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DSM-5 disruptive mood dysregulation disorder: correlates and predictors in young children

  • L. R. Dougherty (a1), V. C. Smith (a1), S. J. Bufferd (a2), G. A. Carlson (a3), A. Stringaris (a4), E. Leibenluft (a5) and D. N. Klein (a3) (a6)
  • DOI:
  • Published online: 20 January 2014

Despite the inclusion of disruptive mood dysregulation disorder (DMDD) in DSM-5, little empirical data exist on the disorder. We estimated rates, co-morbidity, correlates and early childhood predictors of DMDD in a community sample of 6-year-olds.


DMDD was assessed in 6-year-old children (n = 462) using a parent-reported structured clinical interview. Age 6 years correlates and age 3 years predictors were drawn from six domains: demographics; child psychopathology, functioning, and temperament; parental psychopathology; and the psychosocial environment.


The 3-month prevalence rate for DMDD was 8.2% (n = 38). DMDD occurred with an emotional or behavioral disorder in 60.5% of these children. At age 6 years, concurrent bivariate analyses revealed associations between DMDD and depression, oppositional defiant disorder, the Child Behavior Checklist – Dysregulation Profile, functional impairment, poorer peer functioning, child temperament (higher surgency and negative emotional intensity and lower effortful control), and lower parental support and marital satisfaction. The age 3 years predictors of DMDD at age 6 years included child attention deficit hyperactivity disorder, oppositional defiant disorder, the Child Behavior Checklist – Dysregulation Profile, poorer peer functioning, child temperament (higher child surgency and negative emotional intensity and lower effortful control), parental lifetime substance use disorder and higher parental hostility.


A number of children met DSM-5 criteria for DMDD, and the diagnosis was associated with numerous concurrent and predictive indicators of emotional and behavioral dysregulation and poor functioning.

Corresponding author
*Address for correspondence: L. R. Dougherty, Ph.D., Department of Psychology, University of Maryland, College Park, MD 20742, USA. (Email:
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RR Althoff , FC Verhulst , DC Rettew , JJ Hudziak , J van der Ende (2010). Adult outcomes of childhood dysregulation: a 14-year follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry 49, 11051116.

MA Brotman , M Schmajuk , BA Rich , DP Dickstein , AE Guyer , EJ Costello , HL Egger , A Angold , DS Pine , E Leibenluft (2006). Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children. Biological Psychiatry 60, 991997.

SJ Bufferd , LR Dougherty , GA Carlson , DN Klein (2011). Parent-reported mental health in preschoolers: findings using a diagnostic interview. Comprehensive Psychiatry 52, 359369.

SJ Bufferd , LR Dougherty , GA Carlson , S Rose , DN Klein (2012). Psychiatric disorders in preschoolers: continuity from ages 3 to 6. American Journal of Psychiatry 169, 11571164.

LA Clark (2005). Temperament as a unifying basis for personality and psychopathology. Journal of Abnormal Psychology 114, 505521.

WE Copeland , A Angold , EJ Costello , H Egger (2013). Prevalence, comorbidity, and correlates of DSM-5 proposed disruptive mood dysregulation disorder. American Journal of Psychiatry 170, 173179.

LR Dougherty , SJ Bufferd , GA Carlson , MW Dyson , TM Olino , DN Klein (2011). Preschoolers’ observed temperament and DSM-IV psychiatric disorders assessed with a parent diagnostic interview. Journal of Clinical Child and Adolescent Psychology 40, 295306.

HL Egger , A Erkanli , G Keeler , E Potts , BK Walter , A Angold (2006). Test-retest reliability of the Preschool Age Psychiatric Assessment (PAPA). Journal of the American Academy of Child and Adolescent Psychiatry 45, 538549.

N Eisenberg , RA Fabes , B Murphy , P Maszk , M Smith , M Karbon (1995). The role of emotionality and regulation in children's social functioning: a longitudinal study. Child Development 66, 13601384.

SA Francis (2011). Using a framework to explore associations between parental substance use and the health outcomes of their adolescent children. Journal of Child and Adolescent Substance Abuse 20, 114.

M Holtmann , AF Buchmann , G Esser , MH Schmidt , T Banaschewski , M Laucht (2011). The Child Behavior Checklist – Dysregulation Profile predicts substance use, suicidality, and functional impairment: a longitudinal analysis. Journal of Child Psychology and Psychiatry 52, 139147.

J Kim , GA Carlson , SE Meyer , SJ Bufferd , LR Dougherty , MW Dyson , RS Laptook , TM Olino , DN Klein (2012). Correlates of the CBCL-dysregulation profile in preschool-aged children. Journal of Child Psychology and Psychiatry 53, 918926.

FV Krieger , GM Polanczyk , R Goodman , LA Rohde , AS Graeff-Martins , G Salum , A Gadelha , P Pan , D Stahl (2013). Dimensions of oppositionality in a Brazilian community sample: testing the DSM-5 proposal and etiological links. Journal of the American Academy of Child and Adolescent Psychiatry 52, 389400.

RJ Larsen , E Diener (1987). Affect intensity as an individual difference characteristic: a review. Journal of Research in Personality 21, 139.

E Leibenluft (2011). Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youths. American Journal of Psychiatry 168, 129142.

E Leibenluft , P Cohen , T Gorrindo , JS Brook , DS Pine (2006). Chronic versus episodic irritability in youth: A community-based, longitudinal study of clinical and diagnostic associations. Journal of Child and Adolescent Psychopharmacology 16, 456466.

E Leibenluft , DS Charney , KE Towbin , RK Bhangoo , DS Pine (2003). Defining clinical phenotypes of juvenile mania. American Journal of Psychiatry 160, 430437.

DM Margulies , S Weintraub , J Basile , PJ Grover , GA Carlson (2012). Will disruptive mood dysregulation disorder reduce false diagnosis of bipolar disorder in children? Bipolar Disorders 14, 488496.

KE Markon , M Chmielewski , CJ Miller (2011). The reliability and validity of discrete and continuous measures of psychopathology: a quantitative review. Psychological Bulletin, 137, 856879.

S Menard (2002). Applied Logistic Regression Analysis, 2nd edn.Sage Publications: Thousand Oaks, CA.

MK Rothbart , SA Ahadi , KL Hersey , P Fisher (2001). Investigations of temperament at three to seven years: The Children's Behavior Questionnaire. Child Development 72, 13941408.

D Shaffer , M Gould , J Brasic , P Ambrosini , P Fisher , H Bird , S Aluwahlia (1983). A Children's Global Assessment Scale. Archives of General Psychiatry 40, 12281231.

GB Spanier (1976). Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family 38, 1528.

A Stringaris , P Cohen , DS Pine , E Leibenluft (2009). Adult outcomes of youth irritability: a 20-year prospective community-based study. American Journal of Psychiatry 166, 10481054.

A Stringaris , R Goodman (2009). Longitudinal outcome of youth oppositionality: irritable, headstrong, and hurtful behaviors have distinctive predictions. Journal of the American Academy of Child and Adolescent Psychiatry 48, 404412.

A Stringaris , B Maughan , R Goodman (2010). What's in a disruptive disorder? Temperamental antecedents of oppositional defiant disorder: findings from the Avon Longitudinal Study. Journal of the American Academy of Child and Adolescent Psychiatry 49, 474483.

E Youngstrom , JK Youngstrom , M Starr (2005). Bipolar diagnoses in community mental health: Achenbach Child Behavior Checklist Profiles and patterns of comorbidity. Biological Psychiatry 58, 569575.

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