Assessment of affective dysregulation in children: development and evaluation of a semi-structured interview for parents and for children

Anne-Katrin Treier^{1

2}, Sara Zaplana Labarga^{3

4}, Claudia Ginsberg^{3

4}, Lea Teresa Kohl^{3

4}, Anja Görtz-Dorten^{3

4}, Ulrike Ravens-Sieberer⁵, Anne Kaman⁵, Tobias Banaschewski⁶, Pascal-M Aggensteiner⁶, Charlotte Hanisch⁷, Michael Kölch^{8

9}, Andrea Daunke⁹, Veit Roessner¹⁰, Gregor Kohls¹⁰, Manfred Döpfner^{3

4}; ADOPT consortium

Collaborators, Affiliations

Collaborators

ADOPT consortium:
Dorothee Bernheim, Stefanie Bienioschek, Maren Boecker, Daniel Brandeis, Kristina Butz, Jörg M Fegert, Franziska Giller, Carolina Goldbeck, Martin Hellmich, Christine Igel, Michaela Junghänel, Anne Ritschel, Jennifer Schroth, Anne Schüller, Marion Steiner, Anne Uhlmann

Affiliations

¹ School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. anne-katrin.treier@uk-koeln.de.
² Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. anne-katrin.treier@uk-koeln.de.
³ School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
⁴ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
⁵ Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁶ Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
⁷ Faculty of Human Sciences, University of Cologne, Cologne, Germany.
⁸ Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany.
⁹ Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics, and Psychotherapy, University Medical Center Rostock, Rostock, Germany.
¹⁰ Department of Child and Adolescent Psychiatry and Psychotherapy, TUD Dresden University of Technology, Dresden, Germany.

PMID: 38902809
PMCID: PMC11191270
DOI: 10.1186/s13034-024-00762-8

Assessment of affective dysregulation in children: development and evaluation of a semi-structured interview for parents and for children

Anne-Katrin Treier et al. Child Adolesc Psychiatry Ment Health. 2024.

. 2024 Jun 20;18(1):75.

doi: 10.1186/s13034-024-00762-8.

Authors

Collaborators

ADOPT consortium:
Dorothee Bernheim, Stefanie Bienioschek, Maren Boecker, Daniel Brandeis, Kristina Butz, Jörg M Fegert, Franziska Giller, Carolina Goldbeck, Martin Hellmich, Christine Igel, Michaela Junghänel, Anne Ritschel, Jennifer Schroth, Anne Schüller, Marion Steiner, Anne Uhlmann

Affiliations

¹ School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. anne-katrin.treier@uk-koeln.de.
² Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. anne-katrin.treier@uk-koeln.de.
³ School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
⁴ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
⁵ Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁶ Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
⁷ Faculty of Human Sciences, University of Cologne, Cologne, Germany.
⁸ Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany.
⁹ Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics, and Psychotherapy, University Medical Center Rostock, Rostock, Germany.
¹⁰ Department of Child and Adolescent Psychiatry and Psychotherapy, TUD Dresden University of Technology, Dresden, Germany.

PMID: 38902809
PMCID: PMC11191270
DOI: 10.1186/s13034-024-00762-8

Abstract

Background: Children with affective dysregulation (AD) show an excessive reactivity to emotionally positive or negative stimuli, typically manifesting in chronic irritability, severe temper tantrums, and sudden mood swings. AD shows a large overlap with externalizing and internalizing disorders. Given its transdiagnostic nature, AD cannot be reliably and validly captured only by diagnostic categories such as disruptive mood dysregulation disorder (DMDD). Therefore, this study aimed to evaluate two semi-structured clinical interviews-one for parents and one for children.

Methods: Both interviews were developed based on existing measures that capture particular aspects of AD. We analyzed internal consistencies and interrater agreement to evaluate their reliability. Furthermore, we analyzed factor loadings in an exploratory factor analysis, differences in interview scores between children with and without co-occurring internalizing and externalizing disorders, and associations with other measures of AD and of AD-related constructs. The evaluation was performed in a screened community sample of children aged 8-12 years (n = 445). Interrater reliability was additionally analyzed in an outpatient sample of children aged 8-12 years (n = 27).

Results: Overall, internal consistency was acceptable to good. In both samples, we found moderate to excellent interrater reliability on a dimensional level. Interrater agreement for the dichotomous diagnosis DMDD was substantial to perfect. In the exploratory factor analysis, almost all factor loadings were acceptable. Children with a diagnosis of disruptive disorder, attention-deficit/hyperactivity disorder, or any disorder (disruptive disorder, attention-deficit/hyperactivity disorder, and depressive disorder) showed higher scores on the DADYS interviews than children without these disorders. The correlation analyses revealed the strongest associations with other measures of AD and measures of AD-specific functional impairment. Moreover, we found moderate to very large associations with internalizing and externalizing symptoms and moderate to large associations with emotion regulation strategies and health-related quality of life.

Conclusions: The analyses of internal consistency and interrater agreement support the reliability of both clinical interviews. Furthermore, exploratory factor analysis, discriminant analyses, and correlation analyses support the interviews' factorial, discriminant, concurrent, convergent, and divergent validity. The interviews might thus contribute to the reliable and valid identification of children with AD and the assessment of treatment responses.

Trial registration: ADOPT Online: German Clinical Trials Register (DRKS) DRKS00014963. Registered 27 June 2018.

Keywords: Affective dysregulation; Assessment; Children; Clinical interview; Irritability; Reliability; Validity.

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Conflict of interest statement

AGD receives royalties from publishing companies as an author of books and treatment manuals on child behavioral therapy and of assessment manuals, including the treatment manuals evaluated in this trial. She receives income as a consultant for Child Behavior Therapy at the National Association of Statutory Health Insurance Physicians. She also receives consulting income and research support from Medice and eyelevel GmbH. TB served in an advisory or consultancy role for eyelevel GmbH, Infectopharm, Medice, Neurim Pharmaceuticals, Oberberg GmbH, and Takeda. He received conference support or speaker’s fees from Janssen, Medice and Takeda. He received royalties from Hogrefe, Kohlhammer, CIP Medien, and Oxford University Press; the present work is unrelated to these relationships. CH receives royalties from a publishing company as the author of a treatment manual. MK receives royalties from publishing companies as an author of books. He served as PI or CI in clinical trials of Lundbeck, Pascoe, and Janssen-Cilag. He served as a scientific advisor for Janssen. The present work is unrelated to the above grants and relationships. VR has received lecture fees from Infectopharm and Medice. He has carried out clinical trials in cooperation with Servier and Shire Pharmaceuticals/Takeda. The present work is unrelated to the above grants and relationships. MD received royalties from publishing companies as an author of books and treatment manuals on child behavioral therapy and of assessment manuals published by Beltz, Elsevier, Enke, Guilford, Hogrefe, Huber, Kohlhammer, Schattauer, Springer, and Wiley. He received income as a consultant for Child Behavior Therapy at the National Association of Statutory Health Insurance Physicians. He also received consulting income and research support from Lilly, Medice, Takeda, and eyelevel GmbH. AT, SZL, CG, LTK, URS, AK, PA, AD, and GK declare no competing interests.

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Assessment of affective dysregulation in children: development and evaluation of a semi-structured interview for parents and for children

Collaborators

Affiliations

Assessment of affective dysregulation in children: development and evaluation of a semi-structured interview for parents and for children

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

LinkOut - more resources

Full Text Sources