Sammendrag
This paper provides a theoretical and empirical analysis of a recently conceptualized childhood disorder; disruptive mood dysregulation disorder (DMDD). The reinforcement sensitivity theory of personality (RST) is presented as a model for understanding DMDD. Model overlap with the research domain criteria (RDoC), a contemporary framework for research in the field of psychology, is noted, specifically in the domains of threat, reward and cognition. A differential diagnostic analysis compares DMDD to bipolar disorder, ADHD, oppositional defiant disorder, anxiety and depression. In line with the RST, DMDD is proposed to be a disorder of combined neural bottom-up sensitivity, which may compromise top-down control. Research proposals for how to further the understanding of DMDD in line with the RST model, is provided. Results from neuropsychological testing are mixed, showing both deficits and normative performance compared to other clinical groups and healthy controls. fMRI, however, shows increased bottom-up reactivity and compensatory prefrontal control. The anterior cingulate cortex (ACC) is suggested as a switchboard between RST system, and an ACC-mediated visual attention deficit is hypothesized. Furthermore, more ecologically relevant studies, studies on tasks requiring both hot and cool cognition, larger and more DMDD-specific experimental groups and the use of sophisticated fMRI technology, are essential in further delineating the specific features of DMDD and the possible interplay between RST dimensions in childhood irritability.