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Oppositional Defiant Disorder

Oppositional Defiant Disorder

Every child has an occasional moment of disobedience or misbehavior. But when uncooperative, argumentative, and vindictive behavior is so frequent and severe that it disrupts everyday life and relationships, it could be a sign of oppositional defiant disorder (ODD). ODD is a behavioral disorder that is characterized by children being chronically defiant with parents, peers, teachers, and other authority figures. They tend to say no even when saying yes is clearly in their best interest.


ODD is primarily diagnosed in children, however, it is also seen in adolescents and adults.

Research estimates that as many as 5% of all children are affected by ODD and over 10% of people will experience the condition at some point during their lifetime. The condition is more common in boys than girls. Adults with oppositional tendencies who were never diagnosed with the condition as a child may continue to remain undiagnosed.


Signs and symptoms associated with ODD in children and teens include:

  • Frequent outbursts/loss of temper
  • Excessive arguing with adults
  • Blaming others for their mistakes
  • Easily annoyed by others
  • Instigating conflict with others
  • Ignoring, questioning or resisting established rules
  • Saying mean or spiteful things when upset
  • Swearing or using obscene language

Considering that every child may occasionally exhibit these symptoms, it can be difficult for parents to know if their child is just having a bad day or if their behavior is a cause for concern. A quick way to judge if it’s time to seek help is to ask yourself this question:

“When you ask your child to do something, how many times out of 10 will they do it the first time without arguing or fighting?”

Most children will comply 7 to 8 times out of 10 without a problem. For most ODD kids, however, the answer is usually 3 times or fewer. And for many of them, the answer is 0.

In adults, the signs and symptoms of ODD may differ slightly and can include:

  • Feeling angry at the world
  • Feeling restrained
  • Being easily angered
  • Experiencing road rage
  • Contempt for authority
  • Thinking rules are unfair
  • A strong need to win arguments
  • Feeling like a rebel
  • Being vengeful or vindictive
  • Difficulty taking criticism
  • Blaming others for their own mistakes

All of the symptoms seen in children, teens, and adults may range from mild to severe. With ODD, it isn’t just the person with symptoms who suffers—it’s the whole family, as well as friends, colleagues, and classmates. That’s why it’s critical to seek help.


Research shows that it is very common for people with ODD to struggle with co-existing mental health conditions, such as:

ODD is also associated with low self-esteem and learning disorders. It is considered a risk factor for conduct disorder, which is more serious type of behavior disorder that often involves criminal activities, vandalism, and cruelty to animals. Not all children with ODD will develop conduct disorder, but this possibility is another reason why it is so important to seek treatment for the condition.


Being argumentative and uncooperative can undermine a child’s, teen’s, or adult’s life at home, at school, and at work. When ODD remains untreated—or if it is misdiagnosed and mistreated—it increases the risk of:

  • Poor academic achievement
  • Being suspended or expelled from school
  • Antisocial behavior
  • Difficulty landing and keeping a job
  • Having trouble maintaining relationships
  • Getting divorced
  • Having family dysfunction
  • Impulsivity
  • Substance abuse
  • Getting into trouble with law enforcement
  • Suicidal thoughts and behavior

All of these negative consequences can reinforce a person’s feelings of anger, dislike of authority, and belief that problems are other people’s fault.


It’s important to know that having ODD is not a character flaw. In people with ODD, brain scans show marked increased activity in an area of the brain called the anterior cingulate gyrus (ACG). Considered to be the brain’s gear shifter, the ACG—when it is healthy—helps people shift from one thought to another or one activity to the next. When activity is excessively high in this region, people tend to get stuck on thoughts or on a single course of action. For those with ODD, this means getting stuck on saying no, being argumentative, and refusing to budge.


Unfortunately, traditional psychiatry remains the only medical specialty that rarely looks at the organ it treats. In conventional psychiatry, ODD is typically diagnosed based on symptom clusters, and because some of the symptoms of ODD may overlap with those of other mental health conditions, it can be misdiagnosed. By not looking at the brain, mental healthcare professionals may also miss underlying issues, such as a traumatic brain injury, that can contribute to disruptive behaviors associated with ODD.

Without an accurate diagnosis, treatment usually consists of throwing darts in the dark. Healthcare professionals are quick to prescribe medications that may work for some people but can make other people worse! It is not uncommon for it to take weeks, months, or even years for a child or adult to get an accurate diagnosis and the proper treatment. This amounts to a lot of needless suffering. We can do better.


At Amen Clinics, we use brain SPECT imaging as part of a comprehensive evaluation to diagnose and treat our patients with ODD. Brain scans help us better understand how the brain works and can specifically help children and adults with ODD by:

  • Helping identify the type of brain activity pattern to inform treatment decisions
  • Monitoring how well treatment is working so adjustments can be made for faster healing
  • Finding out if there are other co-occurring conditions or underlying issues (such as a traumatic brain injury) that also need treatment
  • Reducing emotional pain and stigma by demonstrating that symptoms and behaviors are not a personal failure
  • Increasing treatment compliance by showing images of your progress
  • Helping families gain a better understanding of their loved one’s condition

At Amen Clinics, we also assess other factors—biological, psychological, social, and spiritual—that can contribute to ODD and offer the least toxic, most effective treatments and strategies to optimize these areas of your life.

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