Main Article Content

Autonomic response and attachment style in disruptive mood dysregulation disorder


Michelle Leal
Marilyn Adan
Keri J. Heilman
Kate Cockcrof

Abstract

Background: Disruptive mood dysregulation disorder (DMDD) is characterised by severe emotion regulation difficulties, particularly  anger and irritability, in children. Despite the impact of attachment on emotional and behavioural regulation, the link between  attachment style and DMDD is under-researched.


Aim: This study investigated whether attachment style and parasympathetic regulation differentiate the response profiles to frustrating conditions between children diagnosed with DMDD and controls.


Setting: Participants  were assessed at schools in Johannesburg, Gauteng, South Africa. Methods: Thirty participants were divided into two matched groups  (nDMDD = 15; nControl = 15) and assessed. Respiratory sinus arrhythmia (RSA) and heart period were measured during an Affective  Posner Task, inducing frustration. Attachment style was assessed using the Attachment Style Classification Questionnaire for children.  Parents of children with DMDD completed a social interaction problems questionnaire.


Results: The DMDD group showed a higher  prevalence of avoidant attachment style (p = 0.013) compared to controls. Both groups displayed adaptive vagal withdrawal and recovery  during the task (p = 0.005; p = 0.021). Controls had significantly higher heart period throughout the assessment (game 1: p = 0.006; game  2: p = 0.013; game 3: p = 0.007). In the DMDD group, lower vagal tone during frustration correlated with more social interaction problems  (p = 0.049).


Conclusion: The study demonstrates a potential link between attachment style and altered physiological state in children with  DMDD.


Contribution: The findings provide insight into possible atypical vagal regulation of the heart and avoidant attachment styles in  DMDD, highlighting potential therapeutic and intervention targets. 


Journal Identifiers


eISSN: 2078-6786
print ISSN: 1608-9685