Defining the developmental parameters of temper loss in young children: Implications for developmental psychopathology

Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL Department of Psychology, University of Massachusetts-Boston, Boston, MA Department of Psychiatry, University of Connecticut Health Center, Farmington, CT Section on Bipolar Spectrum Disorders, Emotion & Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health & Human Services, Bethesda, MD.
Journal of Child Psychology and Psychiatry (Impact Factor: 6.46). 08/2012; 53(11):1099-108. DOI: 10.1111/j.1469-7610.2012.02595.x
Source: PubMed


Temper modulation problems are both a hallmark of early childhood and a common mental health concern. Thus, characterizing specific behavioral manifestations of temper loss along a dimension from normative misbehaviors to clinically significant problems is an important step toward identifying clinical thresholds.

Parent-reported patterns of temper loss were delineated in a diverse community sample of preschoolers (n = 1,490). A developmentally sensitive questionnaire, the Multidimensional Assessment of Preschool Disruptive Behavior (MAP-DB), was used to assess temper loss in terms of tantrum features and anger regulation. Specific aims were: (a) document the normative distribution of temper loss in preschoolers from normative misbehaviors to clinically concerning temper loss behaviors, and test for sociodemographic differences; (b) use Item Response Theory (IRT) to model a Temper Loss dimension; and (c) examine associations of temper loss and concurrent emotional and behavioral problems.

Across sociodemographic subgroups, a unidimensional Temper Loss model fit the data well. Nearly all (83.7%) preschoolers had tantrums sometimes but only 8.6% had daily tantrums. Normative misbehaviors occurred more frequently than clinically concerning temper loss behaviors. Milder behaviors tended to reflect frustration in expectable contexts, whereas clinically concerning problem indicators were unpredictable, prolonged, and/or destructive. In multivariate models, Temper Loss was associated with emotional and behavioral problems.

Parent reports on a developmentally informed questionnaire, administered to a large and diverse sample, distinguished normative and problematic manifestations of preschool temper loss. A developmental, dimensional approach shows promise for elucidating the boundaries between normative early childhood temper loss and emergent psychopathology.

Download full-text


Available from: Seung W Choi
  • Source
    • "In fact, misbehavior co-occurring with significant child distress and/or anger is common, particularly in preschool age children (i.e. temper tantrums) (Giesbrecht, Miller, & Muller, 2010; Wakschlag et al. 2012). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The existing parenting literature is dominated by two worldviews: the behavioral worldview and the relational/emotional worldview. Points of tension between these worldviews are apparent within the scientific literature; however, both approaches can be fully incorporated into an evolutionary science paradigm including contextual behavioral science. Connect and shape is a parenting meta-strategy that combines behavioral and the relational/emotional strategies into a single parent-child interaction. The elements of connect and shape are not new. What is new is the combination of parental responsiveness/emotion coaching and behavioral parenting strategies into a single, clearly elucidated meta-strategy that can be easily incorporated into parenting intervention.
    Full-text · Article · Mar 2015 · Journal of Contextual Behavioral Science
  • Source
    • "First, we assessed child psychopathology and irritability using a comprehensive interview, which allowed us to take into account the intensity, frequency, and duration of irritability. Second, we used a dimensional construct of youth irritability, as the boundaries between clinically significant irritability and normative irritability, particularly in preschoolers, continue to be investigated (Wakschlag et al., 2012). This approach is consistent with the NIMH Research Domain Criteria project, which aims to identify new ways to classify behavior based on dimensional measures of behavior and neurobiological processes (Insel et al., 2010). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Little is known about the predictive validity and clinical significance of chronic irritability during early childhood. This prospective, longitudinal study examined associations of preschool chronic irritability with psychiatric disorders, functional impairment, and service use at age nine in a large community sample.Methods Four hundred and forty-six children were assessed at age three and again at age nine. Child psychopathology and functional impairment were assessed at age three with the Preschool Age Psychiatric Assessment (PAPA) with parents and at age nine with the Kiddie-Schedule of Affective Disorders and Schizophrenia (K-SADS) with parents and children. Items from the PAPA were used to create a dimensional measure of chronic irritability at age three. At age nine, mothers, fathers, and youth completed the Child Depression Inventory (CDI) and the Screen for Anxiety Related Disorders (SCARED).ResultsChronic irritability at age three predicted any current and lifetime anxiety disorders at age nine, current and lifetime generalized anxiety disorder, and current separation anxiety, after controlling for baseline anxiety disorders. In addition, preschool irritability predicted increases in anxiety and disruptive behavior disorder symptoms on the K-SADS, and maternal and paternal reports of depressive and anxiety symptoms on the CDI and SCARED. Lastly, preschool irritability predicted greater functional impairment and outpatient treatment use, even after controlling for all psychiatric disorders at baseline.Conclusions Findings underscore the central role of irritability in developmental psychopathology and support the importance of early detection and interventions targeting preschool irritability.
    Full-text · Article · Feb 2015 · Journal of Child Psychology and Psychiatry
  • Source
    • "The majority of earlier studies on young children have reported broader behavioural dimensions. Although they have supported that symptoms of psychopathology may manifest during early preschool age [7, 8, 21, 47], there has been little diagnostic specificity in the study of continuity of symptoms in previous studies. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Anxiety disorders and attention deficit/hyperactivity disorder (ADHD) develop before school age, but little is known about early developmental pathways. Here we test two hypotheses: first, that early signs of anxiety and ADHD at 18 months predict symptoms of anxiety and ADHD at age 3½ years; second, that emotional dysregulation at 18 months predicts the outcome of co-occurring anxiety and ADHD at age 3½ years. The study was part of the prospective Norwegian Mother and Child Cohort Study (MoBa) at the Norwegian Institute of Public Health. The 628 participants were clinically assessed at 3½ years. Questionnaire data collected at 18 months were categorized into early behavioural scales of anxiety, ADHD, and emotional dysregulation. We investigated continuity in features of anxiety and ADHD from 18 months to 3½ years of age through logistic regression analyses. Anxiety symptoms at 3½ years were predicted by early signs of anxiety (Odds ratio (OR) = 1.41, CI = 1.15-1.73) and emotional dysregulation (OR = 1.33, CI = 1.15-1.54). ADHD symptoms at 3½ years were predicted by early signs of ADHD (OR = 1.51, CI = 1.30-1.76) and emotional dysregulation (OR = 1.31, CI = 1.13-1.51). Co-occurring anxiety and ADHD symptoms at 3½ years were predicted by early signs of anxiety (OR = 1.43, CI = 1.13-1.84), ADHD (OR = 1.30, CI = 1.11-1.54), and emotional dysregulation (OR = 1.34, CI = 1.13-1.58). We conclude that there were modest continuities in features of anxiety and ADHD through early preschool years, while emotional dysregulation at age 18 months was associated with symptoms of anxiety, ADHD, and co-occurring anxiety and ADHD at age 3½ years.
    Full-text · Article · Apr 2014 · European Child & Adolescent Psychiatry
Show more