Oppositional Defiant Disorder

In the previous post, I introduced Disruptive, Impulse-Control, and Conduct Disorders. I described them as disorders involving difficulties in self-regulation of both behaviors (that violate the rights of others and social norms) and emotions (such as anger).

It is possible to outline a spectrum: on one end, we have a stronger focus on behavioral control (Conduct Disorder), and on the other end, a stronger focus on anger control (Intermittent Explosive Disorder). In the middle lies Oppositional Defiant Disorder, with symptoms more or less evenly distributed between these two poles.
Today, I will explain this disorder in my own words.

Individuals with Oppositional Defiant Disorder easily enter into conflict. Moreover, they do not recognize that they are full of anger or that they are the cause of arguments, nor do they perceive themselves as defiant. On the contrary, they attribute responsibility to others for getting into heated discussions and, in general, for their own mistakes.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Oppositional Defiant Disorder is characterized by:

• Being visibly angry and/or irritable, with clearly provocative or even vindictive behaviors. In children under 5 years old, such behaviors occur almost daily, while in individuals aged 5 and above, the frequency is at least once per week. In both cases, the behaviors persist for at least 6 months. Moreover, these problematic interactions are not limited to siblings but also involve others.
• The disorder causes significant personal and social distress.
• The symptoms cannot be better explained by another condition.

Additionally, the DSM-5 specifies that at least 4 out of the following 8 symptoms must be present:

Angry/Irritable Mood
1. Often loses temper
2. Is often touchy or easily annoyed
3. Is often angry or resentful

Defiant/Argumentative Behavior
4. Often argues with authority figures or adults
5. Often actively defies or refuses to comply with requests from authority figures
6. Often deliberately annoys others
7. Often blames others for their own mistakes or misbehavior

Vindictiveness
8. Has been spiteful or vindictive at least twice in the past 6 months.

Sources:

• American Psychiatric Association (2013) – Diagnostic and Statistical Manual of Mental Disorders (5th ed.)
• Bernhill, J. W. (2014) – DSM-5 Clinical Cases

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