5 Tantrum Red Flags
Warning Signs Your Child's Tantrum Might Signal a Mental Health Disorder
WebMD News Archive
Dec. 19, 2007 -- There are five warning signs that a small child's tantrums
might signal an underlying psychiatric disorder, researchers find.
All child tantrums are excruciating to parents. But there are five tantrum
styles that are "red flags" indicating a preschooler may have mental
health problems, find Washington University researchers Andy C. Belden, PhD,
"If you have a child, you are going to have tantrums," Belden, a
developmental psychologist with two small children, tells WebMD. "They
happen, and one of the more important things for parents is to keep eye on them
and think about what the child is actually doing."
Belden, Joan L. Luby, MD, and colleagues conducted long, structured
interviews with 279 caregivers -- nearly all of them mothers -- of 3- to
6-year-old children. They also evaluated the children for psychiatric
They found that tantrums in children who truly had mental health problems
tended to be different from tantrums in healthy children.
"Essentially, we found five tantrum styles. They were strongly
associated with specific diagnoses," Belden says. "No one I have met
can look at a tantrum and give a diagnosis, but these are definitely red flags
worth looking into in terms of getting a mental health referral from a
Tantrum Red Flags
Belden warns that normal children may display every one of these tantrum
warning flags from time to time. But kids with problems show these signs in
nearly every tantrum:
- Aggression toward caregivers, objects, or both. If this happened more
than half the time in the last 10 to 20 tantrums, it may signal disruptive
disorders. "It is not uncommon at all for children to try to kick their
moms because they won't buy them an ice cream cone. But if this happens 90% of
the time, and you have to take cover to protect yourself during a tantrum, this
may mean a problem," Belden says.
- Self-injury. Kids with major depression and kids with mixed
major depression and disruptive behavior were much more likely than healthy
kids to bite themselves, scratch themselves, bang their heads against a wall,
or kick objects in an attempt to hurt their foot.
- Frequent tantrums. Preschoolers who have 10 to 20 tantrums a month at home,
or who have more than five tantrums a day on multiple days outside the home,
are at risk of a serious psychiatric problem.
- Very long tantrums. A five-minute tantrum can seem like a million years to
a parent. But kids who consistently have tantrums that last more than 25
minutes may have underlying problems. "A normal child may have a tantrum
that lasts an hour, but the next one lasts 30 seconds. These children with
psychiatric disorders are having 25-minute or longer tantrums 90% of the
time," Belden says.
- Inability to calm oneself after a tantrum. "These kids almost every
time require some sort of external force to calm them down," Belden says.
"You have to constantly remove them from the situation or bribe them or it
will go on and on."