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DSM-5 disruptive mood dysregulation disorder: correlates and predictors in young children

Published online by Cambridge University Press:  20 January 2014

L. R. Dougherty ,
V. C. Smith ,
S. J. Bufferd ,
G. A. Carlson ,
A. Stringaris ,
E. Leibenluft  and
D. N. Klein
L. R. Dougherty*
Affiliation:
Department of Psychology, University of Maryland, College Park, MD, USA
V. C. Smith
Affiliation:
Department of Psychology, University of Maryland, College Park, MD, USA
S. J. Bufferd
Affiliation:
Department of Psychology, California State University San Marcos, San Marcos, CA, USA
G. A. Carlson
Affiliation:
Department of Psychiatry, Stony Brook School of Medicine, Stony Brook, NY, USA
A. Stringaris
Affiliation:
Institute of Psychiatry, King's College London, London, UK
E. Leibenluft
Affiliation:
Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
D. N. Klein
Affiliation:
Department of Psychiatry, Stony Brook School of Medicine, Stony Brook, NY, USA Department of Psychology, Stony Brook University, Stony Brook, NY, USA
*
* Address for correspondence: L. R. Dougherty, Ph.D., Department of Psychology, University of Maryland, College Park, MD 20742, USA. (Email: ldougher@umd.edu)
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Abstract

Background

Despite the inclusion of disruptive mood dysregulation disorder (DMDD) in DSM-5, little empirical data exist on the disorder. We estimated rates, co-morbidity, correlates and early childhood predictors of DMDD in a community sample of 6-year-olds.

Method

DMDD was assessed in 6-year-old children (n = 462) using a parent-reported structured clinical interview. Age 6 years correlates and age 3 years predictors were drawn from six domains: demographics; child psychopathology, functioning, and temperament; parental psychopathology; and the psychosocial environment.

Results

The 3-month prevalence rate for DMDD was 8.2% (n = 38). DMDD occurred with an emotional or behavioral disorder in 60.5% of these children. At age 6 years, concurrent bivariate analyses revealed associations between DMDD and depression, oppositional defiant disorder, the Child Behavior Checklist – Dysregulation Profile, functional impairment, poorer peer functioning, child temperament (higher surgency and negative emotional intensity and lower effortful control), and lower parental support and marital satisfaction. The age 3 years predictors of DMDD at age 6 years included child attention deficit hyperactivity disorder, oppositional defiant disorder, the Child Behavior Checklist – Dysregulation Profile, poorer peer functioning, child temperament (higher child surgency and negative emotional intensity and lower effortful control), parental lifetime substance use disorder and higher parental hostility.

Conclusions

A number of children met DSM-5 criteria for DMDD, and the diagnosis was associated with numerous concurrent and predictive indicators of emotional and behavioral dysregulation and poor functioning.

Keywords

Disruptive mood dysregulation disorderearly childhoodpredictors
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 11 , August 2014 , pp. 2339 - 2350
Creative Commons
Parts of this are a work of the U.S. Government and not subject to copyright protection in the United States.
Copyright
Copyright © Cambridge University Press 2014

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References

Achenbach, TM, Rescorla, LA (2000). Manual for the ASEBA School-Age Forms and Profiles. University of Vermont, Research Center for Children, Youth, and Families: Burlington, VT.Google Scholar
Achenbach, TM, Rescorla, LA (2001). Manual for ASEBA Preschool Forms and Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families: Burlington, VT.Google Scholar
Althoff, RR, Verhulst, FC, Rettew, DC, Hudziak, JJ, van der Ende, J (2010). Adult outcomes of childhood dysregulation: a 14-year follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry 49, 1105–1116.Google ScholarPubMed
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision. American Psychiatric Press: Washington, DC.Google Scholar
APA (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. American Psychiatric Press: Washington, DC.Google Scholar
Axelson, D, Findling, RL, Fristad, MA, Kowatch, RA, Youngstrom, EA, Horwitz, SM, Arnold, LE, Frazier, TW, Ryan, N, Demeter, C, Gill, MK, Hauser-Harrington, JC, Depew, J, Kennedy, SM, Gron, BA, Rowles, BM, Birmaher, B (2012). Examining the proposed disruptive mood dysregulation disorder diagnosis in the longitudinal assessment of mania symptoms study. Journal of Clinical Psychology 73, 1342–1350.Google Scholar
Brotman, MA, Schmajuk, M, Rich, BA, Dickstein, DP, Guyer, AE, Costello, EJ, Egger, HL, Angold, A, Pine, DS, Leibenluft, E (2006). Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children. Biological Psychiatry 60, 991–997.CrossRefGoogle ScholarPubMed
Bufferd, SJ, Dougherty, LR, Carlson, GA, Klein, DN (2011). Parent-reported mental health in preschoolers: findings using a diagnostic interview. Comprehensive Psychiatry 52, 359–369.CrossRefGoogle ScholarPubMed
Bufferd, SJ, Dougherty, LR, Carlson, GA, Rose, S, Klein, DN (2012). Psychiatric disorders in preschoolers: continuity from ages 3 to 6. American Journal of Psychiatry 169, 1157–1164.CrossRefGoogle ScholarPubMed
Clark, LA (2005). Temperament as a unifying basis for personality and psychopathology. Journal of Abnormal Psychology 114, 505–521.Google Scholar
Copeland, WE, Angold, A, Costello, EJ, Egger, H (2013). Prevalence, comorbidity, and correlates of DSM-5 proposed disruptive mood dysregulation disorder. American Journal of Psychiatry 170, 173–179.Google Scholar
Dougherty, LR, Bufferd, SJ, Carlson, GA, Dyson, MW, Olino, TM, Klein, DN (2011). Preschoolers’ observed temperament and DSM-IV psychiatric disorders assessed with a parent diagnostic interview. Journal of Clinical Child and Adolescent Psychology 40, 295–306.Google Scholar
Dunn, LM, Dunn, DM (1997). Peabody Picture Vocabulary Test, third edn. Pearson Assessments: Bloomington, MN.Google Scholar
Egeland, B, Weinfield, N, Hiester, M, Lawrence, C, Pierce, S, Chippendale, K, Powell, J (1995). Teaching Tasks Administration and Scoring Manual. University of Minnesota Institute of Child Development: Minneapolis, MN.Google Scholar
Egger, HL, Ascher, BH, Angold, A (1996). The Preschool Age Psychiatric Assessment: Version 1.1. Center for Developmental Epidemiology, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center: Durham, NC.Google Scholar
Egger, HL, Erkanli, A, Keeler, G, Potts, E, Walter, BK, Angold, A (2006). Test-retest reliability of the Preschool Age Psychiatric Assessment (PAPA). Journal of the American Academy of Child and Adolescent Psychiatry 45, 538–549.CrossRefGoogle ScholarPubMed
Eisenberg, N, Fabes, RA, Guthrie, IK, Murphy, BC, Maszk, P, Holmgren, R, Suh, K (1996). The relations of regulation and emotionality to problem behavior in elementary school children. Development and Psychopathology 8, 141–162.CrossRefGoogle Scholar
Eisenberg, N, Fabes, RA, Murphy, B, Maszk, P, Smith, M, Karbon, M (1995). The role of emotionality and regulation in children's social functioning: a longitudinal study. Child Development 66, 1360–1384.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1996). The Structured Clinical Interview for DSM-IV Axis I Disorders—Non-Patient Edition. Biometrics Research Department, New York State Psychiatric Institute: New York, NY.Google Scholar
