Psychologists warn against oppositional defiant disorder diagnosis — it could mask deeper issues

• Children who are angry and argumentative can be diagnosed with oppositional defiant disorder.
• Psychologists think it may oversimplify deeper causes, like ADHD, autism, and trauma.

While most children throw tantrums or defy their parents at some point, there's an explanation for when it happens all the time: oppositional defiant disorder.

ODD, which can only be diagnosed in children, is characterized by "losing temper, arguing with adults, defying authority, deliberately annoying others, blaming others for mistakes, being angry and vindictive and resentful," Dr. Daniel Flint, a pediatric psychologist and assistant professor at Baylor College of Medicine, told Business Insider.

According to the DSM-5, a child also has to experience significant impairment, such as academic or social struggles. The behavior also has to be more persistent and frequent than in other children of the same age.

But as specific as the diagnostic criteria are, Flint believes ODD can be a hard disorder to diagnose, mostly because so much of it can be subjective. While he has diagnosed clients with ODD before, he said that he has only done it with many caveats.

"It starts to get into a really, really gray area," he said.

For example, if a child is getting bad grades and acting out in school, there can be other explanations besides an ODD diagnosis, such as their home life.

Dr. Megan Neff, a clinical psychologist specializing in ADHD and autism, told Business Insider that while diagnoses like ODD "help us label and recognize problematic behaviors, they don't inherently explain why these behaviors are happening."

ADHD, autism, and trauma can cause similar behaviors

One of the biggest potential issues with an ODD diagnosis is that it might overlook other explanations for behaviors like picking fights or talking back to adults.

Neff said that undiagnosed autism or ADHD can resemble ODD symptoms. For example, autistic children might have reactions to sensory overload that can look like defiance, while kids with ADHD can be hyperactive and get up from their seats before they have permission to.

Trauma can also be a factor in children's behavior. Flint said that a family going through a divorce or another big transition can greatly impact a child, leading to ODD-like behaviors.

"We need to process what needs that they are not getting met at this time such that they behave in these wild, uncharacteristic ways," Flint said.

An ODD diagnosis can spark fear in parents

One of the biggest issues Flint has with children being diagnosed with ODD is that it can lead to parents believing they have an inherently bad child. Parents may also fall into a cycle of blaming their genetics or past parenting choices.

"When parents fear that their child has ODD, I want them to go, 'Great, we know what to do. We're going to get a good therapist and we're going to fix the problem,'" Flint said. "I don't want them to go, 'Why have we been cursed with this diagnosis?'"

Flint said that having an empowered, responsible, and optimistic mindset is crucial to finding an effective treatment plan.

"An old mentor of mine would always say to parents, 'You're not the agent of blame; you're the agent of change,'" he said.

No matter the cause, there are treatment options available

While treating ODD can seem daunting, there are many potential solutions out there. "All of them are going to incorporate caregivers pretty significantly," Flint said.

Flint said if the child is below seven, parents can try Parent-Child Interaction Therapy, where parents wear a little radio in their ear as they interact with their child. Meanwhile, a therapist observing them from a separate room advises them on how to talk to their kid.

For older kids, he said family therapy or behavioral therapy can be great options as well.