According to the DSM-IV, if a child's problem behaviors do not meet the criteria for Conduct Disorder, but involve a pattern of defiant, angry, antagonistic, hostile, irritable, or vindictive behavior, Oppositional Defiant Disorder may be diagnosed. These children may blame others for their problems. Oppositional Defiant Disorder is a pattern of negativistic, hostile, and defiant behavior lasting at least six months, during which four (or more) of the following are present: 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. It is important to note that a counselor or therapist will consider a diagnosis of oppositional defiant disorder only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level. In other words, the problems and conflicts between teens and parents are as old as time itself, and some conflict is normal and inevitable.

However, when the parent / child conflict becomes increasingly severe and appears to be spiraling out of control, then ODD might be considered. Also, as teens are growing and learning, they will sometimes do some very ill-advised things that can cause them problems, both legal and in school. However, if this behavior does not repeat itself and is a one-time event, then a behavior disorder is probably not present. For a diagnosis of ODD to be made, the disturbance in behavior must be causing significant problems in school, in relationships with family and friends, and in the workplace. ODD will not be diagnosed if the the therapist suspects that the teen's behaviors are being directly caused by another psychotic or mood disorder, such as bipolar disorder. Kids with oppositional defiant disorder will show some of the same behaviors as those listed above for conduct disorder, including being very negative, angry and defiant.

However, with ODD, one does not generally see the mean or cruel behavior that is present in conduct disorder, such as cruelty to animals.