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Clinical features of young children referred for impairing temper outbursts

Roy, Amy K; Klein, Rachel G; Angelosante, Aleta; Bar-Haim, Yair; Leibenluft, Ellen; Hulvershorn, Leslie; Dixon, Erica; Dodds, Alice; Spindel, Carrie
Abstract Objective: In light of the current controversy about whether severe temper outbursts are diagnostic of mania in young children, we conducted a study to characterize such children, focusing on mania and other mood disorders, emotion regulation, and parental psychiatric history. Methods: Study participants included 51 5-9-year-old children with frequent, impairing outbursts (probands) and 24 non-referred controls without outbursts. Parents completed a lifetime clinical interview about their child, and rated their child's current mood and behavior. Teachers completed a behavior rating scale. To assess emotion regulation, children were administered the Balloons Game, which assesses emotion expressivity in response to frustration, under demands of high and low regulation. Parental lifetime diagnoses were ascertained in blind clinical interviews. Results: No child had bipolar disorder, bipolar disorder not otherwise specified (NOS), or major depression (MDD). The most prevalent disorder was oppositional defiant disorder (88.2%), followed by attention-deficit/hyperactivity disorder (74.5%), anxiety disorders (49.0%), and non-MDD depressive disorders (33.3%). Eleven probands (21.6%) met criteria for severe mood dysregulation. During the Balloons Game, when there were no demands for self-regulation, children with severe outbursts showed reduced positive expressivity, and also showed significant deficits in controlling negative facial expressions when asked to do so. Anxiety disorders were the only diagnoses significantly elevated in probands' mothers. Conclusions: Overall, young children with severe temper outbursts do not present with bipolar disorder. Rather, disruptive behavior disorders with anxiety and depressive mood are common. In children with severe outbursts, deficits in regulating emotional facial expressions may reflect deficits controlling negative affect. This work represents a first step towards elucidating mechanisms underlying severe outbursts in young children.
PMID: 24168713
ISSN: 1044-5463
CID: 669182

Jido gyakutai = [Childhood maltreatment]

Wekerle, Christine; Miller, Alec L; Wolfe, David A; Spindel, Carrie B; Fukui, Itaru; Fukui, Itaru; Yano, Hiroaki; Noguchi, Kyoko
Tokyo : Kongoshuppan, 2012
Extent: 120 p. ; 26 cm.
ISBN: 4772413030
CID: 1487042

Adolescent major depression: challenges to treatment [Case Report]

Spindel, Carrie; Gabbay, Vilma; Coffey, Barbara
PMID: 18582185
ISSN: 1557-8992
CID: 91433

Disaster trauma

Chapter by: McGinn, Lata K; Spindel, Carrie B
in: Cognitive-behavioral strategies in crisis intervention by Dattilio, Frank M; Freeman, Arthur [Eds]
New York : Guilford Press, c2007
pp. ?-?
ISBN: 1593854870
CID: 1487012

Childhood maltreatment

Wekerle, Christine; Miller, Alec L; Wolfe, David A; Spindel, Carrie B
Cambridge (MA) : Hogrefe & Huber, cop. 2006
Extent: x, 59, [29] p. ; 26 cm.
ISBN: 9780889373143
CID: 1487022