Rages or temper tantrums? The behavioral organization, temporal characteristics, and clinical significance of angry-agitated outbursts in child psychiatry inpatients

Michael Potegal, Gabrielle Carlson, David Margulies, Zinoviy Gutkovitch, Melanie Wall

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Angry, agitated outbursts (AAOs) are a common precipitant of children's psychiatric hospitalization. In the hospital, AAOs present both management and diagnostic challenges, e.g., while they have recently been described as manic "rages", older studies suggest that they may be exacerbated temper tantrums. Factor analyses of 109 AAOs had by 46 hospitalized 4-12 year olds yielded 3 subsets of behaviors expressing different intensities of anger and 2 subsets expressing different intensities of distress (sadness). Cluster analysis of behavior time course supported the anger-distress distinction; the former behaviors are most probable at AAO onset and then decline while the latter are more evenly distributed across the outburst. Age trends, factor structure, and temporal organization of AAOs all indicate that they are exacerbated tantrums. The AAOs of children with anxiety or PDD diagnoses showed significantly more distress relative to anger. AAOs have clinical implications; their particular characteristics may have diagnostic significance.

Original languageEnglish (US)
Pages (from-to)621-636
Number of pages16
JournalChild psychiatry and human development
Volume40
Issue number4
DOIs
StatePublished - Dec 1 2009

Keywords

  • Anger
  • Anxiety
  • Disruptive behavior
  • Emotion dysregulation
  • Sadness

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