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Oppositional Defiant Disorder

DSM-5 criteria - angry/irritable mood, argumentative behaviour, vindictiveness.

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1 What is the Oppositional Defiant Disorder?

The Oppositional Defiant Disorder is a psychosocial scoring tool used in paediatric practice. DSM-5 criteria - angry/irritable mood, argumentative behaviour, vindictiveness. It scores 8 criteria and interprets the total across 2 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in psychosocial
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 8 criteria: Often loses temper; Often touchy or easily annoyed; Often angry and resentful; Often argues with authority figures / adults; Often actively defies or refuses to comply with rules or requests; Often deliberately annoys others; Often blames others for their mistakes or misbehaviour; Spiteful or vindictive at least twice in the past 6 months. Totals are then banded: any score - Below threshold: fewer than 4 symptoms - threshold not met; 4 criteria met or more - Threshold met: ≥4 symptoms for ≥6 months, during interaction with at least one non-sibling, supports ODD. Assess severity by number of settings involved.
  • DSM-5 threshold: 4 or more of the 8 criteria listed.
  • A diagnosis also requires clinically significant distress or impairment, the required duration, and exclusion of substance use or another condition. Screening aid only - not a diagnosis.
  • Children <5 y: behaviour should occur on most days for ≥6 months. Age ≥5 y: at least weekly.

4 Frequently asked questions

How many criteria does the Oppositional Defiant Disorder use?

8. They are Often loses temper; Often touchy or easily annoyed; Often angry and resentful; Often argues with authority figures / adults; Often actively defies or refuses to comply with rules or requests; Often deliberately annoys others; and others.

What do the bands of the Oppositional Defiant Disorder mean?

The total is interpreted as: any score - Below threshold: fewer than 4 symptoms - threshold not met; 4 criteria met or more - Threshold met: ≥4 symptoms for ≥6 months, during interaction with at least one non-sibling, supports ODD. Assess severity by number of settings involved.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

DSM-5 threshold: 4 or more of the 8 criteria listed.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

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For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.