Oppositional defiant disorder (ODD) is a childhood mental health condition involving disruptive behavior.

Nearly every child will have occasional outbursts of frustration and disobedience, of course. ODD doesn’t refer to developmentally appropriatetemper tantrumsor willful behavior. Instead, ODD involves:

  • a long standing pattern of defiant and argumentative behavior or attitudes toward caregivers, teachers, or other adults
  • vindictiveness toward others
  • a frequentlyirritableand angry mood or short temper

ODD can make it very challenging to interact with other people. Again, the behaviors that characterize this condition go beyond what’s typical for a child’s age and developmental stage.

Tantrums generally begin to taper off by the age of 4. So, you might have some cause for concern when a school aged child continues to have regular tantrums, especially ones severe enough to disrupt everyday life.

Here’s a closer look at ODD, including how it shows up in both children and adults and what treatment approaches are available.

How common is ODD?

According to a2008 review, experts estimate that between 1 and 16 percent of children and adolescents may meet the criteria for diagnosing ODD.

The condition seems to appear more often in boys before adolescence, but at roughly the same rate in people of any gender during adolescence and adulthood.

The evidence supporting its prevalence in boys, however, is somewhat inconsistent. In a2011 study, some experts suggested using different criteria to diagnose ODD in girls, who might display symptoms differently than boys.

症状of ODD often begin by the time a child enters preschool, but nearly always by early adolescence. In general, children typically show signs by the time they enter school.

Sometimes, these signs only show up in one environment or with one individual. For example, children with ODD might only show symptoms at home with family members, or around people they know fairly well.

然而，更严重的症状通常在多种情况下出现，他们可以影响社会关系和发展以及学校或工作。

In children and adolescents

The most common symptoms of ODD in children and adolescents include:

  • 频繁的愤怒剧集
  • irritable mood
  • a short temper or touchy mood
  • being argumentative
  • 习惯refusing to comply with requests from adults
  • excessive arguing with adults and authority figures
  • 习惯questioning or actively disregarding rules
  • 一种旨在破坏，惹恼或愤怒的行为模式，特别是权威人物
  • 倾向于责备他人的错误和不当行为
  • vindictive, spiteful, or resentful behavior, including unkind acts or saying mean things when angry or frustrated

请记住，只有其中一个症状中的一个或两个单独暗示奇怪，特别是在他们临时时。奇怪的人将至少有4种症状，在至少6个月的时间内识别。

In adults

ODD generally isn’t diagnosed in teenagers or adults. But childhood ODD can continue into late adolescence and adulthood, especially when it goes undiagnosed and untreated.

While the general symptoms remain the same, adults with ODD might also:

  • have a lot of anger toward the world
  • feel generally misunderstood, unappreciated, or disliked
  • have strong attitudes of disdain or disrespect for authority figures
  • 不耐烦
  • have a habit of defending themselves forcefully and refusing to consider feedback from others
  • lash out at others when they feel slighted, and have low frustration tolerance
  • have trouble maintaining jobs,romantic relationships, andfriendships，由于频繁的紧张和冲突
  • find it hard to follow rules and expectations at home and work

症状重叠

Some of these signs share similarities with traits associated with other conditions, including:

This overlap can make it more difficult for experts to identify ODD in teens and young adults.

It’s also worth noting that some of these behaviors are pretty common during the teenage years. As a result, parents and teachers might not always find it easy to tell the difference between milder symptoms of ODD and more typicalteenage attitudes.

专家们没有找到一个奇数的单一原因。相反，他们认为它可能由于不同因素的组合而发展，包括基因，环境，人格和气质。

遗传和生物因素

Research suggests genes are responsible for about 50 percent of a child’s risk for the condition.

Children with a family history of depression orADHD也有更高的发展奇数的机会。

一些脑成像 research from 2016 还指出,br的某些部分的差异ain. These parts help regulate impulse control, problem solving, social behavior, and empathy.

这些违规行为可能会因其在与其他因素与其他因素结合而产生奇数的发展。

环境与培养

Many environmental factors at home may contribute to ODD, including:

  • harshorpermissive parenting
  • negative reinforcementfor problematic or disruptive behavior, which can promote future acting out
  • inconsistent or neglectful parenting
  • having a series of caregivers, especially ones who offer inconsistent or detached care
  • rejection from peers
  • violence and abuse in the home or neighborhood
  • a stressful or unpredictable home life
  • living in a low-income household or underserved community

Personality and temperament

Underlying personality traits linked to ODD include:

  • 冲动
  • irritability
  • high emotional reactivity
  • difficulty with emotional regulation
  • callous-unemotional traits, like emotional insensitivity and lower empathy
  • 低挫折耐受性

当然，不是这些特征的每个人都会继续开发奇怪的。

Both nature (biologic factors) and nurture (environment and upbringing) contribute to personality, not to mention overall mental and emotional health, as well as risk and protective factors. A traumatic or difficult childhood can affect a child’s temperament and personality and make it more likely they’ll go on to develop ODD, or another mental health condition.

理解,人ODD often don’t recognize their own behavior as defiant or oppositional. Instead, they might simply believe they’re reacting to unfair circumstances or unjust demands from parents, adults, and other authority figures.

Only trained mental health professionals can diagnose ODD. To do so, they’ll take several things into account.

Is there a pattern?

