Signs & Symptoms of Oppositional Defiant Disorder

Learn more about the causes, symptoms, and effects of oppositional defiant disorder. Understanding what you or your loved one is going through can be the first step to getting help.

Understanding Oppositional Defiant Disorder

Learn about oppositional defiant disorder

A persistent pattern of extremely difficult and challenging behaviors, including tantrums, arguing, and a general display of disruptive behavior, are all symptoms that define oppositional defiant disorder (ODD). In most instances, these disruptive, disobedient, defiant, and often hostile behaviors are directed at parents, teachers, or other adults that are in a position of authority. However, their inappropriate behaviors can also affect others around them. Unlike the difficult or challenging behavior that is normally displayed throughout childhood, the behavior associated with ODD is so severe that it ends up leading to significant disruption in an individual’s life.

This mental health condition is usually diagnosed in childhood or early adolescence, but has the potential to persist into adulthood, particularly if it is left untreated. However, if proper treatment is sought, those with ODD can learn the skills needed to manage their symptoms, engage in more appropriate behaviors, and experience a greater sense of wellbeing.

Causes and Risk Factors

Causes and risk factors for oppositional defiant disorder

An exact cause for oppositional defiant disorder has to this day, still not been identified, but some factors that could possibly contribute to its development may be a combination of both inherited and environmental factors. Possible causes and their explanations are listed below:

Genetic: Many children with oppositional defiant disorder have family members who have certain mental health conditions, including mood disorders, depression, or anxiety, which may contribute to the development of ODD. This information suggests that a vulnerability for developing ODD may, in fact, be inherited.

Physical: Another common hypothesis is that an imbalance of certain chemicals in the brain, such as serotonin, play a role in the development of ODD. When not properly balanced, these brain chemicals can prevent people from being able to regulate their emotions, control impulses, and manage their behavior, which could trigger the onset of ODD symptoms.

Environmental: Environmental factors have always been thought to play a significant role in the development of a mental health disorder including oppositional defiant disorder. The environments in which individuals spend a great deal of time are believed to have an impact on one’s susceptibility to developing oppositional defiant disorder. Any stressful changes that disrupt an individual’s sense of stability in life can increase the risk of the development of disruptive behavior. Some examples of such disruptions can include multiple moves, parental divorce, changing schools often, or constantly changing child care providers.

Risk Factors:

  • Being male
  • Natural disposition
  • Lack of supervision from caretakers
  • Inconsistent or harsh discipline
  • Presence of developmental delays
  • Family history of mental health conditions and/or personality disorders
  • Being the victim of abuse or neglect
  • Growing up in a chaotic environment
  • Exposure to violence, especially in early childhood
  • Being exposed to highly stressful environments on a consistent basis
  • Personal or family history of abusing substances

Signs and Symptoms

Signs and symptoms of oppositional defiant disorder

While at times it may be hard to distinguish the difference between a strong-willed child and one who has oppositional defiant disorder, there are a number of symptoms that arise when this disorder is present. Signs and symptoms of ODD tend to appear before a child turns 8 years old, beginning gradually and then worsening over time. The following are symptoms that are often exhibited by someone with ODD:

Behavioral symptoms:

  • Constant temper tantrums
  • Being argumentative with adults and/or figures of authority
  • Chronic disobedience
  • Lacking proper social skills
  • Refusing to comply with rules or requests
  • Deliberately annoys others
  • Blames others for one’s own mistakes or bad behavior
  • Is spiteful or vindictive
  • Acts aggressively toward peers
  • Frequent angry outbursts
  • Swearing or using obscene language
  • Consistently says mean or hateful things when upset
  • Social withdrawal or isolation
  • Drug and/or alcohol abuse
  • Having difficulty making or keeping friends
  • Intentionally destroying relationships
  • Consistently uncooperative
  • Engages in instigative behaviors

Physical symptoms:

  • Chronic headaches
  • Muscle tension
  • Accelerated heart rate
  • Increased blood pressure
  • Physical injuries resulting from violent or self-harming behaviors

Cognitive symptoms:

  • Problems concentrating
  • Poor, or lack of, decision-making skills
  • Lack of proper impulse control

Psychosocial symptoms:

  • Easily frustrated
  • Tendency to be moody
  • Low self-esteem
  • Extreme agitation
  • Irritability
  • Feelings of hostility
  • Feelings of resentfulness
  • Persistently negative attitude
  • Pervasive feelings of annoyance
  • Suicidal ideation


Effects of oppositional defiant disorder

When individuals with oppositional defiant disorder are not provided with the opportunity to get the proper treatment and support they need, they often experience a number of ill effects in their lives. The following are examples of effects that could potentially occur when the symptoms of ODD are not treated:

  • Inability to meet work requirements
  • Regular disciplinary actions being taken at school
  • Social isolation
  • Conflict within the family
  • Interaction with law enforcement
  • Suspension or expulsion
  • Scholastic failure
  • Rejection by peers
  • Failure to develop and  maintain healthy, meaningful interpersonal relationships
  • Low self-esteem and overall sense of self-worth
  • Engagement in dangerous, high risk behaviors
  • Self-harming behaviors
  • Development of conduct disorder
  • Suicidal thoughts and behaviors

Co-Occurring Disorders

Oppositional defiant disorder and co-occurring disorders

Oppositional defiant disorder will often occur along with another behavioral disorder or mental health problem, which can lead to a number of additional challenges. This is why the presence of any co-occurring disorder(s) should be treated at the same time as oppositional defiant disorder. Some of the most common co-occurring disorders known to exist alongside a diagnosis of ODD include:

  • Bipolar disorder
  • Learning disabilities
  • Intellectual development disorder
  • Language disorder
  • Substance use disorders
  • Conduct disorder
  • Intermittent explosive disorder (IED)
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Anxiety disorders
  • Depressive disorders

My severe depression had taken over my life. I’m so thankful for San Juan Capestrano Hospital for giving me the strength to start living my life again to the fullest.

– Luis S.