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What Leads To Oppositional Defiant Disorder & Can It Be Cured?

The oppositional defiant disorder (ODD) is a set of recurrent negative, provocative and disobedient behaviors, often directed against figures of authority.(1)

Children with this disorder are rebellious, difficult, disobedient and irritable without being physically aggressive or violating the rights of others. Oppositional defiant disorder is sometimes considered a milder form of behavioral disorder. However, these two disorders have notable differences. Children with a behavioral disorder appear to be not conscious about their behavior and, unlike children with oppositional defiant disorder, regularly violate the rights of others, sometimes without any sign of irritability.(1)(2)

Many preschoolers or early teens are provocative, but oppositional defiant disorder is only diagnosed if the disorder persists for more than 6 months and disrupts the social or school functioning of the sufferer.

What Leads To Oppositional Defiant Disorder?

It is not known what causes oppositional defiant disorder. It is probably more common in children from families in which adults have violent arguments. This disorder suggests underlying issues that may need more testing and therapy.

The oppositional defiant disorder is thought to be caused by a combination of social, mental, and biological factors. Oppositional defiant disorder is susceptible to exposure to families with ADHD or mood disorders such as depression or bipolar disorder.

The etiology of oppositional defiant disorder is unknown, but it is probably more common in children from families in which adults produce a model of conflicts and controversial interpersonal relationships. The diagnosis must rather be directed as an indicator of underlying issues that may need additional assessment and care rather than as a correct diagnosis of the oppositional defiant disorder.

You must understand that this tendency to oppose is not intentional in hyperactive children. According to specialists, this lack of discipline is closely linked to his extreme impulsiveness and is, therefore, an integral part of the symptoms of ADHD. It would thus implicate dysfunction of neurotransmitters in the prefrontal cortex level of the child’s brain and would be the result of three factors combined:

  • Inability to control impulses;
  • A feeling of frustration with repeated failures despite efforts;
  • Constant stress during exercise.

There is also the possibility of other co-existing disorders (isolation, depression, anxiety) which explains the child’s need for this self-destructive attitude, both physically and verbally, causing oppositional defiant disorder. It is therefore important to adapt the care according to the child’s real needs and the precise nature of his problem.(2)

Can Oppositional Defiant Disorder Be Cured?

Behavior management techniques such as group therapy are effective in most cases. It is important to identify the issues that might reinforce these symptoms (such as family dysfunction or ADHD) and should be treated or addressed as much as possible.

Oppositional defiant disorder is effectively treated by behavioral techniques, which include strict discipline and encouraging the desired behavior (with rewards). Parents and teachers can learn these techniques from a therapist.

Children can benefit from group therapy that helps them improve their social skills. Medications used for depressive or anxiety disorders can be helpful in extreme cases. In many cases, even without treatment, oppositional defiant disorder may improve over time. (4)(5)


Generally, children with oppositional defiant disorder tend to do the following:

  • Lose their composure easily and repeatedly
  • Arguing with adults and challenging adults
  • Refuse to obey rules deliberately and annoy other people intentionally
  • Blame others for their own mistakes or bad behaviors
  • Being easily annoyed and irritated
  • Being mean or vengeful
  • Many affected children have deficits in social skills. (2)(3)

Diagnosis Of Oppositional Defiant Disorder

Doctors diagnose oppositional defiant disorder based on the child’s symptoms and behavior, which must have been present for at least 6 months and be severe enough to interfere with their ability to carry on normal life.

When an oppositional defiant disorder is suspected, doctors thoroughly assess all children for signs of depression, such as sleep and appetite disorders, and anxiety. In children, depression and anxiety disorders can cause symptoms similar to those of oppositional defiant disorder. For example, sometimes the main symptom of depression is irritability, and extreme anxiety can cause children with anxiety disorders to disobey or be provocative. Doctors must differentiate these disorders from oppositional defiant disorder, by examining the other symptoms which are linked to it.

Doctors should also differentiate oppositional defiant disorder from untreated ADHD, which can also cause similar symptoms. If it is ADHD, these symptoms usually improve when appropriate treatment is started. (3)(4)


  1. Lockwood W. Oppositional Defiant Disorder (ODD). 2018.
  2. Riley M, Ahmed S, Locke A. Common questions about oppositional defiant disorder. American family physician. 2016;93(7):586-591.
  3. 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.
  4. Kimonis ER, Frick PJ, McMahon RJ. Conduct and oppositional defiant disorders. 2014.
  5. Booker JA, Capriola-Hall NN, Dunsmore JC, Greene RW, Ollendick TH. Change in maternal stress for families in treatment for their children with oppositional defiant disorder.
  6. Journal of child and family studies. 2018;27(8):2552-2561.

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:March 4, 2020

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