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You may already be familiar with Oppositional Defiant Disorder and Conduct Disorder as serious behavior concerns. When your teen shows intense defiance or harmful behavior, it can still be confusing to tell them apart. In this guide, you’ll learn how to recognize the differences between ODD and CD, what these patterns often mean, and how to find support that matches your teen’s needs.
Key takeaways
- ODD involves emotionally reactive defiance, while CD includes more severe behaviors like aggression, deceit, or serious rule-breaking, often with less emotional regulation and more intent to violate boundaries.
- ODD typically appears earlier (ages 6–8), and in some teens with persistent symptoms, it can develop into CD during adolescence, making early support essential.
- While ODD is often linked to emotional dysregulation and harsh parenting, CD may stem from structural brain differences and a tendency toward risk-taking or detached aggression.
- Treatment for ODD usually focuses on parent training and emotional skill-building, whereas CD often requires longer-term, intensive behavioral therapy and close professional guidance.
- Parents play a central role: tracking behaviors, involving teens in care decisions, and seeking professional support early can significantly improve long-term outcomes.
What is oppositional defiant disorder (ODD)?
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is the main guide mental health professionals use to diagnose conditions.
According to this guide, oppositional defiant disorder is a pattern of angry, argumentative, or defiant behavior. These behaviors must last at least six months. They must also cause problems at home, at school, or with friends.
Symptoms of oppositional defiant disorder
These behaviors may appear often enough to interfere with home, school, or peer relationships:
- Frequent temper loss: Your teen may have angry outbursts over minor issues or frustration.
- Easily annoyed or touchy: They might get irritated quickly or seem overly sensitive to criticism.
- Persistent anger or resentment: You might notice a frequent, underlying sense of anger or bitterness.
- Frequent arguing with adults: Your teen might regularly talk back, resist rules, or argue with authority figures.
- Deliberately defiant behavior: You may see your teen intentionally refuse to follow directions or purposely do the opposite of what’s asked.
- Blaming others for mistakes: They may refuse to take responsibility and blame others.
- Deliberately annoying others: Your teen might seem to provoke siblings, classmates, or adults on purpose.
- Spiteful or vindictive behavior: You might notice acts of revenge or a desire to get back at others.
What is conduct disorder (CD)?
According to the DSM-5, Conduct Disorder is a behavior problem where a teen repeatedly breaks rules or hurts others in ways that are more serious than what’s typical for their age.
Symptoms of conduct disorder
These behaviors are often more severe and can cause serious disruption at home, school, or in the community:
- Aggressive behavior toward people or animals: Your teen might bully others, show hostile behavior toward authority figures, start fights, or use weapons to threaten or harm.
- Destruction of property: This may involve setting fires, breaking windows, or damaging belongings on purpose.
- Deceitfulness or theft: Your teen might lie to get out of trouble, break into places, or steal things without confronting the victim.
- Serious rule violations: You may see repeated skipping school without permission, running away from home overnight, or staying out without permission at an early age.
Key differences between oppositional defiant disorder and conduct disorder
While oppositional defiant disorder and conduct disorder can sometimes appear similar, they differ in how teens behave and what kind of support they may need:
Symptom structure and severity
- Oppositional defiance is reactive: Children and adolescents with oppositional behavior often react emotionally to frustration or unfairness, mostly toward adults, without trying to cause real harm.
- Conduct disorder includes harm to others: Kids with CD behaviors are more likely to include aggression, deceit, or violation of serious rules. They may intentionally hurt others, destroy property, or break laws in a way that seems planned or indifferent to consequences.
- CD often emerges from high-symptom ODD: A 2025 longitudinal study found that teens with severe and persistent ODD symptoms were more likely to develop Conduct Disorder over time. This progression isn’t guaranteed, but it highlights the importance of early intervention and support.
Underlying causes or risk factors
There’s rarely a single reason a teen develops ODD or CD. How these mental health conditions develop is a combination of various factors:
Brain and behavior differences
While ODD and CD can look similar on the surface, the reasons behind them may be quite different.
A 2023 study found that Parental aggression was associated with increased risk of developing ODD, while structural differences in the limbic system, a brain area involved in emotion and behavior, were more often seen in teens who later developed CD. These distinctions may lead to:
- Emotion regulation difficulties in ODD: Children with ODD tend to act out based on emotional overwhelm. These difficulties may stem from a mix of factors, including genetics, temperament, harsh parenting, early trauma, and chronic stress.
- Risk-taking or aggression in CD: Teens with conduct disorder often tend to make choices that feel more intentional or detached, especially when those choices hurt others.
