Emotional and Behavior

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What Is Oppositional Defiant Disorder?

This is a very good question, and the International Statistical Classification of Diseases and Related  Health Problems, 10th Revision (ICD-10) presents this disorder in a way that isn’t immediately helpful in gaining an understanding because of the double use of the phrase Conduct Disorder, which is a classification category in which Oppositional Defiant Disorder (ODD) is a subcategory, as well as a name for disorders within that category. With the phrase Conduct Disorder being used both as a category and within the category, it is difficult to talk about either the category or its members clearly and to distinguish Oppositional Defiant Disorder from Conduct Disorder. Further complication in understanding comes from the Diagnostic and Statistics Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR), which understands Oppositional Defiant Disorder as a possible precursor of Conduct Disorder.

Let’s take them each in turn.

ICD-10 Understanding of ODD

In the ICD-10, Conduct disorders is the name of category F91, of which there are 10 subcategories. There is a general description of F91 that is meant to cover all of the subcategories, each of which adds distinguishing features. The general description describes “a repetitive and persistent pattern of dissocial, aggressive, or defiant conduct.” To meet the criteria, the conduct must violate and be more severe than age-appropriate expectations, and if the behavior is symptomatic of a different, underlying condition, then ICD-10 indicates that that diagnosis should be preferred.

The categories under F91 are

  • Conduct disorder confined to the family context
  • Unsocialized conduct disorder
  • Socialized conduct disorder
  • Oppositional defiant disorder
  • Other conduct disorders
  • Conduct disorder, unspecified

As you can see, the categories labeled “other” and “unspecified”�at least to the lay person�add greatly to the difficulty of distinguishing these categories.

Within this context, Oppositional Defiant Disorder is distinguished, the ICD-10 says, by occurring in younger children, and featuring behavior that, while meeting the criteria for F91, is not delinquent, or extremely aggressive or dissocial. The three words used to characterize ODD are “defiance, disobedience, and/or disruptiveness.”

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