Rosh Psychiatry Board Practice Exam

When does the initial presentation of oppositional defiant disorder typically occur?

1. Late adolescence

2. Middle adolescence

3. Early adulthood

4. Preschool years

The correct answer is: Preschool years

The initial presentation of oppositional defiant disorder (ODD) typically occurs during the preschool years. This is an important time in child development when behavioral patterns, social interactions, and emotional regulation are being established. Children in this age group often demonstrate defiant, disobedient, and hostile behaviors towards authority figures. These behaviors might manifest through frequent temper tantrums, argumentativeness with adults, and refusal to comply with requests. The early onset of these symptoms offers critical insight into the disorder. Identifying and addressing these behaviors early can promote better outcomes, as interventions are more effective when initiated during the preschool years. In contrast, the other life stages mentioned are generally associated with different developmental challenges and may not present the same characteristic symptoms of ODD. For instance, late and middle adolescence may see more complex manifestations of behavioral issues and may not reflect the straightforward oppositional behaviors typical in younger children. Early adulthood often involves adapting to independence, personal identity, and social relationships rather than the oppositional behaviors seen in preschool-aged children.