Disruptive Mood Dysregulation, and Other Disruptive or Aggressive Disorders in ADHD

Many individuals with ADHD are prone to disturbances in emotional experience that involve a low threshold for activation of negative affective states as well as extreme or under-controlled, affectively driven behaviors. Among youth, the result is a chronic pattern of easily triggered anger, frustration, and irritability that manifests as rageful, hostile, and combative behaviors that can corrode their interpersonal relationships and hinder their involvement in opportunities for satisfying and more appropriate social experiences. This chapter reviews the clinical epidemiology and phenomenology of these difficulties, and considers some of the prominent conceptual issues for the past century or so that they have been major concerns in behavioral science as threats to the well-being of developing children and adolescents. Approaches to clinical assessment and management planning are then proposed.