Those Temper Tantrums May Mean More Than You Think

Conduct disorder signaled by symptoms like aggression and constant anger in preschool children

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Temper tantrums and telling fibs are often a normal part of being a young kid. Some behaviors, however, could be a tip-off that there’s more going on.

A new study identified behaviors that could raise red-flag warnings for parents, educators and health professionals. Children who are extremely defiant, very aggressive or destructive could have conduct disorder, a potentially serious mental health problem.

Children who display these behaviors should have a mental health assessment, the authors of this study said. According to MedlinePlus, children are likely to overcome conduct disorder if they are diagnosed and treated early. Common treatments include medication and talk therapy.

"Previously, we did not understand the empirical differences between normal disruptive behaviors in preschoolers — like temper tantrums, for example — and behaviors that signal problems," said study author Joan L. Luby, MD, of Washington University in St. Louis, in a press release. "If you went to your pediatrician and said, 'My 3-year-old is having tantrums,' the pediatrician wouldn't tell you to see a psychiatrist."

Conduct disorder is a group of behavioral or emotional symptoms that may signal a mental disorder. Children with conduct disorders may also show signs of other problems like anxiety, depression, mood swings or learning problems. Teens and adults with conduct disorder may break laws, have trouble with relationships or be unable to keep a job.

"Parents who believe their child is exhibiting such intense and clinically significant difficulty behaviors, particularly those related to loss of temper above and beyond what is typical for their chronological and developmental age, noncompliance with most requests, aggression towards people and animals, and reduced concern for others, are encouraged to seek comprehensive evaluation," said Crystal Beadle, PhD, a neuropsychologist at Our Children's House at Baylor-Frisco.

"A comprehensive psychological evaluation would help to identify key concerns, as well as detail an appropriate intensive treatment plan, likely including play or talk therapy as well as social skills groups," said Dr. Beadle, who has a child of her own with an oppositional defiant disorder diagnosis. "Parenting classes or behavioral support from a therapist can help parents find an appropriate method of discipline and consistency designed for challenging behaviors, such as Love and Logic, Magic 1-2-3, and a multitude of other parenting resources readily available."

She also recommended that parents seek advice about other possible causes of their child's disruptive behavior, as it is rare for conduct disorder to be diagnosed in early childhood or even before age 10. She said that comprehensive speech and language, occupational therapy, medical and neuropsychological evaluations could rule out such other possible causes.

"If you as a parent suspect the behaviors you are seeing are abnormal in intensity, frequency, or duration, do not hesitate to seek further help and evaluation. Keep asking until you are satisfied every avenue has been pursued," Dr. Beadle said. "Early, intense intervention for children demonstrating high risk behaviors does offer the best long-term outcome, regardless if the underlying cause is language, social or emotionally driven. Ask your child’s physician for a referral to begin the evaluation process."

For their recent research, Dr. Luby and team asked nearly 300 parents about behaviors in their preschool-age children like temper tantrums, stealing, lying, destruction of property, and aggressive behavior toward people or animals. These researchers repeated these interviews after the children reached school age.

Parents and caregivers were asked to rate the intensity of the children’s behavior, how often it happened and the circumstances.

A hungry child who had missed an afternoon nap and had a temper tantrum, for instance, was likely to be acting normally. A child who deliberately broke another child’s toys or lied repeatedly was more likely to have signs of conduct disorder.

Dr. Luby and colleagues found that about 1 in 20 preschoolers in this study had conduct disorder — around one child per class.

Although many behaviors were similar in both children with and without conduct disorder, the severity and frequency of symptoms differed. For instance, a preschool-age child who was emotionally healthy might have a brief temper tantrum if another child stole a toy. The child with conduct disorder would display more anger, would stay angry longer and would become angry more often.

Constant arguing, defiance, stealing, lying and property destruction were all warning signs for later conduct disorder, Dr. Luby and colleagues found. Children who had problems playing with other children were also more likely to be diagnosed with conduct disorder as they grew older.

This study was published Jan. 15 in The Journal of Pediatrics.

A grant from the National Institute of Mental Health funded this research. The authors declared no conflicts of interest.

Review Date: 
January 15, 2015
Last Updated:
January 21, 2015