Research Agenda in Childhood Impairing Emotional Outbursts: A Report of the AACAP Presidential Taskforce on Emotional Dysregulation

Abstract

Objective

As part of the 2019-2021 presidential term of the American Academy of Child and Adolescent Psychiatry (AACAP), the AACAP Presidential Initiative on Emotion Dysregulation in Youth Taskforce was established. The aim was to address emotion dysregulation in children and adolescents, focusing on developing methods for clinicians to identify, characterize, and treat impairing emotional outbursts along with development of a research agenda that would guide relevant researchers and research funders. One method to characterize emotion dysregulation was accomplished by recommendations for use of a diagnostic code that is available in the DSM. The research agenda is presented here.

Method

The Taskforce specifically focused on aggressive behaviors and emotions associated with outbursts. The development of a research agenda took place over 2 years of examination of the current needs in the literature, with contributions from experts in the field. This work dovetailed with the efforts from the Congress on Pediatric Irritability and Dysregulation, which had been meeting since 2015 to advance research into the measurement, pathophysiology, and treatment of emotion regulation problems in youth. We concentrated on the central questions concerning the measurement of outbursts, key questions linking outbursts to other psychopathologies, and how behavior in outbursts is separable from typical behavior.

Results

A description of the qualitative data gathering process is provided here, along with the following: recommendations in the research areas of measurement; pathophysiology; delineating outbursts from other psychopathologies; exploring the cultural, social, and interpersonal aspects of outbursts; understanding the prevention and treatment of outbursts; and exploring how outbursts manifest and are treated based on setting. Specific examples of research opportunities and future directions are provided.

Conclusion

A call is made to funding agencies to examine the spaces within their strategic plans that will allow for engagement in critical efforts to improve the lives of children and adolescents with severe emotional outbursts—some of the most impaired individuals presenting for care in child and adolescent psychiatry.

Plain language summary

The 2019 to 2021 AACAP Presidential Initiative on Emotion Regulation in Youth Taskforce was created by Dr. Gabrielle A. Carlson and aimed to address the field of treatment and research of youth with impairing emotional outbursts. The taskforce was made up of clinicians and researchers, including experts from the Congress on Pediatric Irritability and Dysregulation, and focused on developing methods for clinicians to identify, characterize, and treat impairing emotional outbursts. The 2-year taskforce led to the development of a research agenda to guide next steps for researchers and research funders. Diverse input from junior and senior investigators, clinical psychologists, graduate, and post-graduate students was encouraged. This report details the qualitative data gathering process and recommendations for the field.