Interpersonal Psychotherapy for Adolescents With Mood and Behavior Dysregulation: Evidence-Based Case Study

ABSTRACT

Interpersonal psychotherapy for depressed adolescents, an evidence-based psychotherapy, has been adapted for youth with chronic irritability and excessive reactivity (i.e., temper outbursts), to create Interpersonal Psychotherapy for Mood and Behavior Dysregulation (IPT-MBD). Youth with chronic irritability and excessive reactivity were originally conceptualized as severe mood dysregulation (SMD) and in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) as disruptive mood dysregulation disorder. Because outbursts are the most prominent symptom, behavioral management strategies are typically a common focus of treatment. These outbursts, along with other mood symptoms, result in significant impairment in multiple domains, with a particularly adverse impact on interpersonal functioning. For this reason improving relationships is an important target for treatment. We present an evidence-based case study of an adolescent who met research criteria for SMD and who received the IPT-MBD intervention as part of a research study. Monthly ratings assessing severity and improvement of SMD symptoms were conducted by an independent evaluator. This adolescent had an overall improvement in SMD symptoms, attended all scheduled therapy sessions, and parent and teen reported satisfaction with the treatment. We discuss factors that may influence the effectiveness of this treatment.

Acknowledgments

The authors thank Ryan Moore, LCSW, Jason Straub, LCSW, Paige Johnston, LCPC, Catherine H. Yokum, LCSW, Kenneth Towbin, MD, and the research team of the Section on Bipolar Spectrum Disorders in the Emotion and Development Branch, Intramural Research Program, National Institute of Mental Health.

Conflict of interest

Laura Mufson receives book royalties from Guilford Press Inc. for the book Interpersonal Psychotherapy for Depressed Adolescents (2nd ed., 2004) and from Oxford University Press for the book Preventing Adolescent Depression: Interpersonal Psychotherapy-Adolescent Skills Training (2016). Mark Riddle receives book royalties from the American Academy of Pediatrics for the book Pediatric Psychopharmacology for Primary Care (2015).

Funding

This work was supported by the National Institute of Mental Health, grant number K23MH090246.

Additional information

Funding

This work was supported by the National Institute of Mental Health, grant number K23MH090246.