Thursday, March 18, 2010

Temper Dysregulation Syndrome - TDD

So what is TDD?

Here is the proposed criteria for TDD:

A. The disorder is characterised by severe recurrent temper outbursts in response to common stressors.

  • The temper outbursts are manifest verbally and/or behaviourally, such as in the form of verbal rages, or physical aggression towards people or property.
  • The reaction is grossly out of proportion in intensity or duration to the situation or provocation.
  • The responses are inconsistent with developmental level.

B. Frequency: The temper outbursts occur, on average, three or more times per week.

C. Mood between temper outbursts:

  • Nearly every day, the mood between temper outbursts is persistently negative (irritable, angry, and/or sad).
  • The negative mood is observable by others (e.g., parents, teachers, peers).
D. Duration: Criteria A-C have been present for at least 12 months. Throughout that time, the person has never been without the symptoms of Criteria A-C for more than 3 months at a time.

E. The temper outbursts and/or negative mood are present in at least two settings (at home, at school, or with peers) and must be severe in at least in one setting.

F. Chronological age is at least 6 years (or equivalent developmental level).

G. The onset is before age 10 years.

H. In the past year, there has never been a distinct period lasting more than one day during which abnormally elevated or expansive mood was present most of the day for most days.

Also the abnormally elevated or expansive mood was accompanied by the onset, or worsening, of three of the “B” criteria of mania

  • grandiosity or inflated self esteem,
  • decreased need for sleep,
  • pressured speech,
  • flight of ideas,
  • distractibility,
  • increase in goal directed activity, or
  • excessive involvement in activities with a high potential for painful consequences.

Abnormally elevated mood should be differentiated from developmentally appropriate mood elevation, such as occurs in the context of a highly positive event or its anticipation.

I. The behaviours do not occur exclusively during the course of a Psychotic or Mood Disorder

  • Major Depressive Disorder,
  • Dysthymic Disorder,
  • Bipolar Disorder or
  • Other - they are not better accounted for by another mental disorder e.g., Pervasive Developmental Disorder, post-traumatic stress disorder, separation anxiety disorder.

NB: This diagnosis can co-exist with Oppositional Defiant Disorder, ADHD, Conduct Disorder, and Substance Use Disorders.

The symptoms are not due to the direct physiological effects of a drug of abuse, or to a general medical or neurological condition

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