Disruptive mood dysregulation disorder, parental stress, and attachment styles

Marit Coldevin, Astrid Brænden, Pål Zeiner, Anne-Siri Øyen, A. Melinder, Jan E. Stubberud
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Abstract

Disruptive mood dysregulation disorder (DMDD) is a relatively new diagnostic entity concerning children with chronic irritability and severe anger outbursts. Currently, there is limited knowledge about the parental factors associated with the disorder. The aim of this study was to compare stress levels and attachment styles in parents of children with DMDD with those of parents of children with other diagnoses. Our sample consisted of 218 children (6–12 years, Mage = 9.68 years) referred to child mental health outpatient clinics. Clinicians used a standardized semi-structured diagnostic interview to identify diagnoses. Parental stress levels and attachment styles were assessed using parent reports. We found that parents of children with DMDD experience significantly higher levels of parenting stress related to factors in the child than parents of children with other diagnoses. Furthermore, parents of children with DMDD show a higher association with insecure adult attachment styles than parents of children without DMDD. Finally, an adult preoccupied-ambivalent attachment style explains the variability in parental stress in the DMDD group to a large degree. We discuss how parental stress and an insecure attachment style can be associated with negative parenting practices. An implication from this study could be that treatment results might be improved by involving parents more in treatment programs for children with DMDD.
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破坏性情绪失调症、父母压力和依恋方式
破坏性情绪失调症(DMDD)是一种相对较新的诊断方法,主要针对长期易怒和严重发怒的儿童。目前,人们对与该障碍相关的父母因素了解有限。本研究旨在比较 DMDD 患儿父母与其他诊断儿童父母的压力水平和依恋方式。我们的样本包括 218 名转诊到儿童精神健康门诊的儿童(6-12 岁,平均年龄 = 9.68 岁)。临床医生使用标准化的半结构化诊断访谈来确定诊断。家长的压力水平和依恋方式则通过家长报告进行评估。我们发现,与患有其他诊断的儿童相比,患有 DMDD 的儿童的父母在养育子女方面所承受的压力明显更高。此外,与非 DMDD 儿童的父母相比,DMDD 儿童的父母表现出更高的不安全成人依恋风格。最后,成人先入为主-矛盾型依恋风格在很大程度上解释了DMDD群体中父母压力的变化。我们讨论了父母的压力和不安全的依恋风格如何与消极的养育行为相关联。本研究的一个启示是,让父母更多地参与DMDD儿童的治疗计划,可能会改善治疗效果。
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