CBT and DBT for Youth Diagnosed with DMDD: Two Routes to Progress

Chronic irritability is a core feature of Disruptive Mood Dysregulation Disorder (DMDD). In irritable youth, abnormal threat perception, frustrative non-reward, and heightened frustration to blocked goals lead to dysregulated emotional and behavioral responses, such as contextually inappropriate anger and aggression. Utilizing a biopsychosocial model, cognitive and dialectal behavioral interventions target the cognitive, emotional, physical, and behavioral contingencies that maintain DMDD. The approaches emphasize skill acquisition and application, as well as collaboration between the patient, clinician, and caregivers in a transparent manner that balances acceptance and change. This chapter discusses the components of CBT and DBT interventions in relation to targeting the core symptoms of DMDD. The efficacy of these approaches is demonstrated through promising initial outcomes of CBT and DBT adaptations for DMDD symptoms in youth. This chapter concludes with a detailed explication of CBT and DBT approaches to reducing DMDD symptoms through a case study of “Mikhail.”