Disruptive Behavior Disorders

What is Disruptive Mood Dysregulation Disorder?
"Disruptive mood dysregulation disorder (DMDD) is caused by extreme outbursts that are not normal for the situation in intensity or length of time. These outbursts usually happen three or more times each week for one year or more. Between outbursts, children often are irritable or in an angry mood most of the day. Effective Therapies for Bipolar Disorder and Severe Mood Swings As can be seen below, family psychoeducation plus skill building currently is the best-proven treatment of children and adolescents with BPSD. Treatment studies are not yet available for DMDD; it is suggested that a combination of treatments that are effective for depression and oppositional behavior will be beneficial for this disorder. "
https://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/#effective-treatments

Disruptive Behavior Disorders

What Works

Assertiveness training: Group

School-based group treatment for middle school youth

Assertive Training

Parent Management Training (PMT)

Programs that focus on teaching and practicing parenting skills with parents or caregivers include:

Programs

•Helping the Noncompliant Child

•Incredible Years Parent-Child Interaction Therapy

•Parent Management Training to Oregon Model

•Positive Parenting Program

Multisystemic Therapy (MST)

An integrative, family-based treatment for youth with serious antisocial and

delinquent behavior. Interventions last three to five months and focus on

improving psychosocial functioning for young people and families.

Cognitive Behavioral Therapy (CBT)

CBT emphasizes problem solving skills and anger control/coping strategies and includes:

•Problem-Solving Skills Training

•Anger Control Training

CBT & Parent Management Training

Combines CBT and PMT

(PMT)

 

What Seems to Work

Multidimensional Treatment Foster

Community-based program alternative to institutional, residential and group

Care (MTFC) care placements for use with severe chronic delinquent behavior. Foster

parents receive training and provide intensive supported treatment within the foster home setting.

• Assertiveness training: Group
• School-based group treatment for middle-school youth
• Assertive Training
• According to the American Academy of Pediatrics, the US Food and Drug Administration (FDA) has no approved indications for aggression in children and adolescents apart from irritability-associated aggression in children with autism. In other populations, recent federally supported, evidence-based reviews suggest efficacy for some psychotherapeutic agents, but primary care clinicians are urged to consult with mental health specialists before prescribing medications for aggression.

Medications are frequently used to treat comorbid conditions and are sometimes used off-label treat aggression.

Notes About Medications

• Antipsychotics: Risperidone (risperdal), quetiapine (seroquel), olanzapine (zyprexa), and Abilify (aripiprazole).
• Limited evidence for effectiveness in youth with intellectual disability or pervasive developmental disorder.

 

Stimulant or Atomoxetine: Methylphenidate, d-Amphetamine, atomoxetine.

Limited evidence when comorbid with primary diagnosis of ADHD.

 

Mood Stabilizers: Divalproex sodium, lithium carbonate.

Limited evidence when comorbid with primary diagnosis of bipolar disorder.

 

Selective Serotonin Reuptake Inhibitors (SSRIs)

Limited evidence when comorbid with primary diagnosis of depressive Disorder.

 

 

What Does Not Work

• Boot camps, shock incarcerations
• Ineffective at best; can lead worsening of symptoms.
• Dramatic, short-term or talk therapy
• Little to no effect as currently studied.