Trial reportJournal of child and adolescent psychopharmacology2016
Prevalence and Treatment Outcomes of Persistent Negative Mood Among Children with Attention-Deficit/Hyperactivity Disorder and Aggressive Behavior.
Trial report in Journal of child and adolescent psychopharmacology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Double-Blind, Placebo-Controlled Trial of Flexible Dose Divalproex Sodium Adjunctive to Stimulant Treatment for Aggressive Children With Attention-Deficit Hyperactivity Disorder
Adjunctive Treatment With Divalproex or Risperidone for Aggression Refractory to Stimulant Monotherapy Among Children With ADHD
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Annual Research Review: What processes are dysregulated among emotionally dysregulated youth? - a systematic review.Journal of child psychology and psychiatry, and allied disciplines · 2025Pooled it
- Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review.Frontiers in psychiatry · 2021Pooled it
- Stepped Treatment for Attention-Deficit/Hyperactivity Disorder and Aggressive Behavior: A Randomized, Controlled Trial of Adjunctive Risperidone, Divalproex Sodium, or Placebo After Stimulant Medication Optimization.Journal of the American Academy of Child and Adolescent Psychiatry · 2021Trial
- ADHD in Youth With Major Depressive Disorder in the Texas Youth Depression and Suicide Research Network (TX-YDSRN): Clinical Correlates and Moderators.Journal of attention disorders · 2025Article
- Article
- Article
- Characterizing the Neural Correlates of Response Inhibition and Error Processing in Children With Symptoms of Irritability and/or Attention-Deficit/Hyperactivity Disorder in the ABCD Study®.Frontiers in psychiatry · 2022Article
- Modelling ADHD-Like Phenotypes in Zebrafish.Current topics in behavioral neurosciences · 2022Review
- Phasic Versus Tonic Irritability: Differential Associations With Attention-Deficit/Hyperactivity Disorder Symptoms.Journal of the American Academy of Child and Adolescent Psychiatry · 2021Article
- Preventing Irritability and Temper Outbursts in Youth by Building Resilience.Child and adolescent psychiatric clinics of North America · 2021Review
- Description of Criterion Validity of the Autism Spectrum Rating Scales 6-18 Parent Report: Initial Exploration in a Large Community Sample.Child psychiatry and human development · 2019Article
- Understanding Chronic Aggression and Its Treatment in Children and Adolescents.Current psychiatry reports · 2019Review
- Improvements in Irritability with Open-Label Methylphenidate Treatment in Youth with Comorbid Attention Deficit/Hyperactivity Disorder and Disruptive Mood Dysregulation Disorder.Journal of child and adolescent psychopharmacology · 2018Article
- Irritability in Youths: A Translational Model.The American journal of psychiatry · 2017Review
- Longitudinal course and characteristics of cyclothymic disorder in youth.Journal of affective disorders · 2017Article
- Irritability in Children and Adolescents.Annual review of clinical psychology · 2017Review
- Pediatric Irritability: A Systems Neuroscience Approach.Trends in cognitive sciences · 2017Review
- Cognitive-Behavioral Therapy for a 9-Year-Old Girl With Disruptive Mood Dysregulation Disorder.Clinical case studies · 2016Article
- Disruptive Mood Dysregulation Disorder Among Children and Adolescents.Focus (American Psychiatric Publishing) · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveDiagnostic criteria for disruptive mood dysregulation disorder (DMDD) require 1) periodic rageful outbursts and 2) disturbed mood (anger or irritability) that persists most of the time in between outbursts. Stimulant monotherapy, methodically titrated, often culminates in remission of severe aggressive behavior, but it is unclear whether those with persistent mood symptoms benefit less.This study examined the association between the presence of persistent mood disturbances and treatment outcomes among children with attention-deficit/hyperactivity disorder (ADHD) and periodic aggressive, rageful outbursts.
methodsWithin a cohort of children with ADHD and aggressive behavior (n = 156), the prevalence of persistent mood symptoms was evaluated at baseline and after completion of a treatment protocol that provided stimulant monotherapy and family-based behavioral treatment (duration mean [SD] = 70.04 [37.83] days). The relationship of persistent mood symptoms on posttreatment aggressive behavior was assessed, as well as changes in mood symptoms.
resultsAggressive behavior and periodic rageful outbursts remitted among 51% of the participants. Persistent mood symptoms at baseline did not affect the odds that aggressive behavior would remit during treatment. Reductions in symptoms of sustained mood disturbance accompanied reductions in periodic outbursts. Children who at baseline had high irritability but low depression ratings showed elevated aggression scores at baseline and after treatment; however, they still displayed large reductions in aggression.
conclusionsAmong aggressive children with ADHD, aggressive behaviors are just as likely to decrease following stimulant monotherapy and behavioral treatment among those with sustained mood symptoms and those without. Improvements in mood problems are evident as well. Therefore, the abnormalities in persistent mood described by DMDD's criteria do not contraindicate stimulant therapy as initial treatment among those with comorbid ADHD. Rather, substantial improvements may be anticipated, and remission of both behavioral and mood symptoms seems achievable for a proportion of patients.
trial registrationClinicalTrials.gov (U.S.); IDs: NCT00228046 and NCT00794625; www.clinicaltrials.gov.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.