Final Psychology Project

Childhood Disruptive Mood Dysregulation disorder 1
Childhood Disruptive Mood Dysregulation Disorder
Indila Habib
Ahmed Waleed
M. Ammar Jamshaid
Ms. Hirra Rana
Psychology
Section L
Lahore School of Economics
27th November, 2020
BBA-II

Contents
Abstract (Indila Habib).............................................................................................................................3
Acknowledgement......................................................................................................................................4
Introduction (Ahmed Waleed)..................................................................................................................4
Definition................................................................................................................................................4
Description..............................................................................................................................................4
Symptoms...............................................................................................................................................5
Causes.....................................................................................................................................................6
Treatment and Therapies.......................................................................................................................8
How to cope with a DMDD patient?.....................................................................................................10
Literature Review (Ammar Jamshaid)......................................................................................................11
Methodology (Indila Habib)......................................................................................................................15
Case study 1..........................................................................................................................................15
Case study 2..........................................................................................................................................17
Case study 3..........................................................................................................................................18
Results (Indila Habib)................................................................................................................................19
Case study 1..........................................................................................................................................19
Case study 2..........................................................................................................................................20
Case study 3..........................................................................................................................................21
Limitations (Ahmed Waleed)....................................................................................................................21
Recommendations ...................................................................................................................................22
References................................................................................................................................................23

Abstract (Indila Habib)

Disruptive mood dysregulation disorder is a psychological disorder mostly occurs in children.
The children suffering from DMDD can be cured with specific treatments and therapies. This
research paper will evaluate the symptoms, causes, treatments, relative case studies and
recommendations regarding Disruptive mood dysregulation disorder. This report aims to find out
how DMDD have affected the life of children and the people associated with them. Case studies
have been discussed to highlight the major causes, symptoms and background history of the
patient. Respected results and recommendations are given in order to acknowledge the reader
about the disorder thoroughly.
Acknowledgement
We are grateful to Allah Almighty as without His consent we would not be able to conduct this
research in this ongoing pandemic. The research group is also immensely thankful to our
instructor Ms. Hirra Rana, who gave us the opportunity to work on this prevailing issue of
DMDD and broaden our horizons. She has been extremely encouraging and supportive
throughout the research.

Introduction (Ahmed Waleed)
Definition
“Disruptive Mood Dysregulation Disorder (DMDD) is known as the condition in which a child
is irritable chronically and experiences frequent, outbursts of severe temper that seem out of
proportion to the situation given”.
Children diagnosed with DMDD fail to control their emotions and feelings in an age-appropriate
way.
Description
The disease Disruptive Mood Dysregulation Disorder (DMDD) is a condition that is highly
common in children; it is a condition in which a child exhibits excessive rage, irritability, and
regular and intense outbursts of temper. A very prominent symptom of DMDD can be of a child
being “moody” at all times. Children with DMDD experience severe impairment that requires
clinical attention. DMDD patients (usually young generation) experiences significant problems
at work places and sometimes with peers. As they are vulnerable to developing some kind of
mood disorders, any DMDD patient needs high health care services, hospital services and school
leaves. (Child Mind Institution, 2020).
Symptoms
Symptoms of DMDD typically begin before the age of 10, but specifically children 6 years of
age or teenagers over 18 years of age cannot be diagnosed. Any of the DMDD signs are:
• Part of the day and almost every day, frustration or irritable mood

• At an average of three or more days a week which is out of line with the child's
circumstance and stage of growth, verbal or behavioral temperamental outbursts
• Due to irritability, in more than one place, disrupting functions, such as education, home
and peers.
• Visible extreme temperature outbursts at least three times a week
• Reaction higher than expected
• Symptoms start before the age of 10 years.
A DMDD child must have these symptoms continuously for at least 12 or more months.
The symptoms of DMDD can change as kids grow and develop. A young patient with DMDD,
for instance, may experience less tantrums. Yet symptoms of depression or anxiety are beginning
to appear. Because of this, therapy may change over time. In school, patients with DMDD may
face difficulties and they appear to face trouble maintaining healthy family and peer
relationships. They are still struggling to socialize and take part in events such as team sports or
ventures.
In children with other psychological conditions, including bipolar disorder, depression and
oppositional defiant disorder. Some of the DMDD-associated symptoms are also present. A few
kids with DMDD may have a second disorder, such as anxiety or trouble with focus. This is why
having a comprehensive evaluation is important for a qualified and trained mental health
professional. (AACAP, 2019).

