American Board of Psychiatry and Neurology (ABPN) Practice Exam 2025 - Free ABPN Practice Questions and Study Guide

The diagnosis of Oppositional Defiant Disorder (ODD) is primarily characterized by a pattern of angry, irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least six months. Children with ODD often exhibit oppositional behavior towards authority figures, which is central to this diagnosis. They may argue with adults, defy rules, and refuse to comply with requests, showcasing a persistent pattern of behavior that significantly disrupts their functioning in social, academic, and familial settings.

In contrast, while Attention-Deficit/Hyperactivity Disorder (ADHD) can include impulsive and sometimes oppositional behaviors, it is primarily characterized by inattention and hyperactivity rather than overt oppositionality. Bipolar disorder may include periods of high irritability and risk-taking behaviors, but these episodes are tied to mood swings and not a persistent pattern of defiance toward authority. Conduct disorder is marked by more serious patterns of behavior, including aggression toward people and animals, destruction of property, and serious violations of rules, which is a more severe diagnosis than ODD. Thus, the characteristic behavior of oppositionality towards authority figures aligns most directly with ODD, making it the most appropriate diagnosis in this context.