ODD In Teens: Signs, Symptoms, Causes And Treatment

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Oppositional defiant disorder (ODD) is a disruptive behavior disorder commonly seen in children and adolescents. ODD in teens may cause them to persistently exhibit challenging behaviors such as hostility, anger, intolerance toward rules, and defiance of authorities.

If untreated, ODD may aggravate and result in more serious issues such as antisocial behaviors and conduct disorders. Hence, the symptoms of ODD should be treated early on to prevent future complications.

Read this article to learn about the causes, symptoms, complications, diagnosis, and treatment for ODD in teens, as well as some parental strategies to help them cope.

Symptoms And Signs Of ODD In Teens

Children and teens get into arguments, become angry, and throw tantrums occasionally. However, ODD symptoms can be constant and usually last for at least six months. These symptoms may negatively impact the family environment.

The common ODD symptoms in teens may include (1)

  • Refusing to follow rules
  • Showing disrespectful behavior
  • Throwing frequent tantrums
  • Annoying others on purpose
  • Showing anger and resentment towards others
  • Always arguing to defy adults
  • Blaming others for bad behaviors and mistakes
  • Showing annoyance towards others
  • Facing issues at school
  • Trouble making friends or maintaining friendships
  • Seeking revenge on someone

Seek medical attention if your teen has any of these symptoms frequently and persistently for a few months. Early medical care can help prevent complications of oppositional defiant disorder in teenagers.

Causes And Risks Of ODD

The exact cause of ODD has not been identified yet. However, a combination of biological, genetic, and environmental factors is believed to contribute to the condition (2).

  • Biological factors: Injuries or defects in certain brain areas may result in behavioral Changes in brain chemicals (neurotransmitters) may also play a role in the development of ODD.
  • Genetic factors: Many teens with ODD have a family history of mental disorders such as anxiety disorders, mood disorders, and personality disorders in close relatives. This indicates the possibility of ODD inheritance.
  • Environmental factors: A chaotic family environment, inconsistent discipline by parents, and a family history of substance abuse may also contribute to ODD in teens.

Complications Of ODD

If left untreated, oppositional defiant disorder may lead to more serious behavioral disorders, such as conduct disorder (CD), in some teens. They may also find it challenging to make friends and maintain relationships, thus causing problems at home, school, and other environments in which they live.

The following other complications are often associated with ODD in teens (3).

  • Antisocial behavior
  • Substance abuse
  • Suicide
  • Poor attendance at school or work
  • Impulse control issues
  • Legal complications

Diagnosis Of ODD In Teens

Psychiatrists and psychologists can help diagnose ODD in teens. And to meet the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-5) criteria for diagnosis of ODD, a teen should have at least four symptoms of angry/irritable mood, argumentative/defiant behavior, or vindictiveness for at least six months (4).

In addition, doctors may also consider the negative impact of these symptoms on the teen’s educational, social, and occupational functioning.

Multiple interviews and assessment tools may be used to help in ODD diagnosis. There are no specific lab tests to confirm the diagnosis. Instead, tests and imaging are often ordered to rule out any other causes of symptoms.

Treatment For ODD In Teens

Early treatment is recommended to help prevent complications. Doctors may choose the treatment options based on the child’s age, symptoms, severity, and health status. The following therapies are often recommended for teens with ODD (5).

  • Cognitive-behavioral therapy (CBT): This therapy helps the child control their anger and impulses and communicate and solve their problems effectively.
  • Medicines: No specific medications may be required for ODD. However, children with coexisting conditions, such as ADHD or anxiety, may receive prescription medications depending on their symptoms. Medications can also be prescribed in the case of excessive aggression or impulsivity, which poses a danger to safety of self or others.
  • Family therapy: Changes in the family interactions and their understanding of the child’s condition are necessary to manage a teen with ODD. Family therapy helps the parents, siblings, and other family members to support and encourage the teen with ODD.
  • Peer group therapy: Psychiatrists may recommend peer group therapy since some children develop social and interpersonal skills better around their peers.

