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OPPOSITIONAL DEFIANT DISORDER

DEFINITION

Oppositional defiant disorder is defined as an enduring pattern of uncooperative, defiant, and hostile behavior toward authority figures that does not involve major antisocial violations, is not accounted for by the child's developmental stage, and results in significant functional impairment. A certain level of oppositional behavior is common in children and adolescents, and it is almost expected when the process of individuation and separation from

It should be considered a disorder only when the behaviors are more frequent and intense than in unaffected peers and when they cause dysfunction in social, academic, or work-related oppositional defiant disorder, oppositional disorder, defient, opositional, defiant disorder, defiance disorder, opposition disorder

DSM-IV classification requires the presence of at least four criteria out of a list of eight . No age limits are set, but the disorder typically emerges in childhood. The diagnosis is not made in the presence of

HISTORY

T he signs of oppositional defiant disorder tend to cluster with mild physical aggression and to remain

EPIDEMIOLOGY

In cross-sectional studies conducted in the general population, the prevalence of oppositional defiant disorder varies from 1.7 to 9.9, with a weighted average of 5.7 percent. The rate is higher in boys than

ETIOLOGY

No systematic research into the causes of oppositional defiant disorder has been conducted. Its etiology is believed to be multifactorial. Genetic and environmental factors probably combine in the

Children with oppositional defiant disorder are more likely to have family history of disruptive behavior disorders, substance-use disorders, or mood disorders. A familial component has been shown for the

Psychosocial theorists have hypothesized that temperamental and constitutional factors may be related to the emergence of oppositional defiant disorder in early childhood when coupled with unduly restrictive

DIAGNOSIS AND CLINICAL FEATURES

Oppositional defiant disorder typically starts in the preschool years, at an age when a certain degree of oppositional attitude is considered developmentally normal. Difficult temperament in the first two years of

COURSE AND PROGNOSIS

Longitudinal studies have shown that the signs of oppositional defiant disorder can be stable over time. However, 25 percent of children with that diagnosis do not fulfill the criteria several years later. ODD in preschool age can be a precursor of conduct disorder, but the majority of children with oppositional defiant disorder do not develop conduct disorder. Among the specific features of oppositional defiant

TREATMENT

Extremely few controlled studies are available on the treatment outcome of oppositional defiant disorder. A variety of treatment approaches are commonly employed in clinical practice, including behavior therapy, various forms of family therapy, parent management training, and dynamic psychotherapy. As with conduct disorder, an individualized treatment plan needs to be developed that