Severe, chronic irritable mood has long presented a challenge in child psychiatry because of its poor diagnostic specificity and its inclusion in numerous mood, anxiety, ADHD and disruptive behavior disorders. Parents can provide valuable assistance to children by helping them develop an understanding of the three basic mechanisms used to cope with anger. The next method commonly used for dealing with anger is either to express it openly and honestly or to release it in a passive-aggressive manner. It may be helpful to view actively expressed anger as encompassing three types: appropriate, excessive, and misdirected. Concepts of displacement and the consequences of displacing anger can be difficult for children to understand and accept so concrete examples need to be used.
Some therapists believe they have been successful in treating anger in children and adolescents when their young patients express the anger they had previously denied. As already stated, clinicians often discover that the relationship in which children experience the greatest degree of disappointment, and subsequently the greatest degree of anger, is in the parental relationship, especially the one with the father.
The major cause of anger in the father relationship is the result of growing up with a father who had difficulty in communicating his love and in affirming his children.
Difficulties in the mother relationship that lead to intense anger can be the result of not experiencing enough love and praise, feeling controlled or criticized, or being made to feel that one does not measure.
Other sources of anger sometimes result from hurts and disappointments from siblings or rejection by peers. Some children have difficulties with their anger as a result of modeling after a parent who could not control anger. Many in the mental health field believe that the excessive anger seen in ADHD and other disorders in children is biologically determined (see, for example, Hechtman 1991). Parents can assist their children in their character development by teaching them to be understanding and forgiving when angry. After an angry incident the child can be recommended to try to forgive if they have been truly hurt by another.
Children are usually pleased to learn how the virtue of forgiveness can help them control and resolve their angry feelings. A 2014 study of the crime and psychiatric disorders in 10,123 adolescents revealed that 18.4% had committed a crime. DSM-5 has identified a new disorder in youth, disruptive mood dysregulation disorder (DMDD), with chronic irritability and temper outbursts as the defining symptoms.

Treatment evidence includes cognitive behavioral therapy, especially parental intervention, but there is a pressing need for research on adjunctive pharmacological treatment, as well as other methods of psychotherapy (Krieger, et al. An essential aspect of protecting children from anger is to limit the significantly the amount of screen time in the home and to prohibit viewing violent movies and using violent video games.
Atypical antipsychotic drugs are regularly prescribed for the treatment of bipolar disorder and excessive anger in children and adolescents in addition to mood stabilizing drugs. Other treatment options for disruptive mood and excessive anger in youth, such as forgiveness therapy, need to be considered in view of the recent reports of serious side effects from the use of atypical anti psychotics.
We should not be surprised that children model after the excessive anger in a parent and later overreact in anger as did that parent.
The dangers attached to denial include emotional harm to the child, increased feelings of sadness, guilt and shame, or the misdirection of the resentment toward others.
It is of benefit to review with children the numerous ways in which anger can be vented passively. Children benefit from learning the value of healthy assertiveness as well as the danger of responding consistently to situations in an excessively angry manner. At times, it can be helpful if parents or a therapist relate stories of misdirected anger from their own youthful experience. Actually, what has been accomplished is only one step toward actual resolution because, in itself, expression is incapable of freeing children from the burden of resentment which they carry. This is particularly true at the present time when almost forty percent of children and teenagers do not have their biological fathers at home. Often an older child misdirects anger at a younger sibling that is really meant for a parent or peers.
However, at this time, no specific neurotransmitters have been identified which cause excessive anger.
Also, children can learn to stop denying their anger and to resolve it by thinking at bedtime of forgiving anyone who may have hurt them on that particular day or in the past.
The most difficult aspect of the treatment of males with IED is that of strengthening their self-esteem so that they do not need to rely upon anger and aggression as a source of strength.
On one of his favorites, Combat Arms, he had notched up 83,496 kills, with 22,725 head shots. Specifically, a 2013 retrospective cohort study of youth in the Tennessee Medicaid program with 28,858 recent initiators of antipsychotic drugs and 14,429 matched controls showed that the users of anti psychotics had a 3-fold increased risk for type 2 diabetes that increased with cumulative dose (Bobo, et al., 2013).

The therapist might consider having the young patient complete an anger checklist to identify these behaviors. It is important for them to realize that when they do not resolve their anger from a particular hurt, they may later misdirect the resentment toward others. The experience of anger can lead to a desire for revenge which does not diminish until the existence of the resentful feelings are uncovered and subsequently resolved.
Many children and adolescents crave peer acceptance to develop a positive sense of self and to protect themselves from loneliness. Also, the use of addictive substances can trigger excessive anger as well as personality conflicts, especially narcissism. This does not preclude punishing a child for a display of excessive or misdirected anger, nor asking an angry child to apologize to the recipient of their excessive anger. He also played a game called School Shooting in which the player controls a character who enters a school and shoots students in which he also trained for his murderous attack on first graders and adults. Many parents can also participate in the evaluation of their child's anger by completing an anger checklist in relation to their son or daughter and thus provide the therapist with additional information on the degree of the child's anger. Such anger can damage friendships, interfere with learning, harm family relationships, and limit participation in team sports.
One study of parental love-deprivation and forgiveness revealed that most respondents implicated the father, not the mother, as being emotionally distant (Al-Mabuk, Enright, & Cardis, 1995).
Those children who are scapegoated regularly in school rarely tell their parents how they are being treated because they are so ashamed or because they believe that their parents cannot protect them.
Throughout that time, the individual has not had a period lasting 3 or more consecutive months without all of the criteria. In clinical practice, we find that the most common recipients of misdirected anger are younger siblings, peers, mothers, and teachers. Therefore, parents need to be aware of the various ways in which this conflict can manifest itself.
These include: isolation, withdrawal, ventilation of hostility toward others, social anxiety, or depression.

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