihood of them going on to develop conduct disorder.

For both oppositional defiant disorder and conduct disorder, there has been some evidence to suggest that impaired executive functioning is another cognitive issue associated with the disorders. They have poorer working memory and attention than children without the disorder. Most notably, when placed under stressful conditions, children with oppositional defiant disorder or conduct disorder were unable to adapt to the environment and as a result, their performance on executive functioning tasks was affected negatively.