If you imagine a child with ODD in your head, the child is probably a boy not a girl. There is a fair reason for that, with boys under the age of 12 generally having higher rates of ODD than girls of the same age bracket. The Victorian Government’s Better Health Channel suggests that males of this age with ODD outnumber females of the same age with ODD by 2 to 1, whilst the United States of America’s National Library of Medicine suggests that this ratio is 1.4 to 1 (boys to girls).
However, interestingly the same publication notes that this pre-puberty dominance in the prevalence of ODD among males when compared with females is not the case among adolescents or adults, with males and females having similar rates of the condition at these later stages of development.
Nonetheless, a key question remains – do females with ODD present with different symptoms to males with ODD?
In 2011, the Autonomous University of Barcelona published a key study on exactly this issue, finding many interesting results. 343 children with a diagnosis of Oppositional Defiant Disorder participated in this study – 199 participants were males, and 144 participants were females. The children involved were from a range of socioeconomic backgrounds.
Key ODD disorder symptoms such as losing temper (97% girls, 95% boys), arguing (93% girls, 91% boys), and exhibiting defiance (77% girls, 70% boys) were found to be slightly more common in the girls. However, annoying others (75% boys, 47% girls), blaming others (81% boys, 67% girls), and being spiteful or vindictive (60% boys, 45% girls) were significantly higher in the boys surveyed compared with the girls surveyed.
This study also found that the boys surveyed were significantly more likely to suffer functional impairment at school (23% boys, 19% girls), whilst the girls surveyed were more likely to partake in self-harming behaviour (18% girls, 11% boys), and exhibit negative moods and emotions (19% girls, 12% boys). Nonetheless, the boys surveyed were significantly more likely to be expelled from school (29% boys, 15% girls), whilst also being more involved with police as a result of their behaviour (19% boys, 16% girls).
Perhaps, the most interesting insight from this study is that 85% of the boys surveyed were seeking professional help for Oppositional Defiant Disorder, whilst among the girls surveyed this figure was only 56%. Whilst there could be a multitude of reasons behind this large discrepancy, I believe it demonstrates that ODD-type behaviours among girls is generally less aggressive than the ODD-type behaviour of boys. Thus, because of this the behaviour of girls would be considered by some adults to be less problematic, and thus requiring less urgent treatment. Nonetheless, with higher rates of self-harm among girls with ODD that were a part of this survey, it is clear that girls with ODD also require urgent professional assistance – as long as this professional assistance is provided in a way that suits their sometimes-different needs. It should be noted that the Autonomous University of Barcelona’s study is only one study (click here to read in full: 3939.pdf (psicothema.com)), and other studies on gender differences in ODD may find different results. Nonetheless, given the many clear clinical differences between girls and boys with ODD, which have been identified in this study, it is necessary to consider the sex of the child when attempting to effectively manage and treat this disorder in both girls and boys.