Disruptive Mood Dysregulation Disorder
Sometimes, it is difficult for parents to determine when their child’s behavior falls within evolutionary expectations and when there is a psychological problem. The presence of tantrums and behavior problems in children is frequent, especially at an early age. However, in some cases we may be facing a Disruptive Mood Dysregulation Disorder (TDDEA).
This diagnostic category has recently been included in psychology manuals. Previously, children who fulfilled the symptoms of this syndrome were included in pediatric bipolar disorder, but important differences were found between the two
Disruptive mood dysregulation disorder
The TDDEA describes children with serious emotional and behavioral problems. The main feature is a constantly and chronically irritable mood. In addition, disproportionate outbursts of rage and anger occur frequently (three or more times per week).
This pattern of fussiness and outbursts must occur continuously for at least 12 months to be able to make a diagnosis. That is, the symptoms cannot be interrupted for a period greater than three months. Also, the disorder must have started before the child is 10 years old.
A curious fact is that it is not possible to diagnose TDDEA before the age of six. This is because tantrums and outbursts of anger are frequent in preschoolers and it is not easy to define when they exceed normal intensity.
The consequences of this disorder are significant. This irritable and angry behavior is highly disturbing, so the child’s functioning at home or at school is greatly affected. In addition, there is an increased risk of school dropout and future peer relationship problems.
This syndrome has been found to be more frequent in younger children and its presence decreases in older children and adolescents. However, TDDEA is usually associated with other emotional disorders (such as depression) and behavioral disorders (such as oppositional defiant disorder).
Where did the TDDEA come from?
As with the rest of psychological disorders, there is no single factor that can explain its presence. However, there are some conditions related to TDDEA. 75% of children who suffer from it show a family history of mental health problems. Especially, a substance abuse problem in the parents can lead to the appearance of this disorder.
In addition, it has been observed that the parents of these children are more hostile and critical when it comes to interacting with their children. For this reason, it is convenient that the treatment is also aimed at teaching other parenting models to adults.
Child abuse and the exposure of children to traumatic events are also related to TDDEA. Finally, some personality characteristics such as extroverted temperament, impulsivity or the search for rewards can favor the presence of this disorder.
Treatment
As this is a recently established diagnosis, the best treatment options are still being investigated. Certain drugs, such as stimulants or antipsychotics, have been used, producing the latter good results. Risperidone was able to significantly reduce irritability and aggressive behavior. However, caution must be exercised when administering these medications to minors, as the side effects can be serious.
Regarding psychological treatment, it has been shown that the collaboration of parents is of special importance. Children with TDDEA appear to be especially sensitive to changes in parenting. Therefore, a training for parents, in which they learn strategies to deal with their child’s symptoms, has been very successful.
The psychological work with the minor will be behavioral. It will be aimed at identifying the stressors and triggers that cause outbursts of anger and teaching the child tools to handle them properly.
It is also advisable to have the involvement of the school and educators. They should be aware of the special needs of these children and the possible side effects of the medication, should they take it. Also, it will be very important to show consistency, both at home and at school. This will facilitate behavior change in the child.
