Oppositional Defiant Disorder

Unlike traditional psychiatry, which rarely looks at the brain, Amen Clinics uses brain imaging technology to identify brain patterns associated with oppositional defiant disorder.

What is Oppositional Defiant Disorder?

Children tend to have occasional moment of disobedience or misbehavior. But when a child’s behavior is frequently uncooperative, argumentative, and vindictive and becomes so problematic that it disrupts everyday life and relationships, it could be a sign of oppositional defiant disorder (ODD). This mental health condition is a behavior disorder that is most notably characterized by an ongoing pattern of chronic defiant behavior with parents, peers, teachers, and other authority figures. They tend to say “no” even when saying “yes” is clearly in their best interest.

Who Has ODD?

ODD is somewhat more common in boys than girls and is primarily diagnosed in children; however, it is also seen in adolescents and adults. Research estimates that an average of 3.3% of children have oppositional defiant disorder and more than 10% of people will exhibit defiant behavior and other symptoms of this condition at some point during their life.

Oppositional Defiant Disorder Symptoms in Children and Adolescents

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

  • Frequent temper tantrums
  • Oppositional behavior, such as excessive arguing with adults
  • Blaming others for their mistakes or bad behavior
  • Being easily annoyed by others
  • Angry attitude and feeling resentful
  • Disruptive behavior, including instigating conflicts
  • Defiant behavior
  • Deliberately pestering 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 simply having a bad day. However, if a child’s symptoms occur regularly for at least 6 months, it can be a cause for concern. In mild cases of ODD, children and teens may only show symptoms in one setting, such as with family members at home, whereas in more severe cases, their behavior problems occur in a variety of settings.

ODD Behaviors in Adults

People who had oppositional defiant disorder in childhood but were never properly diagnosed and treated for it may continue to exhibit problematic behavior in adulthood. The symptoms of oppositional defiant disorder in adults can include these:

  • Angry and irritable mood
  • Aggressive behaviors, such as road rage
  • Contempt for authority figures
  • Feeling restrained
  • Being vengeful and exhibiting hostile behavior
  • Thinking rules are unfair
  • A strong need to win arguments
  • Feeling like a rebel
  • Vindictive behavior
  • Difficulty taking criticism
  • Blaming others for their own mistakes

Children and teens who develop ODD are at risk for developing anxiety and depressive disorders. In some cases, individuals develop conduct disorder which can be a precursor to antisocial personality disorder. Furthermore, untreated ODD can have alarming consequences and is associated with higher incidences of:

  • Poor academic achievement, peer rejection, and low self-esteem
  • Being suspended or expelled from school
  • Antisocial behavior
  • Difficulty landing and keeping a job
  • Having trouble maintaining relationships with other children or adults
  • Getting divorced
  • Having family dysfunction and difficulty getting along with other children
  • Impulsivity
  • Substance abuse and other mental illnesses
  • Getting into trouble with law enforcement
  • Suicidal thoughts and behavior

What Causes ODD?

Researchers have yet to identify universally specific risks for developing ODD; however, it is believed that a combination of environmental factors stemming from biological, psychological, and social sources play a role in its development. Possible risk factors include a family history of other mental health disorders such as attention deficit hyperactivity disorder (ADHD), substance abuse, obsessive-compulsive disorder, or mood disorders; aggressive behavior or difficulty regulating emotions; and growing up in an abusive household or with a lack of parental supervision or inconsistent discipline practices.

Why Choose Amen Clinics For Treating ODD?

Unfortunately, traditional psychiatry remains the only medical specialty that rarely looks at the organ it treats—the brain. In that realm, ODD is typically diagnosed based on symptom clusters in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. However, because some of the symptoms of ODD may overlap with those of other mental health conditions, it can be misdiagnosed. If doctors or other mental health professionals do not look at the brain, it can be easy to miss possible underlying issues, such as a traumatic brain injury, that can contribute to disruptive behaviors associated with ODD. An adult or child psychiatrist might be quick to prescribe medications that may work for some people but can make another adult or child 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 for behavioral problems. This amounts to a lot of needless suffering. Brain SPECT imaging changes everything.

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ODD Brains Work Differently

In people with oppositional defiant disorder, brain scans show significantly increased activity in an area of the brain called the anterior cingulate gyrus (ACG), which is considered to be the brain’s gear shifter. When the ACG is healthy, it helps people shift from one thought to another or one activity to the next. However, when this part of the brain is overactive, 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, refusing to budge, and other behavioral issues.

Healthy Brain Scan

ODD Brain Scan

SPECT (single photon emission computed tomography) is a nuclear medicine study that evaluates blood flow and activity in the brain. Basically, it shows three things: healthy activity, too little activity, or too much activity. An “active” scan shows the activity beneath the surface of the brain. Blue represents average activity and red and white represent increasingly higher levels of activity. In the healthy scan on the left, the most active area is the cerebellum (located at the back/bottom part of the brain), which is a normal finding. In the ODD brain on the right, there is very high activity in the front part of the brain, including the ACG.

Ready to learn more? Speak to a care coordinator today!

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Having Oppositional Defiant Disorder Affects Others Too

It’s important to know that having ODD is not a character flaw. However, with oppositional defiant disorder, it isn’t just the person with symptoms who suffers—it’s other family members, as well as friends, colleagues, and classmates. Therefore getting properly diagnosed and treated is critical for improving their emotional well-being, the quality of their relationships, and reducing their risk of other mental health conditions; thus, increasing their chances for greater success in school and in life.

  • 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


“With A Better Brain Comes A Better Life”

– Daniel G. Amen, M.D.


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