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Oppositional Defiant Disorder vs. Conduct Disorder: DSM 5 Definition and Confusion

oppositional defiant disorder

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There is a lot of confusion around oppositional defiant disorder and conduct disorder. How are they similar? How are they different?

The confusion only gets worse when we realize that they often co-occur with autism and ADHD. In this post, we’re going to dive into oppositional defiant disorder and conduct disorder so that we can get an understanding of what they are and how they relate to autism and ADHD.

What is Oppositional Defiant Disorder?

Oppositional defiant disorder (ODD) is defined in the DSM 5 as a pattern of defiant behavior, irritable mood, and vindictiveness that lasts at least 6 months with an individual who is not a sibling. Here are some common characteristics of this condition:

  • loses temper and annoyed easily
  • frequently angry
  • argumentative
  • often defiant and unwilling to cooperate with requests
  • blames others for behaviors
  • can be vindictive

It’s true that all of us can exhibit these behaviors from time to time. The world is messy, and we all get angry sometimes. Classification of ODD requires that these behaviors happen frequently.

For children younger than 5 years old, ODD is a possibility if this behavior happens on most days within the span of 6 months. For those older than 5 years old, we should be aware if this behavior happens at least once a week in the span of 6 months. Of course, every child is different, and many factors play a role in behavior. These are simply guidelines to keep in mind.

The Facts Behind Oppositional Defiant Disorder

What is Conduct Disorder?

According to the DSM 5, conduct disorder (CD) is defined as persistent and repetitive behavior that violates the rights of others or breaks age-appropriate societal norms. To be classified as conduct disorder, someone must display 3 or more of the following characteristics within the past 12 months. 1 characteristic must have been present in the past 6 months.

Aggression towards people and/or animals

  • threatens, bullies, or intimidates others
  • initiates physical fights
  • has used a weapon that can cause harm
  • has been physically cruel
  • has partaken in stealing while confronting an individual
  • has forced someone to partake in sexual activity

Destruction of property

  • has intentionally started fires to cause damage
  • has intentionally destroyed property

Deceitfulness or theft

  • has broken into someone’s house, car, or building
  • lies to obtain things or to avoid obligations
  • has stolen without confronting the victim

Serious violation of rules

  • before age 13, stays out at night despite parental commands not to
  • before age 13, is often absent from school

The behavior relating to conduct disorder is often very disruptive in social academic, occupational, and home settings. If the person demonstrating this behavior is over 18, they may fall within the characteristics of conduct disorder if they do not meet the criteria for antisocial personality disorder.

The Facts Behind Conduct Disorder

The Confusion Between Oppositional Defiant Disorder and Conduct Disorder

If you read all of the characteristics of both ODD and conduct disorder, you may be scratching your head and trying to figure out the difference between them. While they seem very similar on the surface, there’s an important reason why they are two different conditions.

When reading through the characteristics of each condition, you’ll notice that ODD is more temperament based, while conduct disorder is more action oriented. Someone with ODD isn’t necessarily engaging in delinquent behavior. Yes, the behavior of someone with ODD may be unpleasant, unwanted, and uncalled for, but it isn’t delinquent in the way that breaking into someone’s house is.

Some people group ODD and CD together along with other “disruptive behavior disorders.” While they may all live under adjacent umbrellas, they shouldn’t be considered one and the same. A child exhibiting characteristics of ODD will behave very differently than a child exhibiting characteristics of CD. There’s a reason that the DSM 5 has separate entries for these two separate conditions.

How are ODD and CD related to ADHD and Autism?

There is a lot of discussion about ODD and CD and how they relate to ADHD and autism. Unfortunately, there is little we know about how these conditions may or may not be causally related or how they influence each other.

What we do know is that these 4 conditions have a high rate of comorbidity (someone has a diagnosis of two or more of these conditions at the same time). Comorbidity doesn’t mean that the conditions are related necessarily. Yes, it’s interesting whenever conditions appear at the same time within the same person, but they still exist as separate conditions. Basically, ADHD is still ADHD whether it exists alongside ODD or not.

So, how are these 4 conditions comorbidly occurring?

Despite how often these conditions co-occur with each other, the links between them are still fuzzy. Given the research right now, there’s little we definitively know about whether they share a similar psychopathology.

It’s also important to note that certain characteristics of each of these conditions overlap. In some cases, certain characteristics of autism look like characteristics of ADHD. This can make it especially confusing when trying to differentiate between them.

As always, this article is for informational purposes only. If you have questions regarding your child’s behavior and treatment needs, be sure to contact your family doctor.

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