â¢Nil. Disruptive Mood Dysregulation. Disorder: Overlabeling of Tantrums? Disruptive mood dysregulation disorder (DMDD) is a depressive disorder in children ...
Mood Disorders and Suicide
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•Nil Disruptive M o o d D y s r e g u l a t i o n Disorder: Overlabeling of Tantrums?
O n the one h a n d , j u s t as a diagnosis o f b i p o l a r disorder was overused to describe c h i l d r e n w i t h o u t - o f - c o n t r o l rage episodes, a diagnosis o f D M D D m i g h t label as m e n t a l l y i l l
Disruptive m o o d dysregulation disorder ( D M D D ) is
c h i l d r e n w h o m e r e l y have a l o t o f t a n t r u m s , perhaps s i m p l y
a depressive disorder i n c h i l d r e n characterized b y persistent
as a w a y to gain a t t e n t i o n . M o r e o v e r , diagnosing a c h i l d w i t h
i r r i t a b i l i t y and frequent episodes o f o u t - o f - ' c o n t r o l behavior.
D M D D m i g h t focus o n — a n d lead to treatment o f — t h e c h i l d
It is supposed to be a m o r e accurate d e s c r i p t i o n o f kids w h o
w h e n the real p r o b l e m is i n the family.
have o u t - o f - c o n t r o l rage episodes and were i n c o r r e c t l y labeled
O n the other hand, the specifics o f the criteria (e.g., severity,
as h a v i n g b i p o l a r d i s o r d e r a n d t h e n w e r e ( i n a p p r o p r i a t e l y )
frequency, d u r a t i o n ) should prevent diagnosing c h i l d r e n w h o
treated for that disorder. T h e c r i t e r i a for using this diagnosis,
merely are sometimes g r u m p y or t h r o w occasional t a n t r u m s .
w h i c h is b r a n d n e w i n D S M - 5 , include:
T o apply this diagnosis, the child's irritable m o o d must be per-
• Severe, r e c u r r e n t t e m p e r o u t b u r s t s , i n c l u d i n g v e r b a l o r
sistent and daily, even w h e n there is no reinforcement (such as
physical aggression, w i t h a d u r a t i o n or intensity that is o u t o f p r o p o r t i o n to the situation and inconsistent w i t h the child's developmental level. • T h e s e o u t b u r s t s o c c u r at least t h r e e t i m e s a w e e k , o n average.
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attention) for a t a n t r u m . T h e rages must occur i n at least t w o settings (e.g., school and h o m e ) and n o t be an expected r e sponse to a h o m e or school situation. T h i s diagnosis m i g h t lead to fewer such c h i l d r e n being put o n bipolar medication because they w i l l no longer be considered to have bipolar disorder.
• liven between outbursts, m o o d is persistently irritable or angry.
CRITICAL T H I N K I N G E v e n w i t h n a r r o w c r i t e r i a designed to
• T h i s pattern starts b e t w e e n ages 6 and 10, occurs i n at least
prevent inappropriate diagnosis o f bipolar disorder, w o n ' t some
i w o settings, continues for at least 1 year w i t h o u t l e t t i n g up
clinicians apply (and overuse) this diagnosis to c h i l d r e n w h o are
lor 3 m o n t h s , and is n o t exclusively the result o f a n o t h e r
merely " d i f f i c u l t " attention seekers? H o w can we prevent this?