Causes
Here are a number of variables that are believed to be the cause of DMDD, such as genetics,
disposition, accompanied mental conditions and experiences in childhood stage. The disorder is
more prevalent in the early childhood stage and is develops other medical conditions in the
patient. Mostly, they may be defiant oppositional disorder and depressive disorders. The
temperament of a child may act as a risk factor for the development of this disease. Such visible
signs that can be seen in kids include:
• Anxiousness
• Moodiness
• Irritableness
• Difficult conduct
Other DMDD-related risk factors are;
• Parental aggression and use of drug
• Low parental support

• Family-conflicts
• Disciplinary challenges at school
There can be several causes of DMDD including;
Biological Causes of DMDD: DMDD tends to develop in children because of the genetics of the
children as well as the brain mechanisms.
• Neurological disability

Some neurological disorders can be exhausting and affect the overall actions of an individual,
including suffering from persistent migraines. Children and adolescents with neurological
disorders such as migraines appear to experience actions that can become chronic and cause the
diagnosis of DMDD, including irritability and hostility.
• Brain chemistry
The potential cause of DMDD is understood to be brain chemistry. DMDD children have
increased activity related to regulating aggression and avoidance in the brain, i.e., the inferior
frontal gyrus and anterior cingulate cortex.
• Family history
Parents who have any experience of misuse of narcotics and mental illness in them are more
likely to develop a disruptive mood dysregulation disorder disease than other children.
Environmental Causes of disruptive mood dysregulation disorder: Stressful life events can
trigger disruptive mood dysregulation disorder, or it can make it even worsen in children and
adolescents, any mental or physical trauma or sexual assault can be related to the development of
destructive mood dysregulation disorder. Other potential environmental causes and DMDD-
related risk factors include;
• Any recent death of a family member, or divorce
• Lacking in sufficient deficiency in nutrition or vitamin is reported as leading to
the symptoms of this disease such as chronic sadness and irritable mood.

If any causes listed above occur in a child with this disease, the presenting disruptive mood
dysregulation disorder should be treated and the environmental stressor discussed as well (s).
(Copeland, 2020).
Prenatal and Perinatal Causes of DMDD: There is a link between the pregnancy phase of a
woman and postnatal experience and the likelihood that her baby may have DMDD, some
researchers claim. Depression in the pregnancy stage of woman was shown to increase the child's
ability to develop disruptive mood dysregulation disorder during the stage of pregnancy. (Jarrold,
2020).
Treatment and Therapies
Since this is a new condition, the therapy is also dependent on effective for alternative conditions
with similar irritability and temper tantrum symptoms. These guidelines may be attention deficit
hyperactivity disorder (ADHD), anxiety disorders and major depression disorder.
If you see signs of DMDD in a child, it is essential to seek care as it can affect the quality of life
and success of a child in school and can interrupt relationships with his or her family. It's
difficult for kids diagnosed with aggressive mood dysregulation disorder to communicate and
socialize with others. A patient suffering from DMDD can easily overcome depression and
anxiety. For the treatment of DMDD symptoms, two main forms of treatment are commonly
used;
• Medication

