Webinar Overview
This presentation offers a critical evaluation of the phenomenology and treatment of disruptive mood dysregulation disorder (DMDD), a pediatric depressive disorder added to the DSM-5 in 2013. The presentation begins with a historical overview of the DMDD diagnosis and a discussion of how this history paved the way for current clinical practices. It then turns to what is known about DMDD today, reviewing and synthesizing research on its clinical presentation, associated features, prevalence, comorbidities, developmental course, functional outcomes, and risk factors. This review highlights areas of consensus and controversy, revealing DMDD to be an empirically nebulous construct with unresolved questions about its reliability and validity. Implications for diagnostic accuracy and the selection of appropriate and effective interventions are discussed. The following question is posed: Is there something happening in chronically irritable youth that is not being captured by the DMDD diagnosis as it is currently defined? The presentation subsequently examines points of overlap between DMDD symptomatology and trauma-related sequelae. Areas of convergence that are discussed include shared clinical features, such as pervasive emotional and behavioral dysregulation, aggression, attachment disturbances, relationship difficulties, attentional problems, and functional impairment. Shared risk factors are also discussed, including dysregulated temperamental profiles, neurobiological abnormalities in emotion regulation and impulse control, and — most notably — histories of adverse childhood experiences (ACEs). The presentation highlights parental psychopathology, substance abuse, separation, domestic violence, emotional abuse, intergenerational trauma, and poverty as salient predictors of DMDD onset and persistence. Emerging evidence is reviewed, indicating that, for at least a subset of youth, DMDD symptomatology reflects the effects of complex trauma. The presentation then reviews current assessment and treatment practices for DMDD, offering a critical evaluation of their utility for DMDD youth with and without trauma sequelae. The paucity of the evidence base is highlighted and discussed as an ethical concern, especially in regard to pharmacological interventions, which are frequently given precedence over psychotherapy. The presentation underscores the urgent need to integrate trauma-informed principles into every stage of care for DMDD, as current approaches may not only be ineffective but also potentially harmful for the subset of youth whose DMDD presentation represents, or is compounded by, trauma-related pathology. The presentation concludes by arguing for a paradigm shift in how the field conceptualizes irritability and aggression in youth — moving away from viewing these symptoms as signs of something inherently wrong within the child, and toward seeing them as signals to ask what has happened to the child.
Attendance Certificates Available
*Must watch webinar LIVE to receive Certificate
*Each individual requesting a Certificate, must be registered and logged in to zoom under their own name.
If you have questions, please email Amanda.
