Establishing the transdiagnostic contextual pathways of emotional outbursts

Abstract

Emotional outbursts or temper outbursts are challenging behaviours commonly experienced by people with neurodevelopmental disorders and people who have experienced childhood adversity, which can negatively impact individuals and their families. Emotional outbursts may manifest in different situations via unique pathways distinguished by context-specific differences in the regulation and expression of emotions. Caregivers (N = 268) of young people (6-25 years) with emotional outbursts completed a bespoke caregiver-report questionnaire. Potential pathways were identified by examining the patterns of antecedents and setting events related to outbursts through factor and cluster analyses. Six contextual factors were derived from the Emotional Outburst Questionnaire. Based on these factors, the responses were classified into three clusters, which may represent potential pathways of emotional outbursts. The three clusters were characterized by the increased likelihood of outbursts: (1) across all setting events and triggers; (2) in safe setting events; (3) in unsafe setting events. These potential pathways may be related to: (1) differences in sensory processing; (2) masking of emotions in unsafe environments; (3) differences in safety perception. This framework supports a transdiagnostic account of emotional outbursts and may facilitate the development of pathway-specific intervention strategies.

Figure 1

Summary of the description and interpretation of the contextual pathways of emotional outburst, corresponding to the three identified clusters.

Figure 2

Pairwise comparisons of factor scores for the k-means three-cluster solution. Boxplots show mean (black squares) median (horizontal bar), interquartile range (box), range (whiskers) and outliers (circles). All outliers were included in analyses. Unless otherwise specified, all pairwise comparisons within each factor were significant at p < 0.001, adjusted with Tukey’s method. Ns not significant; *p < 0.05.

Figure 3

Pairwise comparisons of non-refined factor scores for the k-means three-cluster solution. Boxplots show mean (black squares) median (horizontal bar), interquartile range (box), range (whiskers) and outliers (circles). All outliers were included in analyses. Unless otherwise specified, all pairwise comparisons within each factor were significant at p < 0.001, adjusted with Tukey’s method. Ns not significant; *p < 0.05.