• Psychotherapy

• Psychological treatment

• Training for parents

• Training based on computers
Psychological interventions should be considered as the top priority to be handled first,
depending on the patient's needs, either with medication or psychological treatments (if
necessary). Working with the doctor to make a medical decision that is best for their child is
crucial for parents. (NIH, 2020).
Therapy: Psychotherapy is accepted as a treatment that includes cognitive behavioral therapy
(CBT) and parent preparation. It helps children learns appreciate the feelings that causes anger
and ways of reacting to different situations. Therapists collaboratively work with parents of
DMMDD children to help them understand and learn ways to respond the discomfort of their
kid's responses.
Medication: Researchers are still studying that which medication would be the best for treating a
patient of disruptive mood dysregulation disorder, psychiatrists may advice antipsychotics,
stimulants, mood stabilizers, or antidepressants to treat symptoms of disruptive mood
dysregulation disorder.
Fearing of signs of irritable mood and causing to symptoms of the disease mania to get worse,
physicians prefer to avoid treating the disorder with stimulants and antidepressants. Some
researchers indicate that in children with DMDD, it is probable that the use of agents is
successful and does not lead to mania. DMDD treatment must be customized to the requirements
of the child and the family. Individual counseling as well as working with the family or school of
children can be included and medicine can also be included to help resolve particular symptoms.
A DMDD patient's parents should read and research about the condition. Before determining
what would be best for their child, they should ask different questions about the costs and

benefits of particular treatment choices. A baby with DMDD can be a very difficult experience.
Appropriate care is therefore, necessary for the child's wellbeing. The caretakers of the child
need adequate knowledge, support and assistance. (Cherry, 2020).
How to cope with a DMDD patient?
It is quite challenging for the parents or care takers of a patient diagnosed with this disease as it
makes difficult for kids to function well in the fields of their lives and parents may find it hard to
handle their child’s immense harsh temper. So there are a few coping strategies that can help
cope up with a DMDD patient.
Understand Your Child's Triggers: Try to prepare for scenarios that can arise at odd times.
Try to momentarily detach your child from the scenario, for example, how your child might
behave at a school event or etc. In many ways, this will benefit you and your kids.
To Keep Your Child Safe: If the child's physical activity is natural; strive in keeping any
harmful things out of your child's reach. All utensils or other items that are sharp, for example,
are kept out of your child's sight to keep him or her safe.
Teach Coping Skills: A child with DMDD was mentally instructed in a case study to recite song
lyrics when he or she gets upset. Deep breathing and reciting verbal instructions were often
promoted until they began to disrupt any feelings associated with frustration or hostility.
Encourage Positive Behaviors: In the form of assessment, applause and rights, parents should
periodically reward their child with DMDD. Children in large or joint families normally go
unnoticed when they act well but when they misbehave, they are unable to get any recognition.
This motivates the child and strengthens the repetition of incorrect behaviors. So, constantly
reward and verify the conduct and reward of your child accordingly.

Since DMDD can be a difficult condition and can have tremendous effects on the life of a child,
it is important for the family of a DMDD patient to regularly check upon their children and seek
medical treatment of their children to ensure safety and happiness of their child.
Literature Review (Ammar Jamshaid)
During the 1990s, there was a great jump up in the diagnosis of bipolar problem in children.
Antipsychotics and mood-stabilizing drugs medications were utilized to treat bipolar problem in
kids. Utilization of these medications prompted the formation of the analysis of disruptive
mood dysregulation problem (DMDD).
Disruptive mood dysregulation issue (DMDD) is a childhood state of irritability, bad tempered,
consistent mood swings, and extreme temper outbursts. DMDD results go past a being a
"moody" child. Children who are diagnosed with DMDD experience genuine impedance that
requires clinical analysis. DMDD is a new disorder, appearing without precedent for Diagnostic
and Statistical Manual of Mental Disorders (DSM-5), distributed in 2013. It was made to all the
more precisely analyze kids who were recently determined to have pediatric bipolar issue,
despite the fact that they didn't encounter the maniac episodes or other charachteristics of
bipolar disorder.

