1. Lipman, Terri H.

Article Content

Belden, A. C., Thomson, N. R., & Luby, J. L. (2008). Journal of Pediatrics, 152, 117-122.


Dealing with childhood tantrums is difficult for parents and healthcare professionals, and parents often ask for guidance from pediatric nurses. When are tantrums "normal" development, and when should they cause concern? The purpose of this study was to investigate whether differences in the tantrum behaviors of healthy versus mood-disordered preschool-aged children can be detected.


Caregivers of 279 preschool-aged children (3-6 years old) completed a psychiatric assessment tool that was used to determine preschoolers' diagnostic classification and measure tantrum behaviors. As a result of the survey, children were placed in one of four diagnostic groups: (a) healthy, (b) pure depressed, (c) pure disruptive, and (d) comorbid depressed/disruptive. Disruptive preschoolers displayed violence during tantrums significantly more often than the depressed and healthy groups. The disruptive group had significantly more tantrums at school/daycare than the depressed and healthy groups and had a more difficult time recovering from tantrums than healthy preschoolers. Depressed preschoolers also demonstrated more aggression toward objects and other people than healthy children. Self-harmful tantrum behaviors were more evident in depressed children than preschoolers in the healthy and disruptive groups.

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This is an important study that provides preliminary guidelines for identifying tantrum behaviors that may be indicators of a psychiatric disorder and would require referral to a mental healthcare professional. Pediatric nurses can use these data for evidence-based practice when advising parents and school nurses. Caregivers of preschoolers should be mindful that the demonstration of violence, slow recovery from tantrums, aggression, and self-harmful behaviors are concerning and may warrant further evaluation.


Terri H. Lipman