Family conflict and marital dissatisfaction
Family dynamics play a role in both the onset of ODD and CD.
A 2025 regression study found that marital dissatisfaction predicted increased symptoms in both disorders, especially when parents argue often or have trouble solving problems together. This kind of tension may lead to:
- Disrupted communication at home: Teens with ODD may respond to this confusion by becoming more argumentative or irritable, while those with CD may push back in more aggressive or harmful ways.
- Inconsistent boundaries: Teens with ODD might test limits more often. At the same time, those with CD may completely disregard them or take advantage of the inconsistency.
- Emotional withdrawal or acting out: Teens with ODD may shut down or argue as a way to express distress. In contrast, those with CD may use acting out to assert control or intimidate others.
Social skills and emotional development
Teens with stronger social skills are less likely to develop symptoms of either condition. A 2025 cohort study found that teens with stronger social skills, as reported by their parents, were less likely to show signs of ODD or CD over time. Social skill gaps can result in:
- Low frustration tolerance: In teens with ODD, this might show up as yelling, arguing, or refusing to follow rules when they can’t express what they need. In teens with CD, it may appear as angry outbursts or physical aggression when things don’t go their way.
- Trouble reading social cues: Teens with ODD may misunderstand what others mean and become easily upset. In contrast, teens with CD may notice social cues but choose to ignore or use them to control others.
- Increased isolation: Teens with ODD may feel misunderstood and withdraw, while peers may avoid teens with CD because of aggressive or deceptive behavior.
Oppositional defiant disorder vs conduct disorder: How they’re diagnosed
ODD is often identified earlier
Symptoms of behavioral disorders, as seen in teens with ODD, tend to start at younger ages and cause noticeable issues at home or school:
- ODD involves a pattern of angry or irritable mood, argumentative or defiant behavior, or vindictiveness lasting at least six months.
- The behavior must occur with at least one person who isn’t a sibling.
- Disruptive behaviors must show up in everyday settings like home, school, or friendships.
- ODD is usually diagnosed in early school years (age of onset is around ages 6 to 8), when these behaviors begin to interfere with routines or relationships.
Conduct disorder requires more severe patterns
CD tends to be diagnosed during later childhood or early adolescence (typically between ages 10 and 16), and includes more serious, intentional behaviors:
- Conduct Disorder diagnosis requires ongoing violations of the rights of others or major rules.
- The DSM-5 includes symptoms like aggression, destruction of property, lying, stealing, and breaking serious rules.
- These behaviors must occur repeatedly for at least 12 months, with at least one symptom showing up in the past 6 months.
- CD is often recognized when patterns escalate or start to involve harm to others or legal consequences.
Note: Some signs of conduct disorder can show up early, but they’re not always noticed right away. The DSM-5 focuses on clear behaviors. Early warning signs like aggression or rule-breaking can be missed. If you’re seeing these patterns, it’s essential to talk with a mental health professional, even if there’s no diagnosis yet.
Differences in treatment for ODD and CD
Treating ODD and CD involves different timelines, approaches, and challenges. While both require consistent effort, CD often needs longer-term, more intensive support.
Treating oppositional defiant disorder (ODD)
Treatment for ODD typically starts earlier and often focuses on emotional and behavioral skill-building:
- Parent management training: These programs help you set clear rules, use logical consequences, and reinforce positive behavior.
- Anger and emotion regulation support: Therapies that teach emotional and self-regulation help teenagers to recognize and manage intense emotions before they escalate.
- Problem-solving or thinking skill support: Some therapies, such as cognitive behavioral therapy, help teens understand social cues and handle peer conflict more calmly.
When symptoms are more severe:
- Look into other possible challenges: ODD often overlaps with conditions like ADHD, anxiety disorder, or substance use, which may also need attention.
- Explore life skills-based programs: These teach teens how to manage stress, plan, and stay emotionally grounded.
- Get support for the whole family: Therapy for parents and siblings can reduce stress and help everyone stay on the same page.
Supporting change over time:
- Talk through upcoming transitions: Helping your teen prepare for changes like a new school can prevent emotional setbacks.
- Stay emotionally present: Check in regularly and remind your teen that setbacks don’t mean failure.
- Encourage healthy connections: Help them find supportive friendships or activities that build confidence.
Treating conduct disorder (CD)
Treatment for conduct disorder typically progresses slowly, but consistent support can still lead to real change over time.
In a 2023 study, girls with CD showed clearer improvement at a 12-week follow-up than right after treatment. To support your teen’s CD treatment:
- Stick with evidence-based programs: Especially those combining cognitive and behavioral therapy techniques.
