The Use of Standard Parenting Management Training in Addressing Disruptive Mood Dysregulation Disorder: A Pilot Study

Abstract

Parent management training has demonstrated effectiveness in the treatment of child behavioural issues and associated conduct difficulties. Anger, aggression, and irritability are common symptoms amongst children presenting with disruptive mood dysregulation disorder. Currently, there are no well-established evidence-based interventions for children presenting with symptoms of disruptive mood dysregulation disorder. This pilot study aims to assess if a standard, well-established, parent management training program (group Triple P) may be effective in addressing disruptive mood dysregulation disorder symptoms. Thirteen parents of children who presented with disruptive mood dysregulation disorder or subthreshold symptoms completed the Triple P behavioural management program (Level 4). Post-treatment, parents reported no significant change on childhood irritability. However, parents noted significant improvement on child overt aggression, behavioural difficulties and an increase in child pro-social behaviours. Despite the many limitations inherent in this pilot study, results suggest that standard parent management training may be useful in addressing overt aggression but not irritability.

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References

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  2. Bor, W., Sanders, M. R., & Markie-Dadds, C. (2002). The effects of the Triple P-Positive Parenting Program on preschool children with co-occurring disruptive behavior and attentional/hyperactive difficulties. Journal of Abnormal Child Psychology, 30(6), 571–587.

    Article  Google Scholar 

  3. Brotman, M. A., Kircanski, K., & Leibenluft, E. (2017). Irritability in children and adolescents. Annual Review of Clinical Psychology, 13, 317–341.

    Article  Google Scholar 

  4. Brotman, M. A., Schmajuk, M., Rich, B. A., Dickstein, D. P., Guyer, A. E., Costello, E. J., et al. (2006). Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children. Biological Psychiatry, 60(9), 991–997.

    Article  Google Scholar 

  5. Derella, O. J., Burke, J. D., Romano-Verthelyi, A. M., Butler, E. J., & Johnston, O. G. (2020). Feasibility and acceptability of a brief cognitive-behavioral group intervention for chronic irritability in youth. Clinical Child Psychology and Psychiatry, 25, 778–789.

    Article  Google Scholar 

  6. Dickstein, D. P., Rich, B. A., Binstock, A. B., Pradella, A. G., Towbin, K. E., Pine, D. S., & Leibenluft, E. (2005). Co-morbid anxiety in phenotypes of paediatric bipolar disorder. Journal of Child & Adolescent Psychopharmacology, 15(4), 534–548.

    Article  Google Scholar 

  7. Dougherty, L. R., Smith, V. C., Bufferd, S. J., Carlson, G. A., Stringaris, A., Leibenluft, E., & Klein, D. N. (2014). DSM-5 disruptive mood dysregulation disorder: Correlates and predictors in young children. Psychological Medicine, 44, 2339–2350.

    CAS  Article  Google Scholar 

  8. Evans, S. C., Weisz, J. R., Carvalho, A. C., Garibaldi, P. M., Bearman, S. K., & Chorpita, B. F. (2020). Effects of standard and modular psychotherapies in the treatment of youth with severe irritability. Journal of Consulting and Clinical Psychology, 88, 255–268.

    Article  Google Scholar 

  9. Furlong, M., McGilloway, S., Bywater, T., Hutchings, J., Smith, S. M., & Donnelly, M. (2013). Behavioural and cognitive-behavioural group-based parenting programs for early-onset conduct problems in children aged 3 to 12 years. The Cochrane Database of Systematic Reviews, CD008225

  10. GNU Project. (2015). GNU PSPP (Version 0.8.5) Computer Software. Free Software Foundation, Boston, MA.

  11. Goodman, R. (2001). Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1337–1345.

    CAS  Article  Google Scholar 

  12. Hawks, J. L., Kennedy, S. M., Holzman, J. B. W., & Ehrenreich-May, J. (2020). Development and application of an innovative transdiagnostic treatment approach for paediatric irritability. Behavior Therapy, 51, 334–349.

