Is Defiance A Symptom Of ADHD & Can You Have Oppositional Defiant Disorder Without ADHD?

ADHD is known as Attention Deficit Hyperactivity Disorder where the individual has differences in brain development and brain activity, and these differences affect attention, focus, self-control, and ability to stay calm or still.(1)

On the other hand, the ODD or oppositional defiant disorder is a childhood illness that is identified by patterns of aggressive, unlawful, and challenging behavior against adults or other personalities in power. Oppositional defiant disorder is also characterized by anger and irritability in children, as well as repetitive fighting.(1)

Is Defiance A Symptom Of ADHD?

Is Defiance A Symptom Of ADHD?

Attacks of anger and resistance are not symptoms of ADHD but are usually the result of symptoms of ADHD. Lack of attention and impulsivity can make it difficult for the child to withstand repeated tasks, request of a lot of work, or make the child feel bored. Children with ADHD can pay attention when they do what they like or hear about the topics they care about. They do not have difficulty in focusing on these tasks. But when tasks are repetitive or boring, they appear restless quickly.(1)

Can You Have Oppositional Defiant Disorder Without ADHD?

Oppositional defiant disorder is related to children’s behavior and how they interact with family, teachers, and peers. ADHD is a neurodevelopmental disorder where several provocative symptoms may be related to oppositional defiant disorder. In fact, about 40% of children with ADHD are believed to have oppositional defiant disorder. But there is also always the possibility of children having oppositional defiant disorder and no ADHD.(1)(2)

To have oppositional defiant disorder, the child must display four symptoms from one of the following categories. Oppositional defiant disorder children do not have violent behavior against individuals or animals, damage property, or display some history of fraud or theft unlike those with behavioral disorders.

These symptoms also need to be maintained for more than six months and have to be compared with the normal behavior of children to make the diagnosis.

  • Angry and annoyed by others.
  • Blame others for their own mistakes.
  • Indulge in frequent arguments.
  • Often, they are in a bad mood.
  • Performing targeted actions to annoy others.
  • Refusal to comply with the majority of requests or consensus-based rules.
  • Sensitive or slightly upset.
  • Spiteful or seeks revenge.

These behavior patterns lead to impairment in school and other social opportunities.

Common characteristics of oppositional defiant disorder are exaggerated, often persistent anger, frequent tantrums or outbursts as well as disregard for authority. Children and adolescents with oppositional defiant disorder often deliberately annoy others, blame others for their own mistakes, and are easily disturbed. Parents often observe rigid and irritable behavior with their siblings. In addition, these children may seem upset about others, and if someone does something, they do not prefer sensitive solutions over revenge.

For a child or adolescent to qualify for a diagnosis of oppositional defiant disorder, these behaviors must cause significant family distress or considerably interfere with academic or social functioning. Disorders could take the form of preventing the child or adolescent from learning at school or friendships or placing him or her in threatening situations.

This behavior must also last for at least six months. The effects of oppositional defiant disorder can be greatly exacerbated by other comorbidities such as ADHD. Other common comorbid conditions are depression and substance disorders. (3)

Causes Of Oppositional Defiant Disorder

The exact cause of oppositional defiant disorder is unknown, but it is believed that a combination of biological, psychological, and environmental factors can contribute to the condition. (4)

Diagnosis Of Oppositional Defiant Disorder

Oppositional defiant disorder was first defined in the DSM-III. Since the introduction of the oppositional defiant disorder as an independent disease to inform the field trials, the definition of this disease has mostly included male subjects. Some clinicians have discussed whether the diagnostic criteria outlined above would be clinically relevant for use with females. In addition, some have raised the question of whether gender criteria and thresholds should be included. Some clinicians have questioned the exclusion of the oppositional defiant disorder on CD.

Management Of Oppositional Defiant Disorder

One of the most important factors in developing and maintaining the negative behaviors associated with oppositional defiant disorder symptoms is an improvement, whether intentional or not, of the undesirable behaviors. The most effective way to treat oppositional defiant disorder is behavioral therapy. Behavioral therapy for children and adolescents mainly focuses on how to inadvertently prevent problematic thoughts or behaviors from increasing unconsciously around a young person. (5)

References:

  1. Harvey EA, Breaux RP, Lugo-Candelas CI. Early development of comorbidity between symptoms of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Journal of abnormal psychology. 2016;125(2):154.
  2. Noordermeer SD, Luman M, Oosterlaan J. A systematic review and meta-analysis of neuroimaging in oppositional defiant disorder (ODD) and conduct disorder (CD) taking attention-deficit hyperactivity disorder (ADHD) into account. Neuropsychology review. 2016;26(1):44-72.
  3. Kimonis ER, Frick PJ, McMahon RJ. Conduct and oppositional defiant disorders. 2014.
  4. Lee S, Burns GL, Beauchaine TP, Becker SP. Bifactor latent structure of attention-deficit/hyperactivity disorder (ADHD)/oppositional defiant disorder (ODD) symptoms and first-order latent structure of sluggish cognitive tempo symptoms. Psychological Assessment. 2016;28(8):917.
  5. Kazdin AE. Problem-solving skills training and parent management training for opposition defiant disorder and conduct disorder. 2010.

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