Establishing the transdiagnostic contextual pathways of emotional outbursts

Abstract

Emotional outbursts or temper outbursts are challenging behaviours commonly experienced by people with neurodevelopmental disorders and people who have experienced childhood adversity, which can negatively impact individuals and their families. Emotional outbursts may manifest in different situations via unique pathways distinguished by context-specific differences in the regulation and expression of emotions. Caregivers (N = 268) of young people (6–25 years) with emotional outbursts completed a bespoke caregiver-report questionnaire. Potential pathways were identified by examining the patterns of antecedents and setting events related to outbursts through factor and cluster analyses. Six contextual factors were derived from the Emotional Outburst Questionnaire. Based on these factors, the responses were classified into three clusters, which may represent potential pathways of emotional outbursts. The three clusters were characterized by the increased likelihood of outbursts: (1) across all setting events and triggers; (2) in safe setting events; (3) in unsafe setting events. These potential pathways may be related to: (1) differences in sensory processing; (2) masking of emotions in unsafe environments; (3) differences in safety perception. This framework supports a transdiagnostic account of emotional outbursts and may facilitate the development of pathway-specific intervention strategies.

A case study on the effect of light and colors in the built environment on autistic children’s behavior

“…The eight sensory systems are visual, auditory, olfactory, gustatory, tactile, proprioceptive, vestibular, and interoception. These are highly central to understanding sensory processing in autism and a sensory integration approach would make them very relevant to investigating visual processing (27)(28)(29). Sensory processing disorder is often a comorbid symptom of ASD, but not all children with sensory processing disorder have autism.…”

Characterising the behaviours in most severe and least severe emotional outbursts in young people

“…This paper forms part of a larger cross-sectional study investigating emotional outbursts in young people with neurodevelopmental disorders 10 . The current sample is a sub-sample of the wider study.…”

“…A study investigating autistic individuals’ experiences of outbursts found that during an outburst they may feel psychologically and physicaly overwhelmed due to feeling not in control of their actions, and may go on to feel further distress afterwards because of remorse for aggressive actions 9 . Despite the prevalence of emotional outbursts, and their impact on both the individual and those around them, effective interventions targeting outbursts are lacking 4 , 10 .…”

“…Studies have characterised the individual behaviours that make up an outburst in individuals with different diagnoses, such as ASD and PWS 5 , 11 . Though these studies look at one diagnosis in isolation, when comparing across diagnoses it appears that the behaviours and characteristics that make up an emotional outburst are broadly similar and outbursts can therefore be considered transdiagnostically 10 .…”

“…In the present study, we apply the Emotional Outburst Questionnaire, which has been developed for measuring the nature and context of outbursts in detail, and has been validated cross-culturally in terms of outburst contexts 10 , 20 . Importantly, the questionnaire includes profiling the characteristics of most and least severe outburst types in the same individual.…”