An empirically based alternative to DSM-5's disruptive mood dysregulation disorder for ICD-11

Lochman, John E.; Evans, Spencer C.; Burke, Jeffrey D.; Roberts, Michael C.; Fite, Paula J.; Reed, Geoffrey M.; Peña, Francisco R. de la; Matthys, Walter; Ezpeleta, Lourdes; Siddiqui, Salma; Garralda, M. Elena

doi:10.1002/wps.20176

Cited by 98 publications

(48 citation statements)

References 32 publications

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“…Other person-centered studies (Gadow & Drabick, 2012;Kuny et al, 2013) have identified that the presence of high irritability in a group is associated with greater severity of outcomes of all types, and Burke (2012) and Gadow & Drabick (2012) also suggest that irritability does not present in the absence of oppositional symptoms. This is consistent with the proposed revision to the International Classification of Diseases (ICD-11;Lochman et al, 2015), which includes a specifier for ODD with irritability, rather than incorporating the new Disruptive Mood Dysregulation Disorder to represent a classification of children with problems of elevated irritability independent of oppositional or DF behavior.…”

Section: Is Odd Irritability Important To Identify In Girls?supporting

confidence: 78%

Longitudinal Profiles of Girls’ Irritable, Defiant and Antagonistic Oppositional Symptoms: Evidence for Group Based Differences in Symptom Severity

Boylan

Rowe

Duku

et al. 2016

J Abnorm Child Psychol

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Objective: Three subdimensions of ODD symptoms have been proposed -angry/irritable (IR), argumentative/defiant (DF) and antagonism (AN). This study tested whether longitudinal symptom trajectories could be identified by these subdimensions. Method: Group-based trajectory analysis was used to identify developmental trajectories of IR, DF and AN symptoms. Multi-group trajectory analysis was then used to identify how subdimension trajectories were linked together over time. Data were drawn from the Pittsburgh Girls Study (PGS; N=2450), an urban community sample of girls between the ages of five--eight at baseline. We included five waves of annual data across ages five-13 to model trajectories.Results: Three trajectories were identified for each ODD subdimension: DF and AN were characterized by high, medium and low severity groups; IR was characterized by low, medium stable, and high increasing groups. Multi-trajectory analysis confirmed these subdimensions were best linked together based on symptom severity. We did not identify girls' trajectory groups that were characterized predominantly by a particular subdimension of ODD symptoms. Membership in more severe symptom groups was significantly associated with worse outcomes five years later. Conclusions: In childhood and early adolescence girls with high levels of ODD symptoms can be identified, and these youth are characterized by a persistently elevated profile of IR, DF and AN symptoms. Further studies in clinical samples are required to examine the ICD-10 proposal that ODD with irritability is a distinct or more severe form of ODD.

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Section: Is Odd Irritability Important To Identify In Girls?supporting

confidence: 78%

Longitudinal Profiles of Girls’ Irritable, Defiant and Antagonistic Oppositional Symptoms: Evidence for Group Based Differences in Symptom Severity

Boylan

Rowe

Duku

et al. 2016

J Abnorm Child Psychol

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“…Despite these differences, however, these studies are consistent in distinguishing a dimension within ODD symptoms that is characterized by persisting anger and touchiness. Studies are also consistent in finding associations between chronic irritability and depression and anxiety, along with an absence of prediction to other psychopathology (e.g., Lochman, Evans, Burke, et al, 2015; Vidal-Ribas, Brotman, Valdivieso, Leibenluft, & Stringaris, 2016). For the present analyses, we will measure chronic irritability using the symptoms of losing temper, being angry, and being touchy, following the model of Burke and colleagues (2014) and the DSM-5 .…”

Section: Childhood Irritabilitymentioning

confidence: 74%

“…A growing literature base highlights the significance of the construct of childhood chronic irritability (e.g., Burke et al, 2014; Lochman et al, 2015). Researchers and clinicians distinguish between chronic and episodic irritability (Leibenluft, Cohen, Gorrindo, et al, 2006), the latter of which represents a marked change from typical functioning as in depression or pediatric bipolar disorder.…”

Section: Childhood Irritabilitymentioning

confidence: 99%

CBT-Enhanced Emotion Regulation as a Mechanism of Improvement for Childhood Irritability

