To meet DSM-IV-TR criteria, certain factors must be taken into account. First, the defiance must interfere with the child’s ability to function in school, home, or the community. Second, the defiance cannot be the result of another disorder, such as the more serious Conduct disorder, depression, anxiety, or a sleep disorder such as DSPS. Third, the child's problem behaviors have been happening for at least six months. The diagnostic criteria for this disorder are as follows:
Diagnostic Criteria
1. A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present:
Note: Consider a criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level.
1. often loses temper
2. often argues with adults
3. often actively defies or refuses to comply with adults' requests or rules
4. often deliberately annoys people
5. often blames others for his or her mistakes or misbehavior
6. is often touchy or easily annoyed by others
7. is often angry and resentful
8. is often spiteful or vindictive
2. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.
3. The behaviors do not occur exclusively during the course of a Psychotic or Mood disorder.
4. Criteria are not met for Conduct Disorder, and, if the individual is age 18 years or older, criteria are not met for Antisocial personality disorder.
If the child meets at least four of these criteria, and they are interfering with the child’s ability to function, then he or she technically meets the definition of Oppositionally defiant.