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Dr. O'Leary discusses his critical perspective on Oppositional Defiant Disorder (ODD) and argues that ODD is not a primary diagnosis but rather a "risk syndrome," a set of symptoms (defiance, irritability, and vindictiveness) resulting from various underlying conditions like ADHD, anxiety, or trauma. He explains that conceptualizing ODD as a stand-alone disorder often leads to the risky treatment pathway of off-label antipsychotic medication, whereas recognizing it as a syndrome necessitates an etiology-focused approach to treat the true root cause, typically with safer, condition-specific interventions. Dr. O'Leary traces the evolution of ODD criteria through the DSM manuals and urges clinicians to use comprehensive evaluations rather than relying on simple screeners, especially when an ODD diagnosis is present.

A more in depth discussion with references can be found here: https://sciencebasedpsych.blogspot.com/2025/10/oppositional-defiant-disorder-not.html

Referenced resources can be found within the show transcripts at https://psydactic_caps.buzzsprout.com

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This is not medical advice. Please see a licensed physician for any personal questions regarding your own or your child's health.