Several requirements must be observed in order the condition could meet the requirements of DSM-IV, namely: the defiant behavior must interfere with the ability to function in home, school or the community; the defiant behavior should not be caused by other childhood disorder such as attention deficit, anxiety, depression or others; and finally, defiant behavior must be observed for at least six months. In addition to these requirements, the following diagnostic criteria are identified for ODD:
A case when a child meets at least four of eight criteria granted that they are interfering with his ability to function is considered to be the case ODD. However, accurate diagnosis is often associated with serious difficulties caused by high comorbidity of ODD with other anxiety disorders and depressive disorders (Rey, 1993). For example, many symptoms of attention-deficit/hyperactivity disorder (ADHD) and conduct disorder overlap while comorbidity of ODD with ADHD has been reported to occur in 50-65% of affected children (Tynan, 2003).
Etiology of ODD is not fully clear, while there is no evidence that it has a unique etiology. Similarly to other developmental and behavioral childhood disorders, the origins of ODD is explained from several distinct stances including strict parenting style (Meeks, 1979), psychodynamic approach (ODD is a fixation in the anal stage of the child's psychological development (Egan, 1991), behaviorist positions (negative reinforcement of inappropriate child behavior and parent-child conflict about issues of control and autonomy (Gard & Berry, 1986), genetics and others. Modern research leans toward the multi-causal theory suggesting ODD may be caused by several etiological factors, either alone or in combination, including genetic, social, constitutional and psychological mechanisms.
Modern practitioners utilize various cognitive-behavioral and psychological approaches, either alone or in combination, to treat ODD children. The most popular among them are behavior therapy, family therapy, parent management training, and child psychotherapy.
Parent Management Training (PMT) is a variation of cognitive-behavioral therapy which seeks to modify the child's behavior by modifying the style of parenting. This therapy proved highly effective for ODD children: some recent studies define the amount of responders around 40-50% (Greene, Ablon & Goring, 2003). Effectiveness of this method was also found in one of the earliest works in the field of ODD treatment, namely Wells and Egan's (1988) report demonstrating that parent training was superior to family systems therapy.
Behavior and psychosocial therapies involving children is also effectively used in treatment of ODD. The core idea underlying such therapies is to help children model behaviors and reactions which would allow them better adapt to the real-life setting. Effectiveness of such