not be made if the symptoms occur exclusiv ely during the course of a mood disorder. 
Disruptive mood dysregulation disorder. Oppositional defiant disorder shares with dis-
ruptive mood dysregulation disorder the symp toms of chronic negative mood and temper
outbursts. However, the severity, frequency, and chronicity of temp er outbursts are more
severe in individuals with di sruptive mood dysregulation disorder than in those with
oppositional defiant disorder. Thus, only a minority of ch ildren and adolescents whose
symptoms meet criteria for oppo sitional defiant disorder woul d also be diagnosed with dis-
ruptive mood dysregulation disorder. When the mood disturbance is severe enough to meet
criteria for disruptive mood dysregulation disorder, a diagnosis of oppositional defiant dis-
order is not given, even if all criteria for oppositional defiant disorder are met.
Intermittent explosive disorder. Intermittent explosive disorder also involves high
rates of anger. However, indi viduals with this disorder sh ow serious aggr ession toward
others that is not part of the defini tion of oppositional defiant disorder. 
Intellectual disability (intell ectual developmental disorder). In individuals with intel-
lectual disability, a diagnosis of oppositional defiant disorder is gi ven only if the opposi-
tional behavior is markedly greater than  is commonly observed among individuals of
comparable mental age and with comparab le severity of intellectual disability. 
Language disorder. Oppositional defiant disorder must  also be distinguished from a
failure to follow directions that is the resu lt of impaired language comprehension (e.g.,
hearing loss). 
Social anxiety disorder (social phobia). Oppositional defiant disord er must also be dis-
tinguished from defiance due to  fear of negative evaluation associated with social anxiety
disorder.