诊断需要至少四种蔑视，论证，愤怒，烦躁的情绪或报复性。这些行为需要在一个6个月内一直持续发生：

  • at least once per week, for anyone over the age of 5
  • on most days, for children under the age of 5
  • with at least one other person besides a sibling

这些标志可能包括：

  • having frequent arguments with authority figures, adults, and peers
  • 彻底藐视权威人物的请求
  • 拒绝遵循方向或遵守requests from authority figures
  • 习惯于故意讨厌他人的习惯
  • 习惯责备别人的错误和不当行为
  • frequently losing their temper
  • touchiness and becoming annoyed quickly

是否影响了他们日常生活的症状？

在诊断奇怪之前，心理健康专业人员还将考虑行为如何影响日常生活。

ODD can cause distress for the person living with the condition and the people they interact with most often, like family, peers, and co-workers. Symptoms of ODD can have a negative impact on:

  • 社交互动
  • family life
  • participation in school
  • performance at work
  • ability to hold a job

Are symptoms related to any other factors?

A mental health professional will also first ensure that symptoms aren’t related to:

  • 物质使用
  • depression
  • bipolar disorder
  • psychosis

他们还将确认不适合破坏性情绪失调障碍的诊断标准。

How severe are symptoms?

When making a diagnosis, experts will also consider symptom severity:

  • Mild symptoms happen only in one setting, such as home, school, or with peers.
  • Moderate symptoms appear in at least two settings.
  • Severe symptoms happen in three or more settings.

Prompt treatment can go a long way toward improving symptoms of ODD and quality of life.

Professional support can also help treat or prevent other mental health conditions that might occur with ODD, including:

治疗通常涉及以下某种组合：

个人治疗

一对一的疗养卫生专业人员的治疗创造了学习对情绪和行为的新方法的机会，包括技能：

Therapy also offers a safe environment to share and address potential contributing factors, including:

Read more about how to find a therapist.

Social skills training can also provide an environment to learn and practice skills for interacting with peers respectfully and more effectively.

Family therapy

A therapist who specializes in家庭治疗可以为改善家庭内的沟通和加强关系提供指导。

Family therapy can support all members of the family by teaching productive strategies for addressing and managing behaviors related to ODD. A family therapist can also offer parents more support with learning and using effective雷竞技ray养育技巧, including consistent discipline and positive reinforcement.

Parent training

治疗奇数might also include programs specifically designed to teach parents new skills to more effectively interact with their children and providemore constructive discipline.

A therapist might teach these skills directly or through “on the spot” coaching.

Some popular parent training programs include:

  • Parent Management Training
  • 令人难以置信的岁月
  • Parent-Child Interaction Therapy
  • 积极的育儿计划雷竞技ray

在学校的干预措施

Support at school can also benefit students with ODD. This can come from teachers, guidance counselors, and other school staff.

School interventions might include:

  • 在需要时提供休息，以便为学生空间提供manage feelings of overwhelm and frustration
  • changing classroom seating
  • 帮助将学生与支持性同行联系起来
  • encouraging positive behavior in the classroom and with peers through positive reinforcement
  • creating a plan to support any learning difficulties and mental health symptoms
  • school-based mental health support
  • regular check-ins with a teacher or other trusted adult

Medications

没有药物专门对待奇数。尽管如此，一些药物可以帮助解决可能使治疗的共同发生的共同发生的症状，包括严重：

  • 焦虑
  • depression
  • ADHD
  • disruptive behaviors, such as aggression

Any of these could make ODD worse and affect overall well-being. When symptoms don’t respond to therapy, medication could lead to enough improvement that therapy becomes more effective.

A psychiatrist might prescribe:

奇怪的往往随着孩子变老而改善，特别是当症状温和或中等时。家庭支持和治疗既是奇怪的改善是否会产生重大影响。

Without professional treatment andsupportive parenting，奇怪的症状经常变得更糟。有条件的人可能：

  • find it challenging to maintain social relationships
  • have regular conflicts and other problems at school
  • have difficulty succeeding at school or work

Teens and adults with ODD may experience substance use disorders at higher rates and have a higher risk of attempting suicide.

Here’s how to support someone thinking about suicide.

Conduct disorder, another mental health condition typically diagnosed in children, is another potential complication of ODD. Some children with ODD go on to develop this condition, which involves more severe and aggressive behavior. Conduct disorder also serves as a risk factor for antisocial personality disorder.

Treatment and support for ODD can help improve symptoms and lower the likelihood of developing either conduct disorder or antisocial personality disorder.

Along withtherapyand other supportive approaches, a few key changes can help improve ODD symptoms.

父母可以通过以下方式支持他们的孩子：

  • 增加积极增强和减少负增强剂
  • providing consistent consequences for misbehavior
  • using predictable and immediate parenting responses
  • modeling positive interactions in the household
  • taking steps to reduce environmental or situational triggers, like overstimulation, lack of sleep, or stressful routine changes

青少年和老年人可能会发现它有助于：

父母不是唯一受到蔑视和奇怪的愤怒挑战的人。在某些情况下，这些症状也可能在学校或仅在学校出现。

Teachers can use the following strategies to help students with ODD stay in the classroom:

  • Collaborate with parents to find the most effective behavior modification techniques.
  • Provide clear expectations and rules. Keep classroom rules in a visible place and offer reminders when needed.
  • Recognize that any changes in the school day, including a fire drill or the order of lessons, can upset students with ODD.
  • Hold students accountable for their actions and provide consistent consequences.
  • Work to establish trust through clear and consistent communication.
  • Offer encouragement and praise for positive changes.

症状of ODD gradually improve for many children with the condition, especially when they have both professional and family support.

专门从事儿童心理健康状况的治疗师可以提供更多的指导。