Table1_Disruptive mood dysregulation disorder, parental stress, and attachment styles.docx

Disruptive mood dysregulation disorder (DMDD) is a relatively new diagnostic entity concerning children with chronic irritability and severe anger outbursts. Currently, there is limited knowledge about the parental factors associated with the disorder. The aim of this study was to compare stress levels and attachment styles in parents of children with DMDD with those of parents of children with other diagnoses. Our sample consisted of 218 children (6–12 years, Mage = 9.68 years) referred to child mental health outpatient clinics. Clinicians used a standardized semi-structured diagnostic interview to identify diagnoses. Parental stress levels and attachment styles were assessed using parent reports. We found that parents of children with DMDD experience significantly higher levels of parenting stress related to factors in the child than parents of children with other diagnoses. Furthermore, parents of children with DMDD show a higher association with insecure adult attachment styles than parents of children without DMDD. Finally, an adult preoccupied-ambivalent attachment style explains the variability in parental stress in the DMDD group to a large degree. We discuss how parental stress and an insecure attachment style can be associated with negative parenting practices. An implication from this study could be that treatment results might be improved by involving parents more in treatment programs for children with DMDD.

破坏性心境失调障碍（Disruptive Mood Dysregulation Disorder，DMDD）是一种相对新兴的诊断分类，针对存在慢性易激惹及严重暴怒发作的儿童群体。目前学界对该疾病相关的父母层面影响因素尚缺乏充分认知。本研究旨在对比DMDD患儿父母与其他诊断儿童父母的压力水平及依恋风格。

本研究的样本纳入218名6至12岁儿童（平均年龄Mage=9.68岁），均为转诊至儿童心理卫生门诊的患儿。临床医师采用标准化半结构化诊断访谈工具进行确诊。通过父母自评的方式评估其压力水平与依恋风格。

研究结果显示，与其他诊断儿童的父母相比，DMDD患儿父母感受到的与儿童相关的养育压力显著更高。此外，DMDD患儿父母相较于非DMDD儿童父母，更易表现出不安全型成人依恋风格。最后，成人先占-矛盾型依恋风格可在很大程度上解释DMDD组父母的压力变异情况。

本研究探讨了父母养育压力与不安全依恋风格如何与消极养育行为产生关联。本研究的实践启示之一为：若在DMDD儿童的治疗方案中加大父母参与度，或可提升治疗效果。