Derella

Johnston

Loeber³

et al. 2017

Journal of Clinical Child & Adolescent Psychology

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Objective. Research supports the clinical importance of childhood irritability, as well as its developmental implications for later anxiety and depression. Appropriate treatment may prevent this progression; however, little evidence exists to guide clinician decision-making regarding treatment for chronic irritability symptoms. Given the empirical support for irritability as a dimension of oppositional defiant disorder (ODD), behavioral interventions that improve ODD symptoms, especially through emotion regulation training, are strong candidates for identifying effective treatment strategies for irritability. Method. Data from a randomized controlled effectiveness trial were used to assess hypotheses regarding irritability. The Stop Now and Plan (SNAP) Program was developed for pre-adolescent youths demonstrating clinically high rates of conduct problems. 252 boys ages 6 to 11 were assigned to participate in either SNAP or standard services; data were collected at four time points over 15 months. Results. Although lower irritability scores over time were seen for the SNAP group compared to standard services, the main effect for treatment was small and did not reach statistical significance. However, a significant indirect effect of SNAP treatment on irritability via improved emotion regulation skills was found; improved emotion regulation skills were associated with significant and substantial reduction in irritability. Conclusions. Specific effects of SNAP for the improvement of emotion regulation skills function as a mechanism for subsequent reductions in irritability, supporting the distinction between emotion regulation and irritability symptoms. Enhancing increased emotion regulation skills within existing evidence-based interventions for children with ODD should provide a strong foundation for treatments to target irritability symptoms.

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“…From research on this proposed category came the diagnostic category entitled disruptive mood dysregulation disorder (DMDD), which has now been included in DSM-5 (American Psychological Association 2013) as a distinct disorder under the category of mood disorders. This approach has since been criticised by the World Health Organisation (WHO) task force (Lochman et al 2015), mainly due to the research on SMD being in its early days, mostly focussed in the USA, and the adaptation to DMDD without adequate peer-reviewed research and limited support for DMDD in field trials. Moreover, concerns have been expressed that DMDD would, in fact, add to the diagnostic confusion rather than alleviate it.…”

Section: Discussionmentioning

confidence: 99%

Bipolar disorder in children and adolescents: diagnostic inpatient rates from 2000 to 2013 in Germany

Rao

Moore

Stewart

et al. 2016

Int J Bipolar Disord

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BackgroundDespite growing consensus on nosology and epidemiology of bipolar disorder (BD) in minors, differences remain. We contribute to this discussion by measuring long-term trends in the inpatient discharge rates of BD in minors.MethodsNationwide German inpatient discharge diagnoses of BD and other related psychiatric disorders were mapped between 2008 and 2013 using registry data from the German Federal Health Monitoring System. This was compared with previously published data, 2000–2007, to assess long-term trends in diagnosis of BD at discharge. Long-term trends (2000–2013) were also computed.ResultsDischarge diagnosis of BD increased by 18% (2.02–2.46 per 100,000) in minors. There was a significant increase of 24.1% in adolescents 15–19 years old (6.56–8.14 per 100,000). BD, at discharge, as a proportion of all psychiatric disorders, increased from 0.26% in 2008 to 0.27% in 2013. When analysing long-term trends (2000–2013), the rates for BD increased significantly as did trends for all mental disorders, except for psychotic disorders, which fell by almost 14%. Between 2000 and 2013, the rate for depression in minors increased by 730%.LimitationsThe dataset consisted of cross-sectional administrative data points with diagnoses based on clinical criteria.ConclusionsThe rate of BD as a discharge diagnosis in German minors has increased significantly, consistently exceeding the general trend for a rise in rates for mental disorders. Overall, the rate of discharge diagnosis of BD from inpatient units in Germany remains a small proportion of all psychiatric diagnoses.

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An empirically based alternative to DSM-5's disruptive mood dysregulation disorder for ICD-11

Cited by 98 publications

References 32 publications

Longitudinal Profiles of Girls’ Irritable, Defiant and Antagonistic Oppositional Symptoms: Evidence for Group Based Differences in Symptom Severity

Longitudinal Profiles of Girls’ Irritable, Defiant and Antagonistic Oppositional Symptoms: Evidence for Group Based Differences in Symptom Severity

CBT-Enhanced Emotion Regulation as a Mechanism of Improvement for Childhood Irritability

Bipolar disorder in children and adolescents: diagnostic inpatient rates from 2000 to 2013 in Germany

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