Discussion board post 5 reply 2

Read the module 5 lecture page (MO1, MO2, MO3, MO4)

1. Read pages 139 through 214 & pages 543 through 665 in the DSM-5-TR  (MO1, MO2, MO3, MO4)
2. Read Boland, R., & Verduin, M. (2022). Kaplan  Chapter 6: Mood Disorders(Bipolar)
3. Read Boland, R., & Verduin, M. (2022). Kaplan chapter 7 (depressive disorder)
4. Read Boland, R., & Verduin, M. (2022). Kaplan Chapter 4: Substance Related and Addictive Disorders
5. Read Zuckerman Review Part 1: Chapters 1-3, pg. 35-50 Mental Status Exam Special emphasis on: • Chapters 3: 3.4, 3.10, 3.28, 3.29 • Chapter 9 • Chapter 10: 10.4, 10.5, 10.6, 10.7, 10.9, 10.11 • Chapter 12: 12.31, 12.36, 12.37 5.
6.  Read Morrison and Flegel: Chapter 13                                                                                                                                                                                                                                                                                                                                                                         Reply to peer post using APA format                                                                                                                                                                                                                      Compare and contrast disruptive mood dysregulation disorder from intermittent explosive disorder with particular emphasis on how comprehensive assessment could help us to arrive at the correct diagnosis.

Disruptive Mood Dysregulation Disorder (DMDD) and Intermittent Explosive Disorder (IED) are both characterized by episodes of irritability and outbursts, yet they are distinct in their diagnostic criteria and features. According to the DSM-5-TR, DMDD is primarily diagnosed in children between the ages of 6 and 18, with symptoms starting before age 10. It involves severe temper outbursts that are grossly out of proportion in intensity or duration to the situation, occurring on average three or more times per week. Additionally, these children exhibit a persistent irritable or angry mood most of the day, nearly every day, and these symptoms must be present for at least 12 months without a break of three or more consecutive months. The symptoms must occur in at least two of three settings (home, school, peers) and be severe in at least one (American Psychiatric Association, 2022).

In contrast, IED is characterized by recurrent behavioral outbursts representing a failure to control aggressive impulses, which can manifest as verbal aggression or physical aggression toward property, animals, or other individuals. The DSM-5-TR outlines that these outbursts must occur either twice weekly on average for a period of three months or involve three episodes of damage or destruction of property and/or physical assault causing injury within a 12-month period. Importantly, IED does not require the persistent irritable mood between outbursts that is seen in DMDD (American Psychiatric Association, 2022).

A comprehensive assessment is critical to distinguish between DMDD and IED. Boland and Verduin (2022) emphasize the importance of a detailed clinical interview to understand the history of the present illness, focusing on the frequency, duration, and severity of the outbursts, the mood between episodes, and the context in which they occur. Gathering developmental history and family history of mood or behavioral disorders is also essential. Behavioral observation in multiple settings (home, school, clinic) can help identify patterns and triggers. Standardized rating scales and questionnaires, such as the Child Behavior Checklist (CBCL) and the Mood Disorder Questionnaire (MDQ), can provide quantifiable data on symptom severity and frequency. Collateral information from teachers, caregivers, and others who interact with the child regularly can offer additional insights into whether the symptoms are pervasive, aligning with DMDD, or more episodic, as seen in IED (Biederman et al., 2020). A medical and neurological evaluation is necessary to rule out other conditions that could explain the symptoms. Finally, assessing the functional impact on the child’s academic performance, social relationships, and family dynamics provides context for the diagnosis, ensuring that the symptoms are not better explained by another mental disorder, a substance, or a medical condition (Boland & Verduin, 2022). By integrating data from these various sources, clinicians can more accurately diagnose and differentiate between DMDD and IED, leading to more tailored and effective interventions.

References

American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).

Biederman, J., DiSalvo, M., Vaudreuil, C., Wozniak, J., Uchida, M., Woodworth, K. Y., Green, A., & Faraone, S. V. (2020). Can the Child Behavior Checklist (CBCL) help characterize the types of psychopathologic conditions driving child psychiatry referrals? Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 8(1), 157–165. https://doi.org/10.21307/sjcapp-2020-016Links to an external site. 

Boland, R., & Verduin, M. (2022). Kaplan & Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry (12th ed.).