- Track patterns over weeks, not days: Look for gradual progress, not overnight change. This might include fewer outbursts, better responses to limits, or more moments of calm between conflicts.
- Work closely with mental health professionals: The more tailored the approach, the better the outcome.
How to support teens with ODD or CD
Remember, these ODD or conduct disorder don’t define your teen. With the right support, many teens with ODD or CD go on to build healthy relationships, stay in school, and thrive. To support your teen:
Keep a behavior journal
Tracking what happens day-to-day can help you and your teen’s care team spot patterns and triggers:
- Look for patterns: These notes can help mental health professionals understand what’s going on more clearly.
- Track daily details: Write down when and where behaviors happen, what triggered them, how your teen responded, and how long it lasted.
- Note what follows: Include any consequences, your response, and what seemed to help or not help.
Talk with a mental health provider
Sharing what you’ve observed helps professionals make an accurate diagnosis and build a better plan:
- Ask for support: If you’re unsure where to begin, your child’s school or doctor can help with a referral.
- Share your notes: Bring your behavior journal to a therapist, counselor, or pediatrician. Your input can guide early screening and treatment decisions.
Involve your teen in the process
Helping your teen feel heard and involved makes treatment more effective:
- Start honest conversations: Let them know you’re working with, not against, them.
- Ask what’s been hard: Invite their views on what’s bothering them or what support they need.
- Build trust together: Including them helps reduce shame and makes it easier to move forward.
Reach out for your support
Supporting a teen with behavioral challenges is hard. Don’t do it alone:
- Talk to someone you trust: A therapist, parent group, or close friend can be a lifeline.
- Care for yourself, too: Your well-being is part of the support system your teen needs.
Sources
- Klos, S., Thöne, A.-K., Döpfner, M., & Görtz-Dorten, A. (2025). Self-rated symptoms of oppositional defiant disorder and conduct disorder: Factor structure, reliability, and validity in a clinical sample of adolescents. Child Psychiatry & Human Development, 56(5), 1147–1160. https://doi.org/10.1007/s10578-024-01802-2
- De Lacy, N., & Ramshaw, M. (2023). Selectively predicting the onset of ADHD, oppositional defiant disorder, and conduct disorder in early adolescence with high accuracy. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1280326
- Adib, F.S., Saadat, S., & Hushmandi, K. (2025). The Role of Dimensions of Parental Marital Satisfaction in Predicting Symptoms of Conduct and Oppositional Defiant Disorders in Primary School Students in Qom, Iran. The Open Public Health Journal. https://doi.org/10.2174/0118749445353615250313170102
- Husby, S., Ascaco, L., & Wichstrøm, L. (2025). Within-person Relations Between Social Skills and Symptoms of Oppositional Defiant Disorder and Conduct Disorder from Preschool to Adolescence – A Birth Cohort Study. Research on Child and Adolescent Psychopathology, 53, 473 – 484. https://doi.org/10.1007/s10802-025-01298-x
- Ljungström, B., Sarenmalm, E., & Axberg, U. (2020). Bottom-up and top-down approaches to understanding oppositional defiant disorder symptoms during early childhood: a mixed method study. Child and Adolescent Psychiatry and Mental Health, 14. https://doi.org/10.1186/s13034-020-00339-1
- Stadler, C., Freitag, C., Popma, A., Nauta-Jansen, L., Konrad, K., Unternaehrer, E., Ackermann, K., Bernhard, A., Martinelli, A., Oldenhof, H., Gundlach, M., Kohls, G., Prätzlich, M., Kieser, M., Limprecht, R., Raschle, N., Vriends, N., Trestman, R., Kirchner, M., & Kersten, L. (2023). START NOW: a cognitive behavioral skills training for adolescent girls with conduct or oppositional defiant disorder – a randomized clinical trial. Journal of child psychology and psychiatry, and allied disciplines. https://doi.org/10.1111/jcpp.13896.
- Dubatova, I., Antsyborov, A., Kalinchuk, A., & Antsyborov, L. (2020). Oppositional Defiant Disorder in Childhood and Adolescence. Interactive science, 8-26. https://doi.org/10.21661/r-551677
Residential Treatment Program for Teens diagnosed with ODD & CD
Our Residential Treatment Program offers a safe space where teens can reflect on their actions, practice healthier choices, and build accountability. With guidance from mental health professionals and ongoing family involvement, treatment focuses on long-term behavior change and rebuilding relationships. Families living in Arizona and Idaho can access our Teen Programs: