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Doctors Debate New ‘Tantrum’ Disorder Diagnosis

Thursday, December 6th, 2012

A new diagnosis that would give the name “disruptive mood dysregulation disorder,” or DMDD, to severe and recurrent temper tantrums is the source of hot debate in the medical community in the wake of the announcement Monday of a number of changes to the manual psychiatrists use to diagnose mental health issues. The announcement also revealed the American Psychiatric Association’s decision to drop “Asperger’s disorder” as a diagnosis distinct from “autism spectrum disorder.”

The debate over DMDD relates to doctors’ concerns that it may be over-diagnosed in children who simply have a harder time learning to regulate their emotions. More from MyHealthNewsDaily:

“Although detailed criteria for the diagnosis have not been released, an APA statement said the condition could apply to “children who exhibit persistent irritability and frequent episodes of behavior outbursts three or more times a week for more than a year.” The addition is intended in part to reduce the number of kids misdiagnosed as having bipolar disorder, who may be treated with powerful drugs.

But some experts say the new condition was added to the manual too soon.

“I think it’s premature to put it in as a full diagnosis,” said Dr. David Axelson, an associate professor of psychiatry at University of Pittsburgh School of Medicine, referring the condition’s inclusion in the front of the manual with other well-accepted diagnoses, rather than in the appendix, which includes provisional diagnoses requiring further research.

Some are concerned that a label of disruptive mood dysregulation disorder would turn normal kid behavior into a medical condition.

But Axelson said the diagnosis requires severe and frequent behavior problems, and if properly applied, kids without a true mental condition would be unlikely to be diagnosed. In addition to frequent outbursts for more than a year, children need to be at least 6, but younger than teenagers, to be given the diagnosis, according to early versions of the criteria.

However, parents might overestimate how often their child behaves badly, because they focus on recent outbursts, and inaccurately reporting behavior to a mental health professional may lead to mislabeling, Axelson said.”

Image: Child having tantrum, via Shutterstock

 

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Researchers Explore the Science of Temper Tantrums

Tuesday, December 6th, 2011

In a groundbreaking new study published in the journal Emotion, scientists studied high-quality audio recordings of over 100 toddlers having temper tantrums, and discovered that the emotional outbursts familiar to every parent actually have predictable rhythms and patterns that, when properly understood, can help parents, teachers, and caregivers tell the difference between a “normal” tantrum, and a sign of an emotional or behavioral disorder.

From NPR.org:

The scientists then analyzed the audio. They found that different tantrum sounds had very distinct audio signatures. When the sounds were laid down on a graph, the researchers found that different sounds emerged and faded in a definite pattern. Unsurprisingly, sounds like yelling and screaming usually came together.

“Screaming and yelling and kicking often go together,” Potegal said. “Throwing things and pulling and pushing things tend to go together. Combinations of crying, whining, falling to the floor and seeking comfort — and these also hang together.”

But where one age-old theory of tantrums might suggest that meltdowns begin in anger (yells and screams) and end in sadness (cries and whimpers), Potegal found that the two emotions were more deeply intertwined.

“The impression that tantrums have two stages is incorrect,” Potegal said. “In fact, the anger and the sadness are more or less simultaneous.”

Green and Potegal found that sad sounds tended to occur throughout tantrums. Superimposed on them were sharp peaks of yelling and screaming: anger.

The trick in getting a tantrum to end as soon as possible, Potegal said, was to get the child past the peaks of anger. Once the child was past being angry, what was left was sadness, and sad children reach out for comfort. The quickest way past the anger, the scientists said, was to do nothing. Of course, that isn’t easy for parents or caregivers to do.

Image: Toddler having a tantrum, via Shutterstock.

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Doctors Debate ‘Temper’ Disorder Name, Relevance

Monday, October 24th, 2011

Doctors and mental health professionals are deep in debate over whether a new named disorder for children with severe temper tantrums should be included in the new version of the mental health diagnostic reference manual.

Disruptive mood dysregulation disorder, or DMDD, would be diagnosed in children 6 years old or older if they suffer from severe irritability and uncontrollable outbursts–far beyond the  “temper tantrums” that every child experiences at some point in normal development.

The Los Angeles Times reports that some proponents of the new diagnosis say it could help reduce the number of bipolar disorder diagnoses made–and medications prescribed–in children who might be able to be managed differently under a DMDD diagnosis.

Opponents, including pediatrician Dr. Claudia Gold, argue that the new label could do just the opposite, leading to more psychiatric prescriptions, not fewer.

“DMDD is being created as a new diagnosis to stem the rising tide of diagnosis of bipolar disorder in children. But I fear that this label will have the same fate, as clinicians feel helpless in the face of these troubled young families,” Gold writes on CNN.com

The new diagnostic reference volume, the DSM-5, will be published in May of 2013.

(image via: http://babyparenting.about.com/)

 

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