Disruptive Mood Dysregulation Disorder

Irritability and fits of rage in minors of these is one of the most recurring reasons in consultations and psychology centers. Although these reactions are relatively common in these stages, their chronicity and intensity must be controlled.

When these accesses are too accentuated and occur too frequently, they can be diagnosed as a Disruptive Mood Dysregulation Disorder. Below we talk about its symptoms and treatment, as well as the controversy surrounding this concept.

• Related article: "The 6 types of mood disorders"

What is Disruptive Mood Dysregulation Disorder?

Disruptive Mood Dysregulation Disorder (MODD) is a relatively new term in clinical psychology and psychiatry which refers to a disturbance of the child's mood. During this, the child shows manifestations of chronic irritability and disproportionate mood swings compared to the situation.

Although these symptoms can also be seen in a wide variety of childhood psychological disorders such as Bipolar disorder, oppositional defiant disorder (ODD)

or the Attention deficit disorder and hyperactivity (ADHD), the idea of ​​creating a new concept such as the TDDEA was founded with the aim of being able to include tantrums and outbursts of anger in the diagnosis.

The incorporation into the DSM-V of this new label for child behavior has been widely criticized. both by professionals in psychology and pedagogy, as well as by researchers in environmental sciences. behavior. One of these criticisms is the questioning of if it is really necessary to create more labels for child behavior, since these tend to create a stigma in the child both personally and socially.

On the other hand, the diagnostic criteria do not take into account the family, school or social context of the minor, which can exert a great influence on both your mood and your behavior, and may be the real cause of these outbursts of anger and anger.

Finally, it has been questioned whether this disorder was substantially different from the others already exposed. However, according to certain studies, there is a disparity both in the etiology, in the evolution and in the neurobiological bases.

Differences with pediatric bipolar disorder

There are many cases of alleged disruptive mood dysregulation disorders that, due to the similarity between the symptoms of both conditions, they have been diagnosed as pediatric bipolar disorder.

The main difference between the two is that, just as in bipolar disorder the child presents well-defined episodes of depressive mood and mania, children diagnosed with ADDD they do not experience these different episodes as precisely or delimited.

In bipolarity, the specific episodes are intermingled with moments of euthymia, while in the ADDD the periods of change are much more persistent and random.

ADDD symptoms

In order to make a satisfactory diagnosis of ADDD, without burdening the child with unnecessary labels, in the fifth volume of the Manual Diagnostic and Statistical of Mental Disorders (DSM-V) describes the diagnostic criteria of this disorder, including its symptoms and its exceptions. These criteria are:

• Symptoms present in boys or girls between the ages of 6 and 18 old.
• Severe and recurrent outbursts of anger in response to common stressors. These outbursts must be incongruent with the child's developmental level, the mood between bouts of rage must be irritable or irascible and the average number of outbursts must be at least three times a day week.
• Symptoms begin before 10 years of age.
• Persistent symptoms for at least 12 months.
• The symptoms have not disappeared for three or more months in a row.
• The symptoms must appear in at least two of the following contexts: home, school, social context; being serious in at least one of them.
• The symptoms cannot be better explained by some other medical condition, nor by the consumption of any drug or substance.
• The symptoms do not meet the criteria for a manic or hypomanic episode for more than a day.
• The symptoms do not meet the criteria for a Major Depressive Episode.

It is necessary to specify that this diagnosis can in no case be made before 6 years of age, since in these stages both tantrums and tantrums as well as outbursts of anger are common and regulations.

On the other hand, the DSM-V specifies the impossibility of this disorder occurring at the same time as a bipolar disorder, a oppositional defiant disorder or a intermittent explosive disorder.

Effects and consequences of TDDEA

According to evaluations and studies in the field of child psychology, it can be seen that approximately 80% of the Children under 6 years of age manifest tantrums more or less recurrently, becoming severe in only 20% of the cases. cases.

For this anger or aggressiveness to be considered pathological it must interfere with the minor's daily life, as well as with their academic performance and in the daily family dynamics. As for the family environment, this disorder tends to generate great impotence and a feeling of disorientation in parents of affected children, since they are unable to manage or control the behavior and acts of the child; fearing to impose punishments that are too rigid or, on the contrary, too lax.

As far as the child is concerned, irascible behavior ends up affecting his relationship with his peers or peers, who fail to understand the reason for their behavior. In addition, the levels of frustration he feels are so high that his attention span ends up diminishing, hindering his academic progress.

Treatment

Due to the novelty of the concept, the treatment of TDDEA is still in the process of research and development by clinical professionals. However, the main protocol for intervention in these cases includes the combination of drugs with psychological therapy.

The medication of choice is usually stimulant drugs or medications antidepressants, while psychotherapy consists of an applied behavioral analysis. In addition, the active role of the parents in the treatment is highlighted, since they must learn to manage the changes in the child's mood in the best possible way.

Pharmacological treatment of disruptive mood dysregulation disorder is another of the points for which this condition has received much criticism, questioning the real need to medicate children.