Tests and diagnosis

By Mayo Clinic Staff

To be diagnosed with oppositional defiant disorder, a child must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

Criteria for oppositional defiant disorder to be diagnosed include a pattern of behavior that lasts at least six months and includes at least four of the following:

  • 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

These behaviors must be displayed more often than is typical for your child's peers.

In addition, to be diagnosed with oppositional defiant disorder, a child's disruptive behavior:

  • Must cause significant problems at work, school or home
  • Must occur on its own, rather than as part of the course of another mental health problem, such as depression or bipolar disorder
  • Must not meet the diagnostic criteria for conduct disorder or, if the affected person is older than age 18, antisocial personality disorder

It can be difficult for doctors to sort and exclude other associated disorders — for example, attention-deficit/hyperactivity disorder versus oppositional defiant disorder. These two disorders are commonly diagnosed together.

Nov. 25, 2014

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