Oppositional Defiant Disorder: how many symptoms are required for diagnosis?

• A. Exactly four symptoms.
• B. At least four symptoms.
• C. At least five symptoms.
• D. At least six symptoms.

Answer: (B)

Oppositional Defiant Disorder is diagnosed when a child shows a persistent pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness that lasts at least six months and causes noticeable impairment. There are eight symptoms spread across those three domains, and you need to meet a minimum threshold: at least four of those symptoms must be present. The symptoms also need to be directed toward at least one person who isn’t a sibling and must be associated with dysfunction in social, school, or other important areas of functioning. This four-or-more rule helps distinguish a broader, disruptive pattern from more limited or passing upset. You could have four, five, six, seven, or all eight symptoms and still meet the diagnosis, as long as the pattern is sustained and impairing.