Dysregulation profile (DP) as a transdiagnostic psychopathological factor in clinically referred children – comparisons between disorders and latent structure

Abstract

Background

Dysregulation Profile (DP) describes the psychopathological construct of concurrent impairments in the ability to regulate emotion, behaviour, and cognition measured by the Child Behaviour Checklist (CBCL). Such transdiagnostic dimensions of psychopathology play an important role in addition to core symptoms of psychiatric diagnosis in clinical practice. Evaluation of DP in children with different mental disorders may improve our understanding and treatment of both contents.

Methods

911 clinically referred children between 6 and 18 years were investigated. The sample consisted of five ‘pure’ disorders groups, that is, tic disorder (TIC), anxiety disorder, obsessive compulsive disorder, depression, Attention Deficit Hyperactivity Disorder (ADHD), and two comorbid disorder group, that is, ADHD + TIC and ADHD + oppositional defiant disorder (ODD). DP level and latent structure were compared across groups.

Results

The rate of severe/abnormal dysregulation rates varied from 15% to 44% when the 210 cut-off was used, and 5% to 18% when stringent cut-off was used (i.e. ≥70 on all DP-subscales). The most affected population were children with comorbid ADHD with ODD/TIC, while least were those with TIC only. Five different latent phenotypes of DP were found.

Conclusion

DP above clinical cut-off level widely exists in clinically referred children in parallel to core symptoms of their diagnosis, especially among children with comorbidities. During clinical assessment it would be worth to clarify the role of DP-related problems within the general psychosocial impairment of the patient to improve a personalized approach.

Keywords:

• Dysregulation profile
• transdiagnostic factor
• children
• Child Behaviour Checklist
• latent class analysis

Acknowledgements

The development of this paper was supported by a scholarship from the Overseas Study Program of Guangzhou Elite Project to B. Wang.

Disclosure statement

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Notes on contributors

Biyao Wang

Dr. Biyao Wang obtained her PhD in the Medical Human Science in the Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of Goettingen. She is now a research associate at the Department of Clinical, Educational and Health Psychology, University College London.

Andreas Becker

Dr. rer. Nat. Andreas Becker is a certified child and adolescent psychologist and works as senior psychologist at the Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of Goettingen. Areas of interest: developmental psychopathology, validation of questionnaires, neurobiological data.

Christina Kaelble

Miss Christina Kaelble is a trainee in internal medicine and just finishing her doctoral thesis in medicine in the Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of Goettingen.

Aribert Rothenberger

Prof. Dr. med. Aribert Rothenberger is a neuropsychiatrist with research focus on the neurobiological background and treatment of child psychiatric disorders (specifically tic disorders and ADHD). Before his retirement in 2017 he was head and director of the Clinic for Child and Adolescent Psychiatry and Psychotherapy at the University Medical Center Goettingen in Goettingen, Germany.

Henrik Uebel-von Sandersleben

Dr. Henrik Uebel- von Sandersleben is a certified child and adolescent psychiatrist and works as Assistant Medical Director at the Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of Goettingen. Areas of interest: ADHD, Tic Disorder and Psychopharmacology.