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Emotion dysregulation is increasingly implicated as a transdiagnostic risk factor in the etiology of mental health problems. This project aimed to explore the links between emotion regulation, negative parenting and student–teacher relationships using longitudinal and ecologically valid data. A sample of n = 209 young people enrolled in the 'Decades‐to‐Minutes' (D2M) study, based in Zurich, Switzerland, provided data from the ages of 7–20 via parent‐ and self‐report questionnaires and ecological momentary assessment. Data were analyzed using Dynamic Structural Equation Modeling (DSEM). Worse student–teacher relationships predicted increased negative affectivity and emotional lability. Negative parenting practices predicted emotional lability only via their impact on student–teacher relationships. The findings point to worse student–teacher relationships as risk factors in the socioemotional development of children and young people. [ABSTRACT FROM AUTHOR]

Background: Emotional lability, defined as rapid and/or intense affect fluctuations, is associated with pediatric psychopathology. Although numerous studies have examined labile mood in clinical groups, few studies have used real‐time assessments in a well‐characterized transdiagnostic sample, and no prior study has included participants with disruptive mood dysregulation disorder (DMDD). The present study leverages ecological momentary assessment (EMA) to assess emotional lability in a transdiagnostic pediatric sample. Methods: One hundred thirty participants ages 8−18 with primary diagnoses of DMDD, attention‐deficit/hyperactivity disorder (ADHD), an anxiety disorder (ANX), or healthy volunteers completed a previously validated 1‐week EMA protocol. Clinicians determined diagnoses based on semi‐structured interviews and assessed levels of functional impairment. Participants reported momentary affective states and mood change. Composite scores of fluctuations in positive and negative affect were generated. Affect fluctuations were compared between diagnostic groups and tested for their association with functional impairment. Results: Diagnostic groups differed in levels of negative and positive emotional lability. DMDD patients demonstrated the highest level of labile mood compared with other groups. Emotional lability was associated with global impairment in the whole sample. Conclusions: Both positive and negative emotional lability is salient in pediatric psychopathology and is associated with functional impairment, particularly in DMDD youth. [ABSTRACT FROM AUTHOR]

Objective: This study was undertaken to report clinical presentations and outcomes of CASPR2‐IgG‐associated seizures. Methods: Mayo Clinic Neuroimmunology database was queried to identify CASPR2‐IgG‐seropositive (CASPR2‐IgG+) patients evaluated at our institution (2009–2019). Results: Of the 53 CASPR2‐IgG+ patients (titer ≥ 1:10), 20 had seizures (38%). All seizure patients were male, with median onset age of 68 years. Eighteen (90%) had seizures at initial presentation. One patient was found to have malignancy (colon adenocarcinoma). Two patients had coexisting LGI1‐IgG. Twelve patients had archived sera, which on titration had CASPR2‐IgG titers ≥ 1:100. Fifteen patients (75%) met criteria for autoimmune encephalitis. Patients most commonly presented with focal onset, nonmotor seizures with impaired awareness (n = 14, 70%). Eleven patients also had focal motor and/or sensory seizures as one of the seizure semiologies. The majority of patients (n = 11, 55%) developed generalized tonic–clonic seizures during their disease course. Seizure clusters occurred in 12 patients. In addition to seizures, patients developed cognitive disturbance (n = 16, 80%), episodic emotional lability (n = 13, 65%), paroxysmal dizziness (n = 9, 45%), episodic ataxia (n = 6, 30%), and chronic ataxia (n = 9, 45%). Only three patients (15%) had coexisting peripheral nervous system involvement. Frontotemporal or temporal ictal and/or interictal electroencephalographic abnormalities were present among nine patients, and three had multifocal epileptiform abnormalities. Eight patients (40%) had medial temporal T2/fluid‐attenuated inversion recovery hyperintensity on brain magnetic resonance imaging. Elevated cerebrospinal fluid protein and/or lymphocytic pleocytosis was present in most cases (13/14, 93%). Thirteen patients reached seizure freedom following initiation of antiseizure medication (ASM; n = 4) or a combination of immunotherapy and ASM (n = 9). Median duration of follow‐up was 25 months (range = 2–136 months). Significance: CASPR2‐IgG evaluation should be considered among older male patients with new onset focal seizures and impaired awareness often occurring in clusters with/without features of encephalitis. Coexisting neurological manifestations, including episodic emotional lability, ataxia, and paroxysmal dizziness, also aid in the diagnosis. [ABSTRACT FROM AUTHOR]

Children with attention‐deficit/hyperactivity disorder (ADHD) exhibit marked difficulty with frequent and intense shifts in negative or positive emotions, referred to as emotional lability. This study examines the relationships between negative emotional lability (NEL), ADHD, and reactive and proactive aggression. A community sample of 96 children (53 with ADHD, 43 control) ages 8–12 and their parents completed a baseline session include a diagnostic structured interview and the Reactive–Proactive Aggression Questionnaire (RPAQ). Parents then rated their child's NEL using the Positive and Negative Affect Scale as part of an Ecological Momentary Assessment protocol 3 times a day for 28 days. Seventy‐three participants (37 with ADHD, 36 control) completed the RPAQ at follow‐up. Hierarchical regression analyses indicated that NEL significantly and independently estimates reactive aggression at baseline and follow‐up, regardless of ADHD status. NEL and ADHD status significantly estimates concurrent proactive aggression, but not at follow‐up. Results of this study suggest that NEL accounts for a significant amount of the variability in reactive aggression, a common difficulty in children with ADHD. Further, individuals that are reportedly emotionally labile become more reactively aggressive over time. Both ADHD diagnostic and NEL are predictors of proactive aggression at baseline, although no interaction occurred. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Emotional lability (EL) is an important trans‐diagnostic concept that is associated with significant functional impairment in childhood and adolescence. EL is typically measured with questionnaires, although little is known about the ecological validity of these ratings. In this paper, we undertook 2 studies addressing this issue by examining the relationship between rating‐based measures of EL and directly measured emotional expressions and experiences. Furthermore, the associations between directly measured emotional expressions and experiences and attention‐deficit/hyperactivity disorder (ADHD) symptomatology were also examined, given the clear association of EL with ADHD in former research. Methods: In Study 1, we examined the relationship between parental report of children's EL and ADHD, and children's emotional expressions in an experimental context (N = 67). In Study 2, we examined the relationship between parental ratings and real‐time measures of emotional experiences in daily life in adolescents (N = 65). Results: EL ratings were associated with different elements of real‐time emotional experiences and expressions. Elements of emotional expressions but not emotional experiences were also associated with ADHD symptom reports. Conclusions: These studies provide evidence for the ecological validity of EL ratings. Furthermore, they add evidence for the associations between EL and ADHD. [ABSTRACT FROM AUTHOR]

The article focuses on findings of a study on posttraumatic stress, experiential avoidance, and emotional lability among inpatient nurses. It states use of electronic daily diary studies that administer repