NIH - Medical Encyclopedia Oppositional Defiant Disorder

"Oppositional defiant disorder is a pattern of disobedient, hostile, and defiant behavior toward authority figures. To fit this diagnosis, the pattern must persist for at least 6 months and must go beyond the bounds of normal childhood misbehavior.

Symptoms: • Arguing with adults • Loss of temper • Angry and resentful of others • Actively defies adults' requests • Spiteful or vindictive behavior • Blames others for own mistakes • Is touchy or easily annoyed • Few or no friends or loss of previous friends • Constant trouble in school ...

Possible Complications: In a significant proportion of cases, the adult condition of conduct disorder can be traced back to the presence of oppositional defiant disorder in childhood ...

Prevention: Consistency in rules and fair consequences should be practiced in the child's home. Punishments should not be overly harsh or inconsistently applied. Appropriate behaviors should be modeled by the adults in the household. Abuse and neglect increase the chances that this condition will occur. "

Highlighted Articles

Oppositional defiant disorder. (Aust Fam Physician. 2008) “DISCUSSION: Many of the behaviours required to meet this diagnosis are not uncommon in the preschool child or adolescent. However, in children with ODD the behaviours are persistent, cause significant distress to the family system, and impact on the child's social and educational functioning. Oppositional defiant disorder usually presents in the preschool years, although it may become evident during adolescence. There is strong evidence that early intervention to increase positive factors in family relationships and to increase both the parents' and child's skill levels can assist in the prevention of more serious disorders and mental health issues.”

Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: results from the National Comorbidity Survey Replication. (J Child Psychol Psychiatry. 2007) "Results: Lifetime prevalence of ODD is estimated to be 10.2% (males = 11.2%; females = 9.2%). Of those with lifetime ODD, 92.4% meet criteria for at least one other lifetime DSM-IV disorder, including: mood (45.8%), anxiety (62.3%), impulse-control (68.2%), and substance use (47.2%) disorders. ODD is temporally primary in the vast majority of cases for most comorbid disorders. Both active and remitted ODD significantly predict subsequent onset of secondary disorders even after controlling for comorbid conduct disorder (CD). Early onset (before age 8) and comorbidity predict slow speed of recovery of ODD. Conclusions: ODD is a common child- and adolescent-onset disorder associated with substantial risk of secondary mood, anxiety, impulse-control, and substance use disorders. These results support the study of ODD as a distinct disorder."

NIH - Medical Encyclopedia Conduct Disorder

"Conduct disorder, a disorder of childhood and adolescence, involves chronic behavior problems, such as defiant, impulsive, or antisocial behavior; drug use; or criminal activity.

Causes: Conduct disorder has been associated with family conflicts, child abuse, poverty, genetic defects, and parental drug addiction or alcoholism. The diagnosis is more common among boys and is estimated to be as high as 10%. However, because many of the qualities necessary to make the diagnosis (such as "defiance" and "rule breaking") can be subjective, it is hard to know how common the disorder really is. For accurate diagnosis, the behavior must be far more extreme than simple adolescent rebellion or boyish exuberance. Conduct disorder is often associated with attention-deficit disorder, and the two together carry a major risk for alcohol and/or other drug dependence. Children with conduct disorder tend to be impulsive, difficult to control, and unconcerned about the feelings of others ...

Symptoms: Cruel or aggressive behavior toward people and animals • Destruction of property, including fire setting • Lying, truancy, running away • Vandalism, theft • Heavy drinking and/or heavy illicit drug use • Breaking rules without apparent reason • Antisocial behaviors, such as bullying and fighting ...

Possible Complications: Children with conduct disorder may go on to develop personality disorders as adults, particularly antisocial personality disorder. As their behaviors worsen, these individuals may also develop significant drug and legal problems.

When to Contact a Medical Professional: See your health care provider if your child seems to be overly aggressive, is bullying others, is being victimized, or continually gets in trouble. Early treatment may help."

Highlighted Articles

A 30-Year Prospective Follow-up Study of Hyperactive Boys With Conduct Problems: Adult Criminality. (J Am Acad Child Adolesc Psychiatry. 2007)

"CONCLUSIONS: Hyperactive/ADHD boys with conduct problems are at increased risk for adult criminality. Hyperactive boys without childhood conduct problems are not at increased risk for later criminality. An intensive 3-year MMT treatment of 6- to 12-year-old hyperactive boys is insufficient to prevent later adult criminality."

From conduct disorder to severe mental illness: associations with aggressive behaviour, crime and victimization. (Psychol Med. 2007)

"CONCLUSIONS: Men and women with severe mental illness who have a history of CD by mid-adolescence are at increased risk for aggressive behaviour and violent crime. These patients are easily identifiable and may benefit from learning-based treatments aimed at reducing antisocial behaviour. Longitudinal, prospective investigations are needed to understand why CD is more common among people with than without schizophrenia."