Loss of Temper and Irritability: The Relationship to Tantrums in a Community and Clinical Sample

Abstract

Background: This study explores the relationship of irritability to tantrums and loss of temper in a community and clinical sample. Methods: The community sample, recruited via commercial mailing lists, consisted of 462 6-year-olds whose parents completed the Child Behavior Checklist (CBCL), and Preschool Age Psychiatric Assessment (PAPA). Tantrums were assessed in the oppositional defiant disorder (ODD) section of the PAPA. Irritability was assessed in the depression section to identify persistently irritable and/or angry mood. The clinic sample, drawn from a child psychiatry clinic, included 229 consecutively referred 6-year-olds from 2005 through 2014 whose parents completed the CBCL and Child and Adolescent Symptom Inventory (CASI). Temper loss and irritability items came from the ODD and depression sections of the CASI, and tantrum description was taken from an irritability inventory. Children's Global Assessment Scale (CGAS) and the CBCL Dysregulation Profile were examined in both samples. Logistic and multiple regression were used to compare rates of diagnosis, CBCL subscales, CGAS, and tantrum quality between children with tantrums only and tantrums with irritability. Results: Almost half (45.9%) of clinic children had severe tantrums; only 23.8% of those were said to be irritable. In the community, 11% of children had tantrums, but 78.4% of those were called irritable. However, irritability in the clinic, although less common, was associated with aggressive tantrums and substantial impairment. In contrast, irritability was associated with only a relatively small increase in impairment in the community sample. Conclusions: Irritability may have different implications in community versus clinic samples, and tantrums assessed in the community may be qualitatively different from those seen in clinics.

The characteristics of temper outbursts in Prader–Willi syndrome

“…This was also consistent with the duration and frequency rates of outbursts displayed by TD children (Österman & Björkqvist, 2010). It is, however, dissimilar to rates of outburst in clinical populations, where outburst rates are much higher in boys than girls (Carlson et al, 2016;Potegal et al, 2009). Examining the differences in symptoms across genetic subtypes is important for elucidating causal mechanisms.…”

Heritability, stability, and prevalence of tonic and phasic irritability as indicators of disruptive mood dysregulation disorder

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Presidential Address: Emotion Dysregulation in Children and Adolescents

“…What behaviors characterize severe outbursts in children under age 13? Using an Irritability Rating Scale that has been part of our standardized outpatient assessment for the past decade, 9 I found that parents of 303 children being evaluated for rages reported that 87% of children wrecked property, 77% threw things, 63% hit/kicked and/or spit during their outbursts, 64% threatened others, 39% hurt themselves, and 34% of parents said that they have had to physically restrain their child. Almost three-fourths (72%) said that these outbursts occurred daily to weekly!…”