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Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun.

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DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet].

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Table 18DSM-IV to DSM-5 Oppositional Defiant Disorder Comparison

DSM-IV: Oppositional Defiant DisorderDSM-5: Oppositional Defiant Disorder
Disorder Class: Attention Deficit and Disruptive Behavior DisordersDisorder Class: Disruptive, Impulse-Control, and Conduct Disorders
A. A pattern of negativistic; hostile, and defiant behavior lasting at least 6 months, during which four (or more of the following are present:
  1. Often loses temper
  2. Often argues with adults
  3. Often actively defies or refuses to comply with adults requests or rules
  4. Often deliberately annoys people
  5. Often blames others for his or her mistakes or misbehavior
  6. Is often touchy or easily annoyed by others
  7. Is often angry and resentful
  8. Is often vindictive
Note: Consider a criterion met only if the behavior occurs more frequently that is typically observed in individuals of comparable age and developmental level.
A. A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms of the following categories, and exhibited during interaction with at least one individual who is not a sibling:
Angry/Irritable Mood
1.

Often loses temper

2.

Is often touchy or easily annoyed

3.

Is often angry and resentful

Argumentative/Defiant Behavior
4.

Often argues with authority figures or, for children and adolescents, with adults

5.

Often actively defies or refuses to comply with requests from authority figures or with rules

6.

Often deliberately annoys others

7.

Often blames others for his or her mistakes or misbehavior

Vindictiveness
8.

Has been spiteful or vindictive at least twice within the past 6 months.

Note: The persistence and frequency of these behaviors should be used to distinguish a behavior that is within normal limits from a behavior that is symptomatic. For children younger than 5 years, the behavior should occur on most days for a period of at least 6 months unless otherwise noted (Criterion AB). For individuals 5 years or older, the behavior should occur at least once per week for at least 6 months. Unless otherwise noted (Criterion AB). While these frequency criteria provide guidance on a minimal level of frequency to define symptoms, other factors should also be considered, such as whether the frequency and intensity of the behaviors are outside a range that is normative for the individual’s developmental level, gender, and culture.
B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning,B. The disturbance in behavior is associated with distress in the individual or others in his or her immediate social context (e.g., family, peer group, work colleagues) or it impacts negatively on social, educational, occupational, or other important areas of functioning,
C. The behavior does not occur exclusively during the course of a Psychiatric or Mood Disorder.C. The behavior does not occur exclusively during the course of a psychotic, substance use, depressive, or bipolar disorder. Also the criteria are not met for disruptive mood dysregulation disorder.
D. Criteria are not met for Conduct Disorder, and, if the individual is age 18 or older, criteria are not met for Antisocial Personality DisorderDropped
Specify current severity:
  • Mild: Symptoms are confined to only one setting (e.g., at home, at school, at work, with peers).
  • Moderate: Some symptoms are present in at least two settings
  • Severe: Some symptoms are present in three or more settings.

From: 3, DSM-5 Child Mental Disorder Classification

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