目标:影响情绪爆发,定义为对相对普通的挫折和失望的极端愤怒或痛苦,影响所有的精神卫生保健系统,急诊科,学校,和少年司法计划。然而,患病率,结果,爆发的影响难以量化,因为它们具有诊断性,并且没有由当前的诊断方法明确定义。研究以各种方式解决了发脾气下的爆发,愤怒,烦躁,侵略,愤怒的攻击,或者情绪和行为失调。缺乏识别和评估整个发展或护理系统中受损情绪爆发的一致方法。
方法:美国儿童和青少年精神病学会总统特别工作组(2019-2021年)进行了叙述性审查,以解决现有文献的局限性和独立于诊断的情感爆发问题。
结果:从现有文献推断,最好的估计表明,爆发发生在4%-10%的社区儿童(学龄前儿童到青少年)。影响情绪爆发可能会对原发性疾病的成功治疗做出反应,特别是对于一些患有注意力缺陷/多动障碍的儿童,他们的药物已经过优化。然而,爆发通常是多方面的,通常代表适应不良或缺乏应对策略和反应。
结论:基于证据的策略对于解决触发因素是必要的,加强,或原谅的行为,并提高解决问题的能力。目前可用的干预措施对于治疗效果仅产生适度的效果大小。需要更具体的定义和措施来跟踪和量化爆发,并设计和评估干预措施的有效性。显然需要更好的治疗。
Impairing emotional outbursts, defined by extreme anger or distress in response to relatively ordinary frustrations and disappointments, impact all mental health care systems, emergency departments, schools, and juvenile justice programs. However, the prevalence, outcome, and impact of outbursts are difficult to quantify because they are transdiagnostic and not explicitly defined by current diagnostic nosology. Research variably addresses outbursts under the rubrics of tantrums, anger, irritability, aggression, rage attacks, or emotional and behavioral
dysregulation. Consistent methods for identifying and assessing impairing emotional outbursts across development or systems of care are lacking.
The American Academy of Child and Adolescent Psychiatry Presidential Task Force (2019-2021) conducted a narrative
review addressing impairing emotional outbursts within the limitations of the existing literature and independent of diagnosis.
Extrapolating from the existing literature, best estimates suggest that outbursts occur in 4%-10% of community children (preschoolers through adolescents). Impairing emotional outbursts may respond to successful treatment of the primary disorder, especially for some children with attention-deficit/hyperactivity disorder whose medications have been optimized. However, outbursts are generally multi-determined and often represent maladaptive or deficient coping strategies and responses.
Evidence-based strategies are necessary to address factors that trigger, reinforce, or excuse the behaviors and to enhance problem-solving skills. Currently available interventions yield only modest effect sizes for treatment effect. More specific definitions and measures are needed to track and quantify outbursts and to design and assess the effectiveness of interventions. Better treatments are clearly needed.