Dysregulation profile (DP) as a transdiagnostic psychopathological factor in clinically referred children – comparisons between disorders and latent structure

Abstract

Background: Dysregulation Profile (DP) describes the psychopathological construct of concurrent impairments in the ability to regulate emotion, behaviour, and cognition measured by the Child Behaviour Checklist (CBCL). Such transdiagnostic dimensions of psychopathology play an important role in addition to core symptoms of psychiatric diagnosis in clinical practice. Evaluation of DP in children with different mental disorders may improve our understanding and treatment of both contents.Methods: 911 clinically referred children between 6 and 18 years were investigated. The sample consisted of five 'pure' disorders groups, i.e., tic disorder (TIC), anxiety disorder, obsessive compulsive disorder, depression, Attention Deficit Hyperactivity Disorder (ADHD), and two comorbid disorder group, i.e., ADHD + TIC and ADHD + oppositional defiant disorder (ODD). DP level and latent structure were compared across groups.Results: The rate of severe/abnormal dysregulation rates varied from 15 % to 44 % when the 210 cut-off was used, and 5 % to 18 % when stringent cut-off was used (i.e. ->70 on all DP-subscales). The most affected population were children with comorbid ADHD with ODD/TIC, while least were those with TIC only. Five different latent phenotypes of DP were found. Conclusion: DP above clinical cut-off level widely exists in clinically referred children in parallel to core symptoms of their diagnosis, especially among children with comorbidities. During clinical assessment it would be worth to clarify the role of DP-related problems within the general psychosocial impairment of the patient to improve a personalized approach.

Emotion dysregulation in ADHD and other neurodevelopmental conditions: a co-twin control study

“…ED has in recent years been conceptualised as a pivotal transdiagnostic construct underlying several psychiatric diagnoses [10][11][12] and has frequently been operationalised by the dysregulation profile (DP) derived from the Child Behaviour Checklist (CBCL) [13]. The DP has been proposed to measure a general dysregulation factor [14][15][16]. Accordingly, the DP has been found to identify ED in several clinical populations, including ADHD, autism, anxiety and depression, as well as in nonclinical populations [16][17][18][19][20].…”

“…The DP has been proposed to measure a general dysregulation factor [14][15][16]. Accordingly, the DP has been found to identify ED in several clinical populations, including ADHD, autism, anxiety and depression, as well as in nonclinical populations [16][17][18][19][20]. Despite recent research emphasising the transdiagnostic nature of ED, there is an ongoing debate regarding the role of ED in ADHD.…”

“…A larger sample would enable further examination of the associations within other relevant sub-cohorts, such as different age groups and medication-naïve individuals. ED was assessed using parental ratings, which may be subject to bias, and although the DP is a well-established measure of general dysregulation [14][15][16], it was not originally developed to specifically measure ED [49]. Therefore, it would have been interesting to include additional and more objective measures targeting ED to increase specificity.…”

Emotional Dysregulation and Adaptive Functioning in Preschoolers With Autism Spectrum Disorder or Other Neurodevelopmental Disorders

“…Among samples of clinically referred children for a suspicion of ASD, about 60% ( 57 ) receive an ASD diagnosis, while the others are very often diagnosed with language disorders, global developmental delays or having inattention, hyperactivity, and disruptive behaviors. The relationship between ADHD ( 58 – 61 ), developmental delays ( 62 ) or other disorders ( 63 ) and emotional has been extensively reported. Moreover boys with specific language impairment, have been reported to have lower emotional regulation abilities than typically developing children ( 64 ).…”

Editorial: Each child with ADHD is unique: Treat the whole patient, not just their symptoms

“…Indeed, this form of heterogeneity is represented in diagnostic systems such as the DSM and ICD adoption of polythetic approaches and the existence of different clinical sub-types or, as they are now termed, presentations. In the case of clinical symptoms these diverse manifestations have common elements and tap shared latent constructs (Wang et al, 2022 ). In this special issue we focus on two other types of heterogeneity.…”