(NIMH, 2017)
Specialists made the new diagnosis to try not to endorse antipsychotics or other mood
stabilizing drugs to kids who didn't completely meet the measures. While these medications
can be exceptionally viable yet they can likewise can have genuine results, for example,
obscured vision, giddiness, and utmost weariness
DMDD leads to a moody behavior. Youngsters with DMDD will in general be constantly touchy
and furious, in any event, when tantrums are absent. Manic episodes will in general travel
every which way. You may inquire as to whether your kid is steadily feeling awful, or if their
disposition is by all accounts strange. If it’s constant, then your child may have DMDD. If not,
then their doctor may consider a bipolar disorder diagnosis. Furthermore, the vital
characteristic of DMDD is irritability, while mania may likewise include happiness, or
outrageous positive feeling or extraordinary fervor or restlessness
(Browne, 2017)
Many children are bad tempered, upset, or grumpy occasionally. Periodic tantrums are likewise
an ordinary piece of growing up. Be that as it may, when kids are normally crabby or furious or
when temper tantrums are incessant, consistently, or are having Severe temper outbursts at
any rate three times each week, and Reaction is greater than anticipated, these might be
indications of a state of mind disorder, for example, DMDD. Some of the symptoms related with
DMDD are likewise present in other youngster mental problems, for example, misery, bipolar
disorder, and oppositional defiant disorder. A few kids with DMDD additionally have a

subsequent issue, for example, issues with consideration or tension. This is the reason to get
evaluated by a qualified mental health professional.
DMDD can impede a youngster's life and academic performance and disturb relations with their
family and friends. Kids with DMDD may think that it's difficult to partake in exercises or make
friends. Having DMDD increases the risk of developing anxiety disorders when you grow up.
The symptomatic measures for disruptive mood of mind dysregulation problem are intended to
isolate kids who experience ongoing difficulty controlling their temperaments from youngsters
who have different disorders that may likewise prompt irregular outbursts, irritability and
outrage, like autism, discontinuous explosive disorder, bipolar disorder or oppositional defiant
disorder (ODD). (AACAP, 2019)
Children with a background of long standing irritability are bound to be determined to have
troublesome temperament dysregulation problem. This may include youngsters who from a
youthful age who have battled to manage frustration or adjust without getting angry.
Sometimes kids with a prior analysis of ADHD or anxiety can get another option or another
diagnosis of DMDD. DMDD happens more regularly in boys than girls.
DMDD isn't so common since this condition is so new, so not a lot of information accessible on
predominance rates. The consequences of one investigation propose that somewhere in the
range of 0.8% and 3.3% of around 3,200 members whose ages were between 2 and 17 had
symptoms of DMDD over a three-month time frame. The issue gives off an impression of being
more normal during youth and is probably going to co-happen with other mental conditions,

most regularly depressive disorders and oppositional defiant disorder. The reasons for DMDD
are not clear, despite the fact that there are various components that are accepted to play a
role. Such components may include, temperament, genes conditions, and childhood
experiences.
(Cherry, 2020)
DMDD shares so much practically speaking with both Oppositional Defiant disorder (ODD) and
Attention deficiency hyperactivity disorder (ADHD) that it's occasionally hard to separate
between these issues. Exactly 90% of kids with DMDD meet the standards for ADHD, and
around 80% meet the models for ODD.DMDD, ODD, and ADHD all reason irritable behavior and
tantrums. The thing that matters is in these problems are their rate and force of how it is
influencing. These practices are less continuous and serious in youngsters with ODD and ADHD
because of cover with ADHD and ODD, countless the very prescriptions that work that was
done for these conditions are moreover helpful for DMDD as they’re similiar. There is no
particular treatment for disruptive mood dysregulation disorder (DMDD), yet the condition is
frequently treated by treatment and meds, for example, antidepressants and energizer drugs,
or a mix of the two. Parents of youngsters with DMDD ought to learn as much as possible about
the diagnosis. Parents are likewise instructed specific strategies they can utilize when reacting
to a youngster's troublesome conduct, to try not to fortify outbursts and rather reward good
behaviors. Children can be given medication when treatment and parent training is not
accessible, or not successful alone It can take a few preliminaries to locate the correct blend of
medicines expected to improve your kid's temperament and conduct. Parents are encouraged

