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ODD recognizes a persistent pathological pattern of interaction, which for briefer periods of time and during well-recognized periods of development is appropriate and typical. Anger and temper management are frequently at the core of the disorder. Authority figures are usually the recipients of often brief tantrums. As in CD, impulsivity is usually absent, and the arguments take on an importance all their own. Many children with ODD would rather win the battle and lose the war. Recognition of societal rules and personal rights distinguishes children with ODD from those with CD. Most children with ODD do not progress to CD; those with earlier onset of symptoms, physical aggression, low socioeconomic status, and parental substance abuse are more likely to develop CD (Loeber et al. 1995; Table 21–23).

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Table Reference Number
TABLE 21–23. DSM-IV-TR diagnostic criteria for oppositional defiant disorder

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