Stability of Disruptive Mood Dysregulation Disorder Symptoms (Irritable-Angry Mood and Temper Outbursts) Throughout Childhood and Adolescence in a General Population Sample

Mayes, Susan Dickerson; Mathiowetz, C.; Kokotovich, Cari; Waxmonsky, James G.; Baweja, Raman; Calhoun, Susan L.; Bixler, Edward O.

doi:10.1007/s10802-015-0033-8

Cited by 51 publications

(36 citation statements)

References 39 publications

(45 reference statements)

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“…Exploratory analyses, examining the subsample of participants with only ODD ( n =15), without comorbid ADHD, further support this idea, as loses temper became the central symptom of ODD (see online supplementary material). This is in line with recent longitudinal work suggesting DMDD symptoms are often components of other disorders, particularly ODD (Mayes et al, 2015). Of course, DMDD cannot be diagnosed until age 6, so it will be interesting to statistically examine symptom networks of both DMDD and ODD in older children to better understand what, if anything, differentiate the disorders.…”

Section: Discussionsupporting

confidence: 91%

ODD Symptom Network during Preschool

Smith

Lee

Martel

et al. 2016

J Abnorm Child Psychol

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Several different conceptualizations of Oppositional Defiant Disorder (ODD) symptoms have been proposed, including one undivided set of symptoms (DSM-IV-TR; APA, 2000); two domains of symptoms subdivided into affective and behavioral; and three domains of symptoms subdivided as angry/irritable, argumentative/defiant, and spiteful. The current study utilizes a novel approach to examining the division of ODD symptoms through use of network analysis. Participants were 109 preschoolers (64 male) between the ages of three and six (M=4.34 years, SD=1.08) and their parents and teachers/caregivers, who provided ratings of ODD symptoms. Results are consistent with 1-, 2-, and 3- cluster solutions of ODD, but perhaps provide most support for the 3-cluster solution. In addition, results support the idea that negative affect, particularly anger, forms the core of the ODD symptom network during preschool. These results suggest the importance of targeting anger in preschool interventions for ODD.

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Section: Discussionsupporting

confidence: 91%

ODD Symptom Network during Preschool

Smith

Lee

Martel

et al. 2016

J Abnorm Child Psychol

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“…The participants with ODD who met DMDD criteria did not differ significantly from their counterparts without DMDD with respect to symptom severity, comorbidity, or functional impairment 36. Other studies of clinical samples have reported similar degrees of overlap,38,48 suggesting the value of first treating the oppositional behaviors and other externalizing problems. While it is uncommon to find children with just DMDD, when it does it occur in isolation, DMDD is still associated with appreciable impairment 29…”

Section: Criticism Of Dmdd Diagnosismentioning

confidence: 74%

Disruptive mood dysregulation disorder: current insights

Baweja¹,

Mayes²,

Hameed³

et al. 2016

NDT

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Disruptive mood dysregulation disorder (DMDD) was introduced as a new diagnostic entity under the category of depressive disorders in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). It was included in DSM-5 primarily to address concerns about the misdiagnosis and consequent overtreatment of bipolar disorder in children and adolescents. DMDD does provide a home for a large percentage of referred children with severe persistent irritability that did not fit well into any DSM, Fourth Edition (DSM-IV) diagnostic category. However, it has been a controversial addition to the DSM-5 due to lack of published validity studies, leading to questions about its validity as a distinct disorder. In this article, the authors discuss the diagnostic criteria, assessment, epidemiology, criticism of the diagnosis, and pathophysiology, as well as treatment and future directions for DMDD. They also review the literature on severe mood dysregulation, as described by the National Institute of Mental Health, as the scientific support for DMDD is based primarily on studies of severe mood dysregulation.

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“…In addition, this study only examined symptom prevalence at a single time point; therefore, we cannot comment on the stability of reported symptoms. In a follow-up study of 376 children in our general population sample (Mayes et al 2015c), only 29% with DMDD symptoms at baseline had DMDD symptoms at follow-up 8 years later, and only 45% with DMDD symptoms at follow-up had DMDD symptoms at baseline (55% new cases). Axelson et al (2012) also reported low stability for DMDD symptoms in a psychiatric sample.…”

Section: Limitationsmentioning

confidence: 80%

Disruptive Mood Dysregulation Disorder Symptoms and Association with Oppositional Defiant and Other Disorders in a General Population Child Sample

Mayes

Waxmonsky

Calhoun

et al. 2016

Journal of Child and Adolescent Psychopharmacology

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Objective: The new Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5) diagnosis, disruptive mood dysregulation disorder (DMDD), has generated appreciable controversy since its inception, primarily in regard to its validity as a distinct disorder from oppositional defiant disorder (ODD). The goal of our study was to determine if the two DSM-5 DMDD symptoms (persistently irritable or angry mood and severe recurrent temper outbursts) occurred independently of other disorders, particularly ODD. Other DSM-5 DMDD criteria were not assessed. Methods: Maternal ratings of the two DMDD symptoms, clinical diagnosis of ODD using DSM-5 symptom criteria, and psychological problem scores (anxiety, depression, oppositional behavior, conduct disorder, and attention-deficit/ hyperactivity disorder [ADHD]) on the Pediatric Behavior Scale were analyzed in a population sample, 6-12 years of age (n = 665). Results: The prevalence of DMDD symptoms (irritable-angry mood and temper outbursts both rated by mothers as often or very often a problem) was 9%. In all, 92% of children with DMDD symptoms had ODD, and 66% of children with ODD had DMDD symptoms, indicating that it is very unlikely to have DMDD symptoms without ODD, but that ODD can occur without DMDD symptoms. Comorbid psychological problems (anxiety, depression, conduct disorder, and ADHD) in addition to ODD did not increase the risk of having DMDD symptoms beyond that for ODD alone. Only 3% of children with psychological problems other than ODD had DMDD symptoms. Conclusions: Our general population findings are similar to those for a psychiatric sample, suggesting that DMDD cannot be differentiated from ODD based on symptomatology. Therefore, it is important to assess all DSM criteria and to examine for comorbid psychopathology when considering a diagnosis of DMDD. Our results support the recommendation made by the World Health Organization's International Classification of Diseases, 11th Revision (ICD-11) panel of experts that DMDD symptoms may be more appropriately classified as an ODD specifier than a separate diagnosis.

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Stability of Disruptive Mood Dysregulation Disorder Symptoms (Irritable-Angry Mood and Temper Outbursts) Throughout Childhood and Adolescence in a General Population Sample

Cited by 51 publications

References 39 publications

ODD Symptom Network during Preschool

ODD Symptom Network during Preschool

Disruptive mood dysregulation disorder: current insights

Disruptive Mood Dysregulation Disorder Symptoms and Association with Oppositional Defiant and Other Disorders in a General Population Child Sample

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