Abnormal Psychology

Childhood Disorders 653

What Is Oppositional Defi ant Disorder?

The defi ning features of oppositional defi ant disorder are overt

disobedience, hostility, defi ance, and negativity toward people in

authority. As noted in Table 14.12, for a diagnosis of oppositional

defi ant disorder, DSM-IV-TR requires that the individual exhibit

four out of eight forms of defi ant behavior (Criterion A), many of

which are confrontational behaviors, such as arguing with adults,

intentionally annoying others, and directly refusing to comply

with an adult’s request. Pia did not comply with her parents’

requests to complete her chores or help with other tasks. Her

teacher has commented on a similar behavior pattern at school.

Other examples of defi ant behaviors include refusing to

negotiate, compromise, or adhere to reasonable directions

and testing the limits of rules; young children with opposi-

tional defi ant disorder may have intense and frequent temper

tantrums. (Violent confrontations are not usually part of op-

positional defi ant disorder.) These behaviors must have been

exhibited for at least 6 months, must occur more frequently

than would be expected for the individual’s age and develop-

mental level, and must impair functioning.

The disruptive behaviors of oppositional defi ant disor-

der are different in several important ways from those char-

acterizing conduct disorder. Oppositional defiant disorder

involves only a subset of the symptoms of conduct disorder—

the overtly defi ant behaviors—and these are often verbal. The

disruptive behaviors of oppositional defi ant disorder are

• generally directed toward authority fi gures;


• not usually violent and do not usually cause severe harm; and


• often exhibited only in specifi c situations with parents or other adults the indi-

vidual knows well (Christophersen & Mortweet, 2001).

According to DSM-IV-TR, if an individual meets the diagnostic criteria for both opposi-

tional defi ant disorder and conduct disorder, only conduct disorder is diagnosed.

During a clinical interview, the young person may not behave disruptively. In

fact, children and adolescents with oppositional defi ant disorder often do not feel

they are being oppositional, but rather believe that they are responding to unreason-

able demands being made of them. It is important for the clinician, then, to obtain

information from others when assessing disruptive behaviors. It is also important that

the clinician keep in mind any cultural factors that might infl uence which sorts of

behaviors are deemed acceptable or unacceptable. Figure 14.2 illustrates the possible

paths for disruptive behavior disorder diagnoses. Table 14.13 lists additional facts

about oppositional defi ant disorder, and Case 14.6 describes Danny, a 6-year-old with

oppositional defi ant disorder, whose symptoms are atypical in that he hits his peers.

Table 14.12 • DSM-IV-TR Diagnostic Criteria for

Oppositional Defi ant Disorder

A. A pattern of negativistic, hostile, and defi ant behavior lasting at least

6 months, during which four (or more) of the following are often present:

(1) loses temper

(2) argues with adults

(3) actively defi es or refuses to comply with adults’ requests or rules

(4) deliberately annoys people

(5) blames others for his or her mistakes or misbehavior

(6) is touchy or easily annoyed by others

(7) is angry and resentful

(8) is spiteful or vindictive

Note: Consider a criterion met only if the behavior occurs more frequently than is typically

observed in individuals of comparable age and developmental level.

B. The disturbance in behavior causes clinically signifi cant impairment in

social, academic, or occupational functioning.

C. The behaviors do not occur exclusively during the course of a psychotic

disorder [Chapter 12] or mood disorder [Chapter 6].

D. Criteria are not met for conduct disorder, and, if the individual is age

18 years or older, criteria are not met for antisocial personality disorder

[Chapter 13].

Source: Reprinted with permission from the Diagnostic and Statistical Manual of Mental

Disorders, Text Revision, Fourth Edition, (Copyright 2000) American Psychiatric Association.

CASE 14.6 • FROM THE OUTSIDE: Oppositional Defi ant Disorder

Danny is 6 years old and is exhibiting behavior problems in his kindergarten classroom and

the child-care after-school program. He is disruptive, hits and touches peers, argues with

teachers, becomes easily frustrated, and has temper tantrums when things do not go his way.

Danny is considered explosive and unpredictable. He is socially immature and disliked by

his peers. Danny’s parents had divorced several years earlier and are both remarried. He lives

with his mother but sees his father regularly. The communication between Danny’s parents is

strained, and they differ in their opinions on how to handle Danny’s behavior. The parents

have different parenting styles and do not always provide Danny with clear and consistent

boundaries across the two households.

(August et al., 2007, p. 137)

Oppositional defi ant disorder

A psychological disorder that typically

arises in childhood or adolescence and is

characterized by overt disobedience,

hostility, defi ance, and negativity toward

people in authority.