Are Temper Tantrums an Early Sign of Mental Illness? A HealthCentral Explainer


The general attitude towards temper tantrums in young children is that they are perfectly normal and an unfortunate developmental phase associated with the “terrible twos.”  While they are normal to a degree and will inevitably occur at one time or another, new research from the Northwestern Feinberg School of Medicine provides a new tool for determining when temper tantrums in young children could be an early warning sign of mental health problems.


The Northwestern researchers wanted to identify, if possible, when a temper tantrum is something more than a typical fit and becomes a reason to seek help.  To that end, they developed an easy-to-administer questionnaire--the Multidimensional Assessment of Preschool Disruptive Behavior (MAP-DB)—meant to help distinguish typical  meltdown behavior from more extreme behavior.  The researchers gave the questionnaire to the parents of a diverse group of 1,500 preschoolers, age three to five.  The survey asked about frequency, quality, and severity of a variety of temper tantrum behaviors and anger management skills over the past month.  The results allowed researchers to gain an understanding of baseline tantrum behavior and to determine which children were normal and which were at risk of developing mental health problems down the road.

The assessment provides a developmentally-based approach, which is different from the Diagnostic and Statistical Manual of Mental Disorders (DSM), which currently does not provide any age-specific markers for measuring clinical significance.  While the assessment shows promise in early detection and  could  be online and in pediatrician offices soon, some areas require further investigation.  For instance when evaluating how often a patient loses his temper,  the term “often” may vary substantially based on the age of the child, family stress levels, and other factors.  Vague criteria may still make it difficult to determine when behavior should become a matter of concern.


What else did the researchers find?

For one thing, they found that temper tantrums aren’t as common as generally assumed.  While the researchers found that preschoolers were indeed more apt to throw fits, fewer than 10 percent had such an episode every day.  This key finding provided scientists with a measurable indicator as to when the frequency of tantrums becomes a concern.  For instance, tantrums are generally more likely to occur when a child is tired, frustrated or irritated; by contrast, it  would be considered atypical if the tantrum came out of nowhere or was so intense the child became sick or fatigued.  Having an atypical temper tantrum on rare occasions doesn’t necessarily signal a problem, but if this kind of behavior occurs daily, it could merit a conversation with your pediatrician.


How important is it to monitor temper tantrums?

Mental illness can be very difficult to diagnosis and often isn’t recognized until behavior is out of control and a child is spiraling downward into chronic mental illness.  There is also the potential danger of a normal but temporarily misbehaving child to be mislabeled and unnecessarily medicated.  Assessing a child early for signs of mental distress can eliminate such complications and prevent negative patterns from becoming ingrained and difficult to overcome.  Early intervention is key in finding effective treatment, and this new diagnostic assessment could be a  significant asset.


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