Francis, SA (2011). Using a framework to explore associations between parental substance use and the health outcomes of their adolescent children. Journal of Child and Adolescent Substance Abuse 20, 1–14.Google Scholar
Holtmann, M, Buchmann, AF, Esser, G, Schmidt, MH, Banaschewski, T, Laucht, M (2011). The Child Behavior Checklist – Dysregulation Profile predicts substance use, suicidality, and functional impairment: a longitudinal analysis. Journal of Child Psychology and Psychiatry 52, 139–147.CrossRefGoogle ScholarPubMed
Kim, J, Carlson, GA, Meyer, SE, Bufferd, SJ, Dougherty, LR, Dyson, MW, Laptook, RS, Olino, TM, Klein, DN (2012). Correlates of the CBCL-dysregulation profile in preschool-aged children. Journal of Child Psychology and Psychiatry 53, 918–926.CrossRefGoogle ScholarPubMed
Krieger, FV, Polanczyk, GM, Goodman, R, Rohde, LA, Graeff-Martins, AS, Salum, G, Gadelha, A, Pan, P, Stahl, D (2013). Dimensions of oppositionality in a Brazilian community sample: testing the DSM-5 proposal and etiological links. Journal of the American Academy of Child and Adolescent Psychiatry 52, 389–400.CrossRefGoogle Scholar
Larsen, RJ, Diener, E (1987). Affect intensity as an individual difference characteristic: a review. Journal of Research in Personality 21, 1–39.Google Scholar
Leibenluft, E (2011). Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youths. American Journal of Psychiatry 168, 129–142.CrossRefGoogle ScholarPubMed
Leibenluft, E, Charney, DS, Towbin, KE, Bhangoo, RK, Pine, DS (2003). Defining clinical phenotypes of juvenile mania. American Journal of Psychiatry 160, 430–437.CrossRefGoogle ScholarPubMed
Leibenluft, E, Cohen, P, Gorrindo, T, Brook, JS, Pine, DS (2006). Chronic versus episodic irritability in youth: A community-based, longitudinal study of clinical and diagnostic associations. Journal of Child and Adolescent Psychopharmacology 16, 456–466.Google Scholar
Margulies, DM, Weintraub, S, Basile, J, Grover, PJ, Carlson, GA (2012). Will disruptive mood dysregulation disorder reduce false diagnosis of bipolar disorder in children? Bipolar Disorders 14, 488–496.Google Scholar
Markon, KE, Chmielewski, M, Miller, CJ (2011). The reliability and validity of discrete and continuous measures of psychopathology: a quantitative review. Psychological Bulletin, 137, 856–879.Google Scholar
Menard, S (2002). Applied Logistic Regression Analysis, 2nd edn. Sage Publications: Thousand Oaks, CA.Google Scholar
Rettew, DC (2008). Temperament and child psychopathology: beyond associations. In Developmental Psychopathology and Wellness: Genetic and Environmental Influences (ed. Hudziak, J. J.), pp. 67–84. American Psychiatric Publishing: Washington, DC.Google Scholar
Rothbart, MK, Ahadi, SA, Hersey, KL, Fisher, P (2001). Investigations of temperament at three to seven years: The Children's Behavior Questionnaire. Child Development 72, 1394–1408.CrossRefGoogle ScholarPubMed
Shaffer, D, Gould, M, Brasic, J, Ambrosini, P, Fisher, P, Bird, H, Aluwahlia, S (1983). A Children's Global Assessment Scale. Archives of General Psychiatry 40, 1228–1231.Google Scholar
Spanier, GB (1976). Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family 38, 15–28.Google Scholar
Stringaris, A, Cohen, P, Pine, DS, Leibenluft, E (2009). Adult outcomes of youth irritability: a 20-year prospective community-based study. American Journal of Psychiatry 166, 1048–1054.CrossRefGoogle ScholarPubMed
Stringaris, A, Goodman, R (2009). Longitudinal outcome of youth oppositionality: irritable, headstrong, and hurtful behaviors have distinctive predictions. Journal of the American Academy of Child and Adolescent Psychiatry 48, 404–412.Google Scholar
Stringaris, A, Maughan, B, Goodman, R (2010). What's in a disruptive disorder? Temperamental antecedents of oppositional defiant disorder: findings from the Avon Longitudinal Study. Journal of the American Academy of Child and Adolescent Psychiatry 49, 474–483.Google Scholar
Youngstrom, E, Youngstrom, JK, Starr, M (2005). Bipolar diagnoses in community mental health: Achenbach Child Behavior Checklist Profiles and patterns of comorbidity. Biological Psychiatry 58, 569–575.Google Scholar