A. A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least
6 months as evidenced by at least four symptoms from any of the following categories, and exhibited
during interaction with at least one individual who is not a sibling.
Angry/Irritable Mood
- Often loses temper.
- Is often touchy or easily annoyed.
- Is often angry and resentful.
Argumentative/Defiant Behavior - Often argues with authority figures or, for children and adolescents, with adults.
- Often actively defies or refuses to comply with requests from authority figures or with rules.
- Often deliberately annoys others.
- Often blames others for his or her mistakes or misbehavior.
Vindictiveness - Has been spiteful or vindictive at least twice within the past 6 months.
Note: The persistence and frequency of these behaviors should be used to distinguish a behavior that is
within normal limits from a behavior that is symptomatic. For children younger than 5 years, the behavior
should occur on most days for a period of at least 6 months unless otherwise noted (Criterion A8). For
individuals 5 years or older, the behavior should occur at least once per week for at least 6 months, unless
otherwise noted (Criterion A8). While these frequency criteria provide guidance on a minimal level of
frequency to define symptoms, other factors should also be considered, such as whether the frequency
and intensity of the behaviors are outside a range that is normative for the individual’s developmental level,
gender, and culture.
B. The disturbance in behavior is associated with distress in the individual or others in his or her
immediate social context (e.g., family, peer group, work colleagues), or it impacts negatively on
social, educational, occupational, or other important areas of functioning.
C. The behaviors do not occur exclusively during the course of a psychotic, substance use, depressive,
or bipolar disorder. Also, the criteria are not met for disruptive mood dysregulation disorder.
Specify current severity:
- Mild: Symptoms are confined to only one setting (e.g., at home, at school, at work, with peers).
- Moderate: Some symptoms are present in at least two settings.
- Severe: Some symptoms are present in three or more settings.
Above is oppositional defiant disorder (DSM-5) diagnostic criteria.
