Module 14: Oppositional and Aggressive Behaviors

Sisters FightingOppositional and Aggressive Behaviors

Children and adolescents frequently exhibit oppositional behaviors as they develop. Every parent is familiar with the toddler who is enchanted with the word “no” or the teen who pushes for a later curfew. Such responses are part of developing autonomy and independence.

Some children and adolescents, however, experience periods of turbulence that are significantly disruptive and that may affect functioning. These children and teens may have an aggressive/oppositional problem, oppositional defiant disorder (ODD), or conduct disorder (CD).

The assessment of oppositional and aggressive behaviors is complex and must take into account a child’s or adolescent’s social context and the degree to which patterns of undesirable behaviors are protective (e.g., aggressive behaviors in neighborhoods with a high incidence of violence may not indicate a disorder).1, 2 However, any symptoms of oppositional and aggressive behaviors significant enough to be disruptive or to interfere with functioning should be considered indicators for further intervention, even if the criteria for a formal diagnosis are not met.

Key Facts:

  • Between 7.3 and 11.1 percent of children and adolescents have a disruptive behavior disorder.3
  • Of all the risk factors for CD, age at onset of oppositional and aggressive behaviors seems to be the most important. Children who display antisocial and aggressive behaviors during elementary school are at the highest risk for frequent, serious, and persistent antisocial behavior as adults.4
  • While 90 percent of youth with CD meet the criteria for ODD, only about 30 percent of children with ODD go on to develop CD in adolescence.5, 6
  • Almost any condition with socially unacceptable behaviors can appear to be CD. However, most of these lack CD's defining characteristic: persistently inappropriate behavior that violates the rules and rights of others.7
  • Adolescents with CD are at an increased risk for suicidal behaviors and suicide completions than adolescents without CD.8
  • Physically abused children and adolescents are more likely to become seriously delinquent and violent juveniles.9


  1. American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, D.C.: American Psychiatric Association.
  2. American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th, text revision ed.). Washington, D.C.: American Psychiatric Association.
  3. Reyes, M., Buitelaar, J., Toren, P., Augustyns, I., & Eerdekens, M. (2006). A randomized, double-blind, placebo-controlled study of Risperidone maintenance treatment in children and adolescents with disruptive behavior disorders. The American Journal of Psychiatry, 163, 402-410.
  4. Chen, X., Thrane, L., Whitbeck, L. B., Johnson, K. D., & Hoyt, D. R. (2007). Onset of conduct disorder, use of delinquent subsistence strategies, and street victimization among homeless and runaway adolescents in the Midwest. Journal of Interpersonal Violence, 22, 1156-1183.
  5. Hinshaw, S. P., & Anderson, C. A. (2003). Conduct and Oppositional Defiant Disorders. In E. J. Mash, & R. A. Barkley (Eds.), Child Psychopathology (2nd ed., pp. 141-198). New York, NY: The Guilford Press.
  6. Connor, D. F. (2002). Aggression and Antisocial Behavior in Children and Adolescents: Research and Treatment. New York, NY: The Guilford Press.
  7. Karnik, N. S., & Steiner, H. (2005). Disruptive Behavior Disorders. In W. M. Klykylo, & J. L. Kay (Eds.), Clinical Child Psychiatry (Second ed., pp. 191-202). Chicester, West Sussex, England: John Wiley & Sons Ltd.
  8. Nock, M. K., & Kessler, R. C. (2006). Prevalence of and risk factors for suicide attempts versus suicide gestures: Analysis of the National Comorbidity Survey. Journal of Abnormal Psychology, 115 (3), 616-623.
  9. Lansford, J. E., Miller-Johnson, S., Berlin, L. J., Dodge, K. A., Bates, J. E., & Pettit, G. S. (2007). Early physical abuse and later violent delinquency: A prospective longitudinal study. Child Maltreatment, 12, 233-245

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