ODD can co-exist with ADHD, learning disabilities, mood disorders (depression), and anxiety disorders.

ODD has 3 major categories of risk factors:

• Biological factors include family genes that are passed down and chemical imbalances in the brain. 
• Developmental factors suggests that children with ODD had difficulty separating from their primary attachment figures and developing independent behaviors during their toddler years. 
• Learned factors suggests that the negative attitudes of children with ODD are responses to the negative reinforcement used by parents. Negative reinforcement provides the child with the attention that they desire for their out-of-control behavior, and results in an increase in oppositional defiant behaviors.

Negative behaviors include:

• Temper tantrums
• Excessive arguments with adults
• Intentionally annoying or upsetting others
• Blaming others for their mistakes or misbehavior
• Seeking revenge
• Speaking harshly or unkindly when upset
• Swearing or using obscene language
• Being angry or resentful
• Being easily annoyed by others
• Refusing to follow rules or constantly questioning rules