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Oppositional Defiant Disorder and Conduct Disorder


Oppositional Defiant Disorder and Conduct Disorder


Simply put, children with ODD and CD disrespect others (particularly authority figures in ODD) and don’t follow rules.

Oppositional defiant disorder is the milder of the two and is typically diagnosed earlier. Children with ODD show a pattern of disobedient, hostile, defiant behavior toward authority figures such as parents, teachers, daycare workers etc. Symptoms include refusing to follow rules, deliberately annoying others, arguing often, blaming others for mistakes, difficulty making or keeping friends, discipline problems at school, acting spitefully or seeking revenge, and being touchy or easily annoyed.  Some research suggests that approximately half of children with untreated ODD will continue to have the behavior years later and about half of those kids (about 1/4 of the original group) will progress to conduct disorder.

Children and adolescents with conduct disorder not only break rules, but also show no respect for other people’s rights. They may be aggressive to people and animals (bully, fight, use weapons, intentionally hurt pets, steal), destroy property (for example throw or smash things, punch holes in walls, set fires) lie to get things they want or to avoid consequences, stay out past curfew, run away and skip school.

Many children with these diagnoses also have diagnoses of ADHD (Attention Deficit Hyperactivity Disorder) and in fact, some common genetic factors have been identified as putting children at higher risk for all three disorders. Shared traits seen in children at risk for these disorders are fearlessness in toddlers and risk-taking behaviors in children and adolescents.  That does not mean that they are not treatable or that environment is not important though.

Children who are exposed to violent, high-crime neighborhoods, violence in the home, neglect and abuse are more likely to develop ODD and CD. It is also more likely if the child’s parent (usually the father) has a history of arrests and breaking rules, and that risk is even higher if the father is in the home with the child. (Usually having the father in the home is a good thing for a child’s mental health and behavior, but not if the father is setting a bad example.) A protective environmental factor  (in other words, one that decreases the chances a child with have ODD or CD) is parent knowledge of what their children – particularly adolescents are doing.

ODD and CD are controversial diagnoses since there are so many environmental risk factors. Some question if the children and adolescent are being labeled for adapting and responding to hostile, toxic environments, particularly when they have been exposed to violent, high-crime neighborhoods. There is also a possibility that children who have been abused are displaying anger, irritability, disregard to others' rights and disrespect of adults because of their trauma and have some form of PTSD (Post-traumatic Stress Disorder). For example, a young boy who lives in fear and is hurt repeatedly by those who are supposed to provide for and protect him has reason to be angry, distrust adults, and have a hard time believing that rules are put in place for his own good.

ODD and CD are treatable. Successful interventions will typically involve the parent and/or entire family. Treatments that focuses on strengthening connections with others (usually caregivers, sometimes peers) and putting consistent rewards and consequences in place can be very helpful.  Treating other mental illnesses the child may have, such as ADHD or depression, can help decrease the severity of symptoms.

Black youth have higher rates of conduct disorder diagnoses. Some hypothesize that this is because of higher exposure to trauma, higher likelihood of exposure to high-crime neighborhoods and/or the additional stress caused by encountering racism.