to keep in touch with their doctor until a powerful treatment plan is created.
(CMI, 2019)
Adapting to disruptive mood dysregulation disorder can introduce difficulties for the both;
children and their caretakers. The diagnosis can make it hard for children to work at home and
at school, and parents and different relatives may think that its resilient to deal with kids' acute
temper outbursts. For Example, in one case study a kid with DMDD was educated to
intellectually to sing songs whenever she becomes angry. This method was likewise joined with
deep breathing and presenting verbal suggestions to help stop furious outbursts before they
started. Award good behaviors with consideration, applause, and benefits in multi-youngster
families, kids now and again go unnoticed when they are acting acceptable, yet can get one-on-
one consideration when they get into bad behavior. This will in general fortify misbehavior and
dispirit good behavior. Ensure that you notice and prize your kid's appropriate behavior.
(Watson, 2020)
Methodology (Indila Habib)

Our research is mainly based on secondary research method. There are 3 case studies given
below that consist of 3 different children facing DMDD, their respective causes and historical
background.
Case study 1: A case report of an 8-year-old suffering from DMDD due to Pre and
postnatal causes.
Name: Smith.
Age: 8-year-old.

Smith was living with his parents and his younger brother and was assessed on the grounds that
his parents were at their "absolute limits" with respect to how to deal with his explosive
outbursts, which were happening a few times each day. Ms. A, Smith's mom, expressed, "It has
arrived at that level where I despise my child." At the time of the evaluation, Smith was
exhibiting temper outbursts a few times each day that kept going around 10 minutes, and more
extreme 30-minute outbreak various times each week, during which he turned out to be
physically aggressive. For instance, during an ongoing tantrum, Smith kicked and poked holes in
his room doorway, He would not like to interact with kids of his age in the beginning and would
refuse to play with them and sometimes get angry on not getting proper attention. Moreover,
Smith's mother explained that she usually had bruises on her arms from blocking Smith's strikes.
When irritable, Smith seemed upset and restless and frequently expressed that he wanted to be
left alone. Whenever his parents tried to cheer his mood up, it resulted in the opposite way that
is, his grouchiness and anger used to elevate.
The history of presenting illness was explained by Smith’s mother saying that, Dillon had
consistently been a troublesome kid. As a child, he was colicky and cried ceaselessly for a few
hours every day. As a toddler, he threw tantrums various times each day, which Ms. A. (Mother)
attributed to the "horrible twos." Sadly, Smith's outbursts escalated as he grew up. When Smith
was 5, his temper tantrums included hitting and kicking his parents and throwing objects at them.
He had difficulties adapting a different environment outside home and this was evident from his
expulsion from school when he was in prekindergarten due to his agitated behavior. When
Smith got into school, his compliance and tantrums increased because homework added another
source of frustration to him. He was extremely distractible and showed resistance when
requested to do schoolwork. He was constantly restless and reluctant to sit in his chair for more