Various types of psychotherapies are attempted in the initial phase of treatment. This may help the therapist know which works best for the teen. Regular follow-ups and therapy sessions are planned based on the symptoms and improvements shown.

How To Prevent ODD In Teens?

The exact ways to prevent ODD are not known. However, certain parenting approaches can help prevent ODD and many other psychiatric disorders in childhood and adolescence. In addition, problematic behaviors can be reduced by psychotherapy in many teens (5).

Further, school-based programs and parent training programs can help teens with ODD improve their relationships and interactions with family and peers.

Parenting Tips For Helping A Teenager With ODD

Parents’ role is crucial in oppositional defiant disorder treatment in teens. Parenting strategies should aim at anticipating problematic behaviors and handling tantrums or outbursts. You may also implement consistency in a teen’s routine and life to reduce the symptoms.

Boston Children’s Hospital recommends the following strategies to manage children and teens with ODD (6).

  • Create a warm and loving parent-child bond.
  • Set simple and clear house rules.
  • Make the household environment structured and predictable.
  • Praise good behavior such as getting ready for school, waking on time, and doing school work.
  • Discourage bad behavior, such as high-pitched or loud cry (whining) and badgering, and praise them when they stop it.
  • Remind them of consequences, such as reduced screen time or time out, for destructive or dangerous behaviors such as physical aggression.
  • Avoid punishment since it could do more harm while handling mental health issues.

Frequently Asked Questions

1. Can my child develop ODD without ADHD?

Yes, ODD can develop independently of ADHD (7). However, children with ODD have an increased risk of developing other disorders, including ADHD or mood disorders (8).

2. Can my child outgrow ODD?

Studies show that ODD symptoms may resolve within three years in around 67% of children. The rest may develop conduct disorder in due course, and the risk is three times greater in children who manifest the symptoms at an early age. Around 10% of children with ODD may develop a persistent personality disorder, called Anti-Social Personality Disorder (8).

If you notice any signs of oppositional defiant disorder in your teen, do not panic, as you can manage it through different therapies. You can seek suggestions from the therapists and participate in peer groups to get more ideas on management. Remember, teenagers are a tender age, and as parents, you need to develop strategies to help your children avoid problems and move on towards their life goals. The more you understand ODD in teens and how to deal with your teenager, the better it gets for you and them.

Key Pointers

  • Disrespectful behavior, frequent tantrums, extreme anger, and annoyance are some symptoms of the oppositional defiant disorder (ODD) in teens.
  • Biological, genetic, and environmental factors are believed to cause this condition.
  • If not treated on time, ODD may lead to complications, such as substance abuse, legal issues, suicide, etc.
  • Treatment includes medication and different therapies.
  • Creating a loving environment, avoiding punishment, and reducing screen time are some ways to prevent this issue.


MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
  1. Oppositional Defiant Disorder.
  2. Oppositional Defiant Disorder.
  3. Oppositional Defiant Disorder.
  4. Common Questions About Oppositional Defiant Disorder.
  5. Oppositional Defiant Disorder (ODD) In Children.
  6. Treatment for Oppositional Defiant Disorder.
  7. Hyo-Won Kim et al.; (2009); Does oppositional defiant disorder have temperament and psychopathological profiles independent of attention deficit/hyperactivity disorder?
  8. Oppositional Defiant Disorder Resource Center.
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Dr Bisny T. Joseph

Dr. Bisny T. Joseph is a Georgian Board-certified physician. She has completed her professional graduate degree as a medical doctor from Tbilisi State Medical University, Georgia. She has 3+ years of experience in various sectors of medical affairs as a physician, medical reviewer, medical writer, health coach, and Q&A expert. Her interest in digital medical education and patient education made... more

Dr. Neha Bhave Salankar

Dr. Neha Bhave Salankar is a consultant psychiatrist at Bhave Institute of Mental Health based in Nagpur. Having been a meritorious student throughout, she bagged the prestigious gold medal for medicine in MBBS as well as in MD psychiatry. She also took training in Child and Adolescent Psychiatry at National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru. She is... more