Pediatric Study Reveals Tantrum Behavior Links to Psychiatric Disorders

The January 2008 Journal of Pediatrics will reveal research linking tantrums in children to a more serious risk disorders, such as depression and disruptive disorders, than healthy children. The study resulted in identifying five warning signs.

Dr. Andrew C. Belden of the Washington University School of Medicine in St. Louis authored the study. Researchers compared tantrums in healthy children aged 3-6 to those in children that had been previously diagnosed with depression and disruptive disorders including attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD).

In a telephone interview on Thursday, December 20, 2007, Dr. Belden stated, “It’s clearly normal for young children to have occasional tantrums.” He went on to add that healthy children may even display extreme behavior during tantrums.

His warning came in this statement: “But if a child is regularly engaging in specific types of tantrum behaviors, there may be a problem.” The study has identified five specific tantrum behaviors that may be indicative of psychiatric illness.

Dr. Joan Luby, chief investigator for the study, stated that the purpose of the study was to identify depression and disruptive disorders in pre-school aged children. Dr. Luby said, “It’s important to find age-specific ways to diagnose depression and other problems in young children because it can be difficult to get very young children to tell you about their feelings.”

The following tantrum behaviors were observed by researchers as connected to depression and diagnosable disruptive disorders:

Severe aggression toward a caregiver or violent destructive behavior toward an object or toy during a tantrum is a sign of concern for parents. The study linked these behaviors to disruptive disorder diagnosis.

Scratching themselves to the point of bleeding, head banging and biting themselves was only identified with depressive disorders. Researchers found that this behavior did not manifest in healthy children or those with ADHD or disruptive disorders.

The study concluded that self-injurious behavior manifesting at this young age is almost always associated with psychiatric diagnosis.

Multiple tantrums
Children having more than 5 tantrums per day on consecutive days were targeted as children with disruptive disorders. Additionally, children with more than 10-20 tantrums per month are advised to seek professional intervention.

Long tantrums
Healthy children displayed tantrums lasting an average of 10 minutes each. Diagnosed children averaged tantrums of 25 minutes. This marked difference is indicative of psychiatric illness factors.

Inability to soothe self
Children should be able to stop tantrum behavior and calm themselves by distraction on their own without intervention of the parent. Tantrums which require the parent to bribe or provide other distraction to calm tantrums came from children at much greater risk of psychiatric problems.

The study, based mostly on parental reporting of behaviors, will be continued to produce more empirical data by use of video taping toddler behaviors. Dr. Belden stresses that the replication of these results with other children will be necessary to specifically classify which behaviors are problematic.

Parents should be aware of the frequency and severity of tantrums. Tantrums, in and of themselves, are not a psychiatric problem. Monitoring the behaviors during and the length of the tantrum are key.

Belden concludes that the best finding was that tantrums are not always a sign of psychiatric doom for a child. He advises that in the instance of self-injury, parents should seek pediatric or psychiatric help for their child.

Reuters Life! December 20, 2007

Belden, AC, Thomson NR, Luby JL. Temper tantrums in healthy versus depressed and disruptive preschoolers: defining tantrum behaviors associated with clinical problems. The Journal of Pediatrics, vol. 151:6, Jan. 2008. doi:10.1016/j.jpeds.2007.06.030