than 10 minutes. He likewise tried to avoid every day schedules, for example, picking up his
garments and brushing his teeth, and to avoid them he used to throw tantrums. Around the time
he began first grade, his anger and irritability were on edge and he used to get inflamed by little
things such as, sitting too close to him or touching his hair. Smith also began to make hostile
attributions with respect to his friends' intensions. For instance, when playing tag, Smith would
get angry, stating that others had hit him intentionally when they were only tagging him. He also
expressed the negative thoughts that nobody preferred him, that he didn't have any friends, and
that his parents didn't cherish him. Smith often experienced issues controlling these thoughts.
Smith would bring up an angering occasion all of a sudden, for example, being shouted at by his
instructor a couple of days earlier, and stayed upset for a few hours. Smith's outbursts at school
prompted his classification as emotionally upset children, and he was moved to a more modest
classroom. Despite of this more supportive climate, Smith kept on being problematic and to
experience issues focusing, adhering to guidelines, and finishing classwork. He became
exhausted easily and would not complete his work. Instructors started to put less workload on
him in order to avoid his tantrums. In addition, his family cut back on family social events and
tried not to include Smith on tasks, due to the humiliation they had to face by his fit of rage.
A comprehensive diagnostic interview was held, which included clinical interview from the child
and parents that confirmed that Smith’s behaviors and mood symptoms were consistent with
disruptive mood dysregulation disorder (DMDD). In the interview with parents' doctors started
looking into family’s medical history, it came forward that Smith’s mother had gone through
maternal depression during her pregnancy and also had some postpartum depression issues
because when Smith was born his weight was very less and doctors held him under observation
for 2 weeks during which his mother’s condition got worse off. (Psychiatry, 2014)


Case study 2: A case study of 9-year-old girl, suffering from DMDD due to family conflict
(Environmental cause).
Name: Bella.
Age: 9-year-old.
Bella, her mother and stepfather lived together. Bella's mom looked for treatment because of her
increasing problematic behaviors. It included rebelliousness at home and at school, physical
aggression towards peers, and frequent behavioral meltdowns that were not age-appropriate, for
instance, whenever she got agitated, she started stomping her feet aggressively against the floor.
Outbursts also included shouting, yelling, slamming doors, punching, and crying. Tantrums
temper mostly appeared 3-4 times per week by minor things such as when anyone asked her to
take her daily medications or even when someone was standing close too to her. Her mother
noticed that it was hard for Bella to "move on" when something displeased her. Her mother also
noticed that Bella started to had a low tolerance level and seemed "cranky" most of the time and
Bella was in danger for suspension from her sports team because of unprovoked physical
aggression towards her teammates. At least one phone call to Bella's home from school was
made because of Bella's refusal to consent or ill-mannered behavior with instructors. Her present
troublesome behaviors were causing critical impedance in making new friends and meeting
academic objectives.
While looking into the history, Bella’s mother was asked about any pre- or perinatal
complications but she denied to have any. Although, a series of event was noticed that might
have elevated this exasperated behavior of hers. Her mother told her that Bella was extremely

close with her father, but due to certain differences we got divorced. I would drop Bella at her
father's place on every weekend before going to work but, she wasn’t old enough to understand
why she had to visit two different houses to meet her parents. Her mother stated, “Bella often
used to ask me that did daddy left us because of her.” Even if she visited her dad on weekends
but he wasn’t there when his daughter needed him. After sometime her complaints started
coming from the school that Bella is having trouble while concentrating during lectures and she
isn’t performing well in academics. Steadily the degree of her anger increased and complaints
regarding physical aggression towards her peers started coming in. (Tudor, 2016)

Case study 3: A case report of 6-year-old facing DMDD due to genetic problem from her
father’s side (Biological cause).
Name: Anne
Age: 6-year-old
A girl name “Anne” age “six years” was seen for non-ending irritability, oppositional behavior
and tantrums. Her parents denied these symptoms as she was only a child and thought of it as
childhood willfulness but as she grew up, these behaviors started getting worse. Her parents said
they tried everything the pediatrician suggested and explored the online websites for mental
health as well but there was no improvement. She had meltdowns almost every day at home but
also at school and even with her friends, as soon as the environment changed, her level of
aggressiveness started to increase. Triggers included, but were not limited to, tactile sensitivity
(clothing, touch, getting hair and nails cut), minor frustrations and any redirection and attempt to
calm her went in vain. She was an intelligent and an active kid but any discomfort in her routine
or if there is something she doesn’t like (Food, toys, etc.) would result in severe mood swings
and her mood would rapidly change from expansive to tearfulness and anger.
From infancy through about five “Anne” was observed with sleeping problems and with time
above symptoms (anger, anxiousness etc.) started to appear. (Lesya, 2016)

