Key Takeaways
- Defiant behavior is a hallmark of both oppositional defiant disorder (ODD) and pathological demand avoidance (PDA), but the two conditions differ in causes, characteristics, and co-occurring conditions.
- People with ODD are hostile toward authority figures like parents and teachers, while PDA behaviors are driven by anxiety related to everyday demands and routines.
- Managing ODD or PDA often requires an individualized approach to care, including close collaboration from family, mental health professionals, and teachers.
Oppositional defiant disorder (ODD) and pathological demand avoidance (PDA) are both behavioral conditions associated with repetitive acts of defiance and poor emotional regulation. But while ODD is characterized by hostile behavior toward authority figures, PDA is primarily driven by anxiety and a need for control.
Learning to recognize the signs and risk factors for each condition can help you better manage symptoms and seek treatment for yourself or a child in your life.
Understanding ODD
People with ODD consistently show disdain and disrespect for authority figures, like parents, caregivers, teachers, and other adults. The condition is typically diagnosed in children and adolescents but can continue into adulthood without access to treatment.
Leading signs and symptoms of ODD include:
- Being unusually angry, irritable, or vindictive
- Throwing frequent temper tantrums
- Arguing excessively with adults
- Refusing to follow rules
- Deliberately annoying or upsetting people
- Blaming others for their own mistakes or misbehaviors
Understanding PDA
While ODD involves a conscious decision to disobey authority, PDA behaviors are driven by anxiety and a desire for autonomy. People with PDA have an extreme and persistent resistance to everyday demands, like getting dressed and following routines. The condition can cause fear and frustration in young children, and it can be exhausting and overwhelming for adults.
Other key features of PDA include:
- Having a strong need for control over their environment
- Engaging in compulsive behavior, often focused on other people
- Being prone to mood swings and impulsivity
- Resisting or avoiding activities of daily living
- Using social strategies to avoid demands
- Having trouble understanding social cues
Other differences between ODD and PDA
ODD is recognized as an official mental health diagnosis, while PDA is a set of traits and behaviors that’s often considered part of the autism spectrum profile.
A few other key differences between ODD and PDD include:
- Motive: ODD involves deliberate attempts to annoy or defy other people, while PDA stems from an intense desire for personal control.
- Frequency of symptoms: ODD is often limited to specific people or places, like at home or at school, while PDA is typically all encompassing and pervasive.
- Duration of symptoms: Some children will outgrow ODD with access to early intervention and treatment, but PDA is considered a lifelong condition.
- Coexisting Conditions: People with ODD often meet criteria for mood disorders, anxiety disorders, impulse control disorders, and substance use disorders. PDA most frequently co-occurs with autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD).
Finding the right diagnosis for you or a loved one
ODD and PDA are both defined by demand avoidance, as well as impulsivity, mood swings, and other shared symptoms. Because PDA isn’t an official, diagnosable condition, it’s thought that many people who show signs of PDA never receive treatment for it. In fact, some experts believe that it’s often misdiagnosed as other conditions, including ODD, conduct disorders, and ADHD.
To be diagnosed with ODD, a person must consistently show four or more symptoms of defiance, argumentativeness, anger, irritable mood, or vindictiveness over a six-month period. There’s no official diagnostic criteria for PDA, but the Extreme Demand Avoidance Questionnaire’ (EDA-Q) can help identify traits associated with the condition.
The care you need, when you need it
Learn how Rula can support your mental health journey
Treatment and support strategies for ODD and PDA
If you think you might have PDA or ODD, it’s important to meet with a mental health professional to better understand your symptoms and how to manage your well-being moving forward. Your exact treatment plan will depend on your age, severity of symptoms, and any co-occurring mental health conditions. For children and teens, treatment typically involves a collaborative effort from caregivers, teachers, and mental health professionals.
When managing ODD, many people benefit from individual therapy, which may include cognitive behavioral therapy (CBT) or some type of family therapy, like parent-child interaction therapy. Treatment typically also includes parent management therapy (PMT) to show parents how to encourage healthy behavior change in their children. Children may also benefit from school-based interventions to improve academic performance, peer relationships, and problem-solving skills.
Talk therapy is also considered a first-choice treatment approach for PDA. The exact technique depends on the person and their therapist but may include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), or acceptance and commitment therapy (ACT).
How to support someone living with ODD or PDA
In addition to therapy, here are seven additional ways that you can support someone with ODD or PDA.
- Focus on solutions. Take a proactive and collaborative approach to addressing and solving problems.
- Encourage healthy coping mechanisms. Mindfulness, journaling, and other relaxation techniques can help people manage stress, anger, and frustration.
- Provide positive feedback. Offer recognition and encouragement when someone demonstrates flexibility, cooperation, or other positive behaviors.
- Promote peace whenever possible. Pick your battles to avoid creating additional power struggles or anxiety.
- Avoid non-negotiable words. Examples include “no” for people with ODD and “need,” “will,” and “can’t” for people with PDA.
- Advocate for healthy lifestyle choices. Eating a balanced diet, getting enough sleep, and spending quality time with family and friends can support their mental health.
- Prioritize building new skills. Healthy communication techniques, emotional regulation, and social skills help people with ODD or PDA manage symptoms and overcome challenges in their lives.
Find care with Rula
If you or someone in your life is showing defiant attitudes and behaviors, know that balance and peace are possible. Getting an accurate diagnosis is the first step in learning to manage symptoms, improve behaviors, and create a more positive future.
With Rula, you have access to a diverse network of therapists who understand your symptoms and how to help you feel your best. In as little as three minutes, you can find a therapist who takes your insurance and offers the specialized treatment you deserve. And our convenient online appointments means that you can connect with your therapist at a time and place that works for you.
About the author
Alex Bachert
Alex Bachert is a freelance copywriter and mental health advocate. Since earning her masters degree in public health, she has focused her career on creating informative content that empowers people to prioritize their health and well-being. Alex has partnered with organizations like Ro, WellTheory, and Firsthand, and her work has been recognized by the Digital Health Association. When she’s not writing about mental health, Alex is usually playing pickleball, meeting with her local board of health, or enjoying time with her three kids.
Rula's editorial process
Rula's editorial team is on a mission to make science-backed mental health insights accessible and practical for every person seeking to better understand or improve mental wellness. Rula’s clinical leadership team and other expert providers contribute to all published content, offering guidance on themes and insights based on their firsthand experience in the field. Every piece of content is thoroughly reviewed by a clinician before publishing.
