Table 1.
Diagnosis Assessment Methods
| SMD criteria (Leibenluft 2011) | Questions | Scale | Informant |
|---|---|---|---|
| (1) Markedly increased reactivity to negative emotional stimuli manifesting verbally or behaviorally on average at least three times weekly | • Often loses temper Has this been a problem for at least 6 months? |
DBD Parent Interview | Parent |
| • Loses temper: Has there ever been a time when you would get upset easily and lose your temper? Did it take much to get you mad? How often did you get really mad or annoyed and lose your temper? Where do you lose your temper? What do you do when you have a temper tantrum? | K-SADS-PL | Parent Child |
|
| (2) Abnormal mood (anger or sadness), present at least half of the day most days | • Is often angry and resentful Has this been a problem for at least 6 months? |
DBD Parent Interview | Parent |
| • Irritability and anger: Subjective feeling of irritability, anger, crankiness, bad temper, short temper, resentment or annoyance, whether expressed overtly or not. Rate the intensity and duration of such feelings. Was there ever a time when you got annoyed, irritated, or cranky at little things? • Duration of irritable mood |
K-SADS-PL | Parent Child |
|
| (3) Hyperarousal (≥3 of insomnia, agitation, distractibility, racing thoughts or flight of ideas, pressured speech, intrusiveness) | • Easily distracted • Often talks excessively • Often interrupts or intrudes on others Has this been a problem for at least 6 months? |
DBD Parent Interview | Parent |
| • Depressive disorders Insomnia • Bipolar disorder Decreased need for sleep Accelerated, pressured speech or increased amount of speech Racing thoughts Flight of ideas Distractibility |
K-SADS-PL | Parent Child |
|
| (4) Symptoms cause severe impairment in at least one setting (home, school, or with peers) and at least mild impairment in a second setting; | DBD Parent Interview KSADS PL |
Parent | |
| (5) SMD symptom onset must be before age 12 and must be currently present for at least 12 months without symptom-free periods>2 months | DBD Parent Interview KSADS PL |
Parent | |
| (6) Absence of manic or psychotic symptoms. | K-SADS-PL | Parent Child |
|
| (7) Absence of pervasive developmental disorder | Social Communications Questionnaire | Parent | |
| (8) IQ >70 | WISC-IV | Child |
Additional disruptive mood dysregulation disorder (DMDD) criteria: 1) Considered abnormal mood only if irritable or angry, not sad or depressed. 2) Criterion 1 required severe recurrent temper outbursts, three or more times/week. 3) Required age of onset before 10.
SMD, severe mood dysregulation; DBD, disruptive behavior disorder; K-SADS-PL, Kiddie Schedule for Affective Disorders and Schizophrenia for School-Aged Children – Present and Lifetime Version; IQ, intelligence quotient; WISC-IV, Wechsler Intelligence Scale for Children, 4th ed.