Results (Indila Habib)
Case study 1
After the diagnoses, it was evident that Smith suffered DMDD because of prenatal and prenatal
and perinatal causes. Smith and his parents consulted a child psychiatrist to discuss the
prescription. The psychiatrist prescribed citalopram, which is a serotonin reuptake inhibitor
antidepressant, combined with the stimulant methylphenidate, with the expectation that it would
improve Smith’s hyperactivity and subsequently lessen his fits of rage. From his history he
noticed that Smith had a history of having an irritable temperament before the age of ten which
may be the certain cause of DMDD. The parents were referred for 'parent management training',
which offers explicit strategies that helped them in dealing with Smith when he experienced
explosive outbursts. Simultaneously, Smith received cognitive-behavioral therapy (CBT) that
aimed at teaching him how he can better regulate his mood and improve his frustration tolerance.
In CBT, they taught him coping skills which helped him regulate his anger, irritability and
relabel the hostile attributes. At last, a school conduct every day report card was built up in
which Smith was compensated for positive behaviors in the classroom as he was more focused
and tried to do better and he started to control his tantrums and behave in a certain manner with
his parents. (Psychiatry, 2014)

Case study 2
When her mother went to the child psychiatrist, after observing her, conducting clinical
interviews with Bella and her mother and listening to all of her history, the psychiatrist
diagnosed DMDD in Bella. The divorce of Bella parents had a great impact on her mental health.
Her mother was a working woman and she could not give her the time and attention she required.
Most of all Bella considered the divorce of her parents occurred because of her somehow. She
was not satisfied with her life that resulted in her constant mood of irritability and anxiousness.
The psychiatrist suggested a Dialectical behavioral therapy for children (DBT-C). It serves to
teach children mindfulness, emotional regulation, and how to tolerate feelings of frustration. In
DBT-C, instead of dismissing the child’s emotions, the therapist validates them in order to help
the child develop skills to manage their feelings. Her mother was also suggested to take parent
management training, during which parents are trained explicit strategies they can utilize when
reacting to their child's tantrums to try to avoid unwanted behavior and relieve the kid by saying
kind words like “I'm with you or we will pass this difficulty together".
After 12 weekly sessions of 60 minutes with her psychologist, Bella’s level of irritability
decreased and she was much more satisfied now in terms of life and academics. 6 follow up
sessions were also arranged in order to get the surety of her mental health. (Tudor, 2016)

Case study 3
When her parents took her to the doctor (A pediatric neurologist who specialized in sleep
disorders), he believed that she is suffering from Disruptive mood dysregulation disorder
because after evaluation he came to know that on fathers' side there was a history of anxiety,
depression and childhood disorder and some other bipolar issues like bipolar in nature. Genetic
history is the strongest factor that can cause DMDD within a child.
The therapist suggested CBT (cognitive-behavioral therapy) which helped her in learning skills
such as how to deal with frustration, how to deviate your attention from something that’s
bothering you. The treatment additionally shows adapting abilities for controlling anger and
approaches to distinguish and re-mark the distorted perceptions that cause the outburst. Along
with it, he also prescribed a stimulant that will help her control her impulses and an
antidepressant such as, SSRI. After three months of continuous sessions, better sleep cycle along
with eliminated tantrums and mood swings were observed within Anne. (Lesya, 2016)

Limitations (Ahmed Waleed)

 We cannot identify the authenticity of the case studies as our research was based on
secondary data.
 Certain outcomes could not be well interpreted because of the use of advanced medical
terms.
 Due to the pandemic, we were unable to visit work fields and conduct interviews of
people. The pandemic also restricted us to use the secondary data only and our
conclusions are based on it.
 As many people neglect or are not aware of DMDD, it was extremely difficult to find
case studies regarding this disorder.
Recommendations
1. Further research should be conducted in terms of this psychological disorder as the exact
symptoms are not yet known by the specialists.
2. To better cater any early recognition and symptoms of disruptive mood dysregulation
disorder, the medical literature suggests the increase collaboration of families, physicians
and mental health professionals to better assist any DMDD patient.
3. Online medical courses should be given to inform the family and physical therapists
regarding the symptoms of DMDD of common psychiatric disorders.
4. In Pakistani society, people consider it as childhood willfulness and try not to categorize
the constant irritability as a psychological disorder. People whose children are going
through DMDD should consult a therapist instead of neglecting the situation.

