title: The behavioral organization, temporal characteristics, and diagnostic concomitants of rage outbursts in child psychiatric inpatients.
abstract: Angry outbursts, sometimes called rages, are a major impetus for the psychiatric hospitalization of children. In hospitals, such outbursts are a management problem and a diagnostic puzzle. Among 130 4- to 12-year-olds successively admitted to a child psychiatry unit, those having in-hospital outbursts were likely to be younger, have been in special education, have had a preadmission history of outbursts, and to have a longer hospital stay. Three subsets of behaviors, coded as they occurred in 109 outbursts, expressed increasing levels of anger; two other subsets expressed increasing levels of distress. Factor structure, temporal organization, and age trends indicated that outbursts are exacerbations of ordinary childhood tantrums. Diagnostically, children with outbursts were more likely to have language difficulty and a trend toward attention-deficit/hyperactivity disorder. Outbursts of children with anxiety diagnoses showed significantly more distress relative to anger. Outbursts were not especially associated with our small sample of bipolar diagnoses.
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, MMC 486, 420 Delaware Street SE, Minneapolis, MN 55455, USA. poteg001@umn.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Potegal
authors.forename: Gabrielle A
authors.initials: GA
authors.lastname: Carlson
authors.forename: David
authors.initials: D
authors.lastname: Margulies
authors.forename: Joann
authors.initials: J
authors.lastname: Basile
authors.forename: Zinoviy A
authors.initials: ZA
authors.lastname: Gutkovich
authors.forename: Melanie
authors.initials: M
authors.lastname: Wall
mesh_terms: D001521:Behavior Therapy; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D006760:Hospitalization; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000534:rehabilitation*; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011889:Rage; D011795:Surveys and Questionnaires; D013997:Time Factors