Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
J Child Psychol Psychiatry. 2012 Nov;53(11):1099-108. doi: 10.1111/j.1469-7610.2012.02595.x. Epub 2012 Aug 29.
Temper modulation problems are both a hallmark of early childhood and a common mental health concern. Thus, characterizing specific behavioral manifestations of temper loss along a dimension from normative misbehaviors to clinically significant problems is an important step toward identifying clinical thresholds.
Parent-reported patterns of temper loss were delineated in a diverse community sample of preschoolers (n = 1,490). A developmentally sensitive questionnaire, the Multidimensional Assessment of Preschool Disruptive Behavior (MAP-DB), was used to assess temper loss in terms of tantrum features and anger regulation. Specific aims were: (a) document the normative distribution of temper loss in preschoolers from normative misbehaviors to clinically concerning temper loss behaviors, and test for sociodemographic differences; (b) use Item Response Theory (IRT) to model a Temper Loss dimension; and (c) examine associations of temper loss and concurrent emotional and behavioral problems.
Across sociodemographic subgroups, a unidimensional Temper Loss model fit the data well. Nearly all (83.7%) preschoolers had tantrums sometimes but only 8.6% had daily tantrums. Normative misbehaviors occurred more frequently than clinically concerning temper loss behaviors. Milder behaviors tended to reflect frustration in expectable contexts, whereas clinically concerning problem indicators were unpredictable, prolonged, and/or destructive. In multivariate models, Temper Loss was associated with emotional and behavioral problems.
Parent reports on a developmentally informed questionnaire, administered to a large and diverse sample, distinguished normative and problematic manifestations of preschool temper loss. A developmental, dimensional approach shows promise for elucidating the boundaries between normative early childhood temper loss and emergent psychopathology.
情绪调节问题既是幼儿期的一个显著特征，也是常见的心理健康问题。因此，沿着从正常行为问题到临床显著问题的维度来描述情绪失控的特定行为表现，是确定临床阈值的重要一步。
在一个多样化的学龄前儿童社区样本中（n=1490），描绘了父母报告的情绪失控模式。使用发育敏感问卷——多维度学龄前破坏性行为评估（MAP-DB），从发脾气特征和愤怒调节的角度评估情绪失控。具体目标是：（a）记录从正常行为问题到临床相关情绪失控行为的学龄前儿童情绪失控的正常分布，并检验社会人口统计学差异；（b）使用项目反应理论（IRT）来构建情绪失控维度模型；（c）检验情绪失控与并发情绪和行为问题的关联。
在所有社会人口统计学亚组中，单维情绪失控模型都很好地拟合数据。几乎所有（83.7%）的学龄前儿童有时会发脾气，但只有 8.6%的儿童每天发脾气。正常行为问题比临床相关的情绪失控行为更常见。更轻微的行为往往反映了可预见情境下的挫折感，而临床相关的问题指标则是不可预测的、持续时间长的和/或具有破坏性的。在多变量模型中，情绪失控与情绪和行为问题有关。
基于发展的问卷的父母报告，对一个大的、多样化的样本进行了评估，区分了学龄前儿童情绪失控的正常和问题表现。发展性、维度性方法有望阐明正常幼儿期情绪失控和新兴精神病理学之间的界限。