5. Parents and other people should be supportive of the children, they should show gestures
that let their children feel safe, encourage positive behavior and work with them in
learning coping skills so, children do not feel isolated.

References
 Temper Tantrums Are a Key Sign of DMDD. (2020). Retrieved 26 November 2020, from
https://www.verywellmind.com/disruptive-mood-dysregulation-disorder-4774447
 What are the Causes of DMDD? | HealthyPlace. (2020). Retrieved 26 November 2020, from
https://www.healthyplace.com/parenting/dmdd/what-are-the-causes-of-dmdd
 (Psychiatry, 2014). Retrieved 26 November 2020, from
https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.2014.13101301
 Help, G., Professionals, F., Listed, G., Help, G., Professionals, F., & Therapist, F. et al. (2020). Disruptive
Mood Dysregulation (DMDD). Retrieved 26 November 2020, from https://www.goodtherapy.org/learn-
about-therapy/issues/disruptive-mood-dysregulation
 Cognitive-Behavioral Therapy for a 9-Year-Old Girl with Disruptive Mood Dysregulation Disorder - Megan
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Childhood Disruptive Mood Dysregulation disorder 1

Childhood Disruptive Mood Dysregulation Disorder

Ms. Hirra Rana

Lahore School of Economics

27th November, 2020

Lahore School of Economics

Lahore School of Economics

Abstract (Indila Habib)

about the disorder thoroughly.

throughout the research.

Lahore School of Economics

Introduction (Ahmed Waleed)

proportion to the situation given”.

leaves. (Child Mind Institution, 2020).

Lahore School of Economics

circumstance and stage of growth, verbal or behavioral temperamental outbursts

• Visible extreme temperature outbursts at least three times a week

• Reaction higher than expected

• Symptoms start before the age of 10 years.

professional. (AACAP, 2019).

Lahore School of Economics

signs that can be seen in kids include:

Other DMDD-related risk factors are;

• Parental aggression and use of drug

• Low parental support

• Disciplinary challenges at school

There can be several causes of DMDD including;

children as well as the brain mechanisms.

Lahore School of Economics

diagnosis of DMDD, including irritability and hostility.

frontal gyrus and anterior cingulate cortex.

related risk factors include;

• Any recent death of a family member, or divorce

• Lacking in sufficient deficiency in nutrition or vitamin is reported as leading to

Lahore School of Economics

Treatment and Therapies

hyperactivity disorder (ADHD), anxiety disorders and major depression disorder.

• Training for parents

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• Training based on computers

Psychological interventions should be considered as the top priority to be handled first,

crucial for parents. (NIH, 2020).

Therapy: Psychotherapy is accepted as a treatment that includes cognitive behavioral therapy

patient of disruptive mood dysregulation disorder, psychiatrists may advice antipsychotics,

stimulants, mood stabilizers, or antidepressants to treat symptoms of disruptive mood

Lahore School of Economics

need adequate knowledge, support and assistance. (Cherry, 2020).

How to cope with a DMDD patient?

cope up with a DMDD patient.

Lahore School of Economics

Literature Review (Ammar Jamshaid)

mood dysregulation problem (DMDD).

Lahore School of Economics

obscured vision, giddiness, and utmost weariness

characteristic of DMDD is irritability, while mania may likewise include happiness, or

outrageous positive feeling or extraordinary fervor or restlessness

Lahore School of Economics