Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review

Paulus, Frank W.; Ohmann, Susanne; Möhler, Eva; Plener, Paul L.; Popow, Christian

doi:10.3389/fpsyt.2021.628252

Cited by 55 publications

(32 citation statements)

References 460 publications

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“…The close relationship between ED and core autism symptoms has led some to suggest that ED should be considered among the ASD features ( 50 ). But, ED is also a well known transdiagnostic risk factor for many mental disorders in children and adolescents, such as, among the others, ADHD, mood disorders, posttraumatic stress disorder, non-suicidal self-injury, and disruptive mood dysregulation disorder ( 65 ). In fact, the CBCL-AAA index was initially studied as a measure of high risk for bipolar disorder in adolescence ( 66 – 69 ), and subsequently as a risk factor for other psychopathology associated with suicidality in adults ( 68 , 70 ).…”

Section: Discussionmentioning

confidence: 99%

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

Davico

Marcotulli²,

Cudia³

et al. 2022

Front. Psychiatry

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AimEmotional dysregulation (ED), defined by deficits in the ability to monitor and modulate the valence, intensity, and expression of emotions, is typically expressed with irritability, tantrums, mood fluctuations, and self-harm in young children with autism spectrum disorder (ASD). Although ED does not represent a diagnostic feature of ASD, its manifestations are an important contributor to functional impairment and clinical referral. This study aims to examine the relationship between ED and adaptive functioning in preschoolers clinically referred for ASD or other neurodevelopmental disorders.MethodsA sample of 100 children (74% males, mean age 39.4 ± 12.3 months), consecutively referred to a university clinic for neurodevelopmental disorders, received clinical assessments of psychopathology with the CBCL and the Autism Diagnostic Interview-Revised, of ED- with the CBCL-Attention, Anxious/Depressed, and Aggression index (CBCL-AAA), of autism symptom severity with the ADOS-2 Calibrated Severity Score (ADOS-CSS), and of global developmental/cognitive delay (GDD) with the WPPSI-IV or other age-appropriate standardized scales. Adaptive functioning was measured with the ABAS-II. Sixty-five children met DSM-5 criteria for ASD. Multivariate regression models were applied to evaluate the relative contribution of ED, ASD severity and GDD to the ABAS-II general (GAC), conceptual (CAD), social (SAD), and practical (PAD) adaptive functioning domains.ResultsOverall (n = 100), lower adaptive functioning was associated with higher CBCL-AAA (p = 0.003), higher ADOS-CSS (p < 0.001), and presence of GDD (p = 0.023). In the ASD group (n = 65), worse CAD was predicted by GDD (p = 0.016), and worse SAD and PAD by higher ADOS-CSS (p = 0.032) and ED (p = 0.002). No sex differences were detected in the study variables.ConclusionTogether with the severity of global developmental delay and of autism symptoms, ED is a significant contributor to impairment in adaptive functioning among young children with a neurodevelopmental disorder and, in particular, with ASD. ED could represent a specific target for early interventions aimed at enhancing adaptive functioning in early childhood.

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Section: Discussionmentioning

confidence: 99%

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

Davico

Marcotulli²,

Cudia³

et al. 2022

Front. Psychiatry

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“…IGD possibly mediated ADHD youth’s development of DMDD-like symptoms and more psychiatric disorders, such as more severe ADHD, mood disorders, self-injury, eating disorders, ODD, conduct disorder (CD), personality disorders, and substance use disorders during the critical period of the COVID-19 pandemic [ 28 ]. For the early prevention of more children and adolescents becoming mood-dysregulated after excessive gaming during the COVID-19 pandemic, this study result suggests that child mental health experts develop earlier detection and prevention strategies for children and adolescents hidden behind internet addiction.…”

Section: Introductionmentioning

confidence: 99%

Structural Equation Modeling (SEM): Gaming Disorder Leading Untreated Attention-Deficit/Hyperactivity Disorder to Disruptive Mood Dysregulation

Tzang

Chang

2022

IJERPH

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(1) Background: Internet gaming disorder (IGD) in youths likely leads to disruptive mood dysregulation, especially among those with attention-deficit/hyperactivity disorder (ADHD). Whether IGD mediates the pathways leading ADHD to disruptive emotional dysfunction remains unclear. This study aims to elucidate the direct or indirect influence of IGD on ADHD; (2) Method: The Swanson, Nolan, and Pelham Version IV questionnaire was used to evaluate symptoms of ADHD and oppositional defiant disorder, and the Chen gaming disorder scale was used to measure IGD. A psychiatrist diagnosed ADHD, IGD, and disruptive mood dysregulation disorder (DMDD)-like symptoms. Structural equation modeling was applied to evaluate the role of IGD in mediating ADHD progression to disruptive mood dysregulation; (3) Results: Among a total of 102 ADHD youths, 53 (52%) of them with IGD were significantly more likely to have poor interpersonal relationships (p < 0.01) and DMDD-like symptoms (p < 0.01) than ADHD youths without IGD. IGD played a mediating role in increasing the risk of disruptive mood dysregulation in ADHD youths; (4) Conclusions: The findings suggest that IGD mediates ADHD’s progression to disruptive mood dysregulation. Intensive biopsychosocial interventions are warranted for ADHD youths with IGD. More children and adolescents became mood-dysregulated after excessive gaming during the COVID-19 pandemic; this study’s results suggest that child mental health experts develop earlier detection and prevention strategies for children and adolescents hidden behind internet addiction.

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“…Some of the psychological and intrapersonal aspects predictive of self-harming behavior reported in the literature include: a tendency for perfectionism; a limited problem-solving capacity; a self-critical style; alexithymic traits; and impulsiveness [5,[7][8][9][10][11][12][13]. Emotional dysregulation also seems to be strongly associated with NSSI [14][15][16][17]. Much attention has also been paid in the literature to the psychopathological correlates associated with self-harming behavior.…”

Section: Introductionmentioning

confidence: 99%

“…Much attention has also been paid in the literature to the psychopathological correlates associated with self-harming behavior. In particular, NSSI often appears to be associated with borderline personality disorder (BPD) [14] and with other psychiatric diagnoses of both internalizing and externalizing type-including mood disorders [1,6,[17][18][19], eating disorders [18,[20][21][22], and substance abuse [19]-especially in adolescence [6]. One interesting psychopathological correlate of self-harming that has been examined less often in the literature concerns symptoms of somatization.…”

Section: Introductionmentioning

confidence: 99%

Alexithymia and Psychopathological Manifestations Centered on the Body: Somatization and Self-Harm

Gatta

Angelico

Rigoni

et al. 2022

JCM

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The present study aimed to investigate alexithymia and psychopathological manifestations centered on the body in a sample of adolescents with somatizing and/or self-harming issues to analyze the phenomenon of NSSI linked to Somatic Symptom Disorders (SSD). A sample of 184 adolescents between 12 and 19 years of age, was divided into three groups, one with NSSI (n = 49) and the second group with SSD (n = 57), comparing them with a third group of adolescents with SSD and NSSI (n = 78) to investigate their differences and similarities in psychopathological correlates and to analyze the mediation role of alexithymia and emotional dysregulation in NSSI and SSD related to internalizing problems. The battery of tests included the Toronto Alexithymia Scale (TAS-20) and the Youth Self-Report 11–18 (YSR). The NSSI + SSD group scored higher than the other two groups on all the YSR scales. The affective syndromes were the only clinical condition that discriminated between the three groups. On all the other syndrome scales, the NSSI + SSD group differed from the other two groups, while there were no differences between the NSSI group and the SSD group. The NSSI + SSD group revealed a more severely deficient emotional self-regulation. Difficulty identifying feelings was a trait shared by adolescents with SSD and those engaging in NSSI, a more complex overall alexithymia profile was associated with the combination of self-harming behavior and somatization. Alexithymia and emotional dysregulation played a mediating role in the relationship between internalizing problems and somatization. We did not find a mediating role in alexithymia and emotional dysregulation in the relationship between internalizing problems and self-injurious behavior. The combination of NSSI and SSD gave rise to more severe psychopathological correlates, clinical levels of alexithymia, and more severe deficient emotional self-regulation. Results of mediation role indicated a link between alexithymia, emotional dysregulation, and somatization.

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Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review

Cited by 55 publications

References 460 publications

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

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

Structural Equation Modeling (SEM): Gaming Disorder Leading Untreated Attention-Deficit/Hyperactivity Disorder to Disruptive Mood Dysregulation

Alexithymia and Psychopathological Manifestations Centered on the Body: Somatization and Self-Harm

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