Psychological Disorders: Oppositional Defiant Disorder
American
Description
A. A pattern of negativistic, hostile, and defiant behavior lasting
at least 6 months, during which four (or more) of the following are
present:
often loses temper
often argues with adults
often actively defies or refuses to comply with adults' requests or
rules
often deliberately annoys people
often blames others for his or her mistakes or misbehavior
is often touchy or easily annoyed by others
is often angry and resentful
is often spiteful or vindictive
Note: Consider a criterion met only if the behavior occurs more frequently
than is typically observed in individuals of comparable age and developmental
level.
B.
The disturbance in behavior causes clinically significant impairment
in social, academic, or occupational functioning.
C. The behaviors do not occur exclusively during the course of a Psychotic
or Mood Disorder.
D. Criteria are not met for Conduct Disorder, and, if the individual
is age 18 years or older, criteria are not met for Antisocial Personality
Disorder.
European
Description
This type of conduct disorder is characteristically seen in children
below the age of 9 or 10 years. It is defined by the presence of markedly
defiant, disobedient, provocative behaviour and by the absence of
more severe dissocial or aggressive acts that violate the law or the
rights of others. The disorder requires that the overall criteria
for F91 be met: even severely mischievous or naughty behaviour is
not in itself sufficient for diagnosis. Many authorities consider
that oppositional defiant patterns of behaviour represent a less severe
type of conduct disorder, rather than a qualitatively distinct type.
Research evidence is lacking on whether the distinction is qualitative
or quantitative. However, findings suggest that, in so far as it is
distinctive, this is true mainly or only in younger children. Caution
should be employed in using this category, especially in the case
of older children. Clinically significant conduct disorders in older
children are usually accompanied by dissocial or aggressive behaviour
that go beyond defiance, disobedience, or disruptiveness, although,
not infrequently, they are preceded by oppositional defiant disorders
at an earlier age. The category is included to reflect common diagnostic
practice and to facilitate the classification of disorders occurring
in young children.
Diagnostic
Guidelines
The essential feature of this disorder is a pattern of persistently
negativistic, hostile, defiant, provocative, and disruptive behaviour,
which
is clearly outside the normal range of behaviour for a child of the
same age in the same sociocultural context, and which does not include
the more serious violations of the rights of others as reflected in
the aggressive and dissocial behaviour specified for categories F91.0
and F91.2. Children with this disorder tend frequently and actively
to defy adult requests or rules and deliberately to annoy other people.
Usually they tend to be angry, resentful, and easily annoyed by other
people whom they blame for their own mistakes or difficulties. They
generally have a low frustration tolerance and readily lose their
temper. Typically, their defiance has a provocative quality, so that
they initiate confrontations and generally exhibit excessive levels
of rudeness, uncooperativeness, and resistance to authority.
Frequently,
this behaviour is most evident in interactions with adults or peers
whom the child knows well, and signs of the disorder may not be evident
during a clinical interview.
The
key distinction from other types of conduct disorder is the absence
of behaviour that violates the law and the basic rights of others,
such as theft, cruelty, bullying, assault, and destructiveness. The
definite presence of any of the above would exclude the diagnosis.
However, oppositional defiant behaviour, as outlined in the paragraph
above, is often found in other types of conduct disorder. If another
type (F91.0-F91.2) is present, it should be coded in preference to
oppositional defiant disorder.
Excludes:
* conduct disorders including overtly dissocial or aggressive behaviour
(F91.0-F91.2)