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Mental health: Oppositional defiant disorder

It's not unusual for children, especially those in their "terrible twos" and early teens, to defy authority every now and then. They may express their defiance by arguing, disobeying or talking back to their parents, teachers or other adults. When this behaviour lasts longer than six months and is excessive compared to what is usual for the child's age, it may mean that the child has a type of behaviour disorder called oppositional defiant disorder (ODD).

ODD is a condition in which a child displays an ongoing pattern of uncooperative, defiant, hostile and annoying behaviour towards people in authority. The child's behaviour often disrupts the child's normal daily activities including activities within the family and at school.

Many children and teens with ODD also have other behavioural problems such as attention-deficit/hyperactivity disorder ( ADHD), learning disabilities, mood disorders (such as depression) and anxiety disorders. Some children with ODD go on to develop a more serious behaviour disorder called conduct disorder.

What are the symptoms of oppositional defiant disorder?

Symptoms of ODD may include:

  • Throwing repeated temper tantrums
  • Excessively arguing with adults
  • Actively refusing to comply with requests and rules
  • Deliberately trying to annoy or upset others, or being easily annoyed by others
  • Blaming others for your mistakes
  • Having frequent outbursts of anger and resentment
  • Being spiteful and seeking revenge
  • Swearing or using obscene language
  • Saying mean and hateful things when upset

Many children with ODD are also moody, easily frustrated and have a low self-esteem. They also may use drugs and alcohol.

What causes oppositional defiant disorder?

The exact cause of ODD is not known, but it is believed that a combination of biological, genetic and environmental factors may contribute to the condition.

  • Biological. Some studies suggest that defects in or injuries to certain areas of the brain can lead to serious behavioural problems in children. ODD has also been linked to abnormal amounts of special chemicals in the brain called neurotransmitters. Neurotransmitters help nerve cells in the brain communicate with each other. If these chemicals are out of balance or not working properly, messages may not make it through the brain correctly, leading to symptoms of ODD and other mental health illnesses. Many children and teens with ODD also have other mental health illnesses such as ADHD, learning disorders, depression or an anxiety disorder, which may contribute to their behaviour problems.
  • Genetics. Many children and teens with ODD have close family members with mental health illnesses, including mood disorders, anxiety disorders and personality disorders. This suggests that a vulnerability to develop ODD may be inherited.
  • Environmental. Factors such as a dysfunctional family life, a family history of mental illnesses and/or substance use, and inconsistent discipline by parents may contribute to the development of behaviour disorders.
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