    Article  Google Scholar 

  13. Julious, S. A. (2005). Sample size of 12 per group rule of thumb for a pilot study. Pharmaceutical Statistics: The Journal of Applied Statistics in the Pharmaceutical Industry, 4(4), 287–291.

    Article  Google Scholar 

  14. Kircanski, K., Clayton, M. E., Leibenluft, E., & Brotman, M. A. (2018). Psychosocial treatment of irritability in youth. Current Treatment Options in Psychiatry, 5, 129–140.

    Article  Google Scholar 

  15. Perepletchikova, F., Nathanson, D., Axelrod, S. R., Merrill, C., Walker, A., Grossman, M., et al. (2017). Randomized clinical trial of dialectical behaviour therapy for preadolescent children with disruptive mood dysregulation disorder: Feasibility and outcomes. Journal of the American Academy of Child and Adolescent Psychiatry, 56, 832–840.

    Article  Google Scholar 

  16. Sanders, M. R. (1999). Triple P-Positive Parenting Program: Towards an empirically validated multilevel parenting and family support strategy for the prevention of behaviour and emotional problems in children. Clinical Child and Family Psychology Review, 2, 71–90.

    CAS  Article  Google Scholar 

  17. Sanders, M. R., Kirby, J. N., Tellegen, C. L., & Day, J. J. (2014). The Triple P-Positive Parenting Program: A systematic review and meta-analysis of a multi-level system of parenting support. Clinical Psychology Review, 34, 337–357.

    Article  Google Scholar 

  18. Stringaris, A., Goodman, R., Ferdinando, S., Razdan, V., Muhrer, E., Leibenluft, E., & Brotman, M. A. (2012). The Affective Reactivity Index: A concise irritability scale for clinical and research settings. Journal of Child Psychology and Psychiatry, 53, 1109–1117.

    Article  Google Scholar 

  19. Stringaris, A., & Taylor, E. (2015). Disruptive mood. Irritability in children and adolescents. Oxford: Oxford University Press.

    Google Scholar 

  20. Stringaris, A., Vidal-Ribas, P., Brotman, M. A., & Leibenluft, E. (2018). Practitioner review: Definition, recognition, and treatment challenges of irritability in young people. Journal of Child Psychology and Psychiatry, 59, 721–739.

    Article  Google Scholar 

  21. Sukhodolsky, D. G., & Scahill, L. (2012). Cognitive-behavioural therapy for anger and aggression in children. New York: Guilford Press.

    Google Scholar 

  22. Tarren-Sweeney, M. (2013). The Brief Assessment Checklists (BAC-C, BAC-A): Mental health screening measures for school-aged children and adolescents in foster, kinship, residential and adoptive care. Child and Youth Services Review, 35, 71–779.

    Google Scholar 

  23. Van Teijlingen, E., & Hundley, V. (2002). The importance of pilot studies. Nursing Standard (through 2013), 16(40), 33.

    Article  Google Scholar 

  24. Waxmonsky, J. G., Waschbusch, D. A., Belin, P., Li, T., Babocsai, L., Humphery, H., et al. (2016). A randomized clinical trial of an integrative group therapy for children with severe mood dysregulation. Journal of the American Academy of Child and Adolescent Psychiatry, 55, 196–207.

    Article  Google Scholar 

  25. Yudofsky, S. C., Silver, J. M., Jackson, W., Endicott, J., & Williams, D. (1986). The Overt Aggression Scale for the objective rating of verbal and physical aggression. American Journal of Psychiatry, 143, 35–39.

    CAS  Article  Google Scholar 

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Correspondence to Gary Byrne.

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The Health Service Executive (HSE) provided ethical approval for this study and authors’ research conduct was compliant with the ethical principles of the organisation.

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Byrne, G., Connon, G. The Use of Standard Parenting Management Training in Addressing Disruptive Mood Dysregulation Disorder: A Pilot Study. J Contemp Psychother (2021). https://doi.org/10.1007/s10879-021-09489-5

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Keywords

  • Disruptive mood dysregulation disorder
  • Parent management training
  • Irritability
  • Overt aggression
  • Triple P