Skip to main content
    • Aa
    • Aa

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)...

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:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

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.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 23
Total number of PDF views: 133 *
Loading metrics...

Abstract views

Total abstract views: 561 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 26th June 2017. This data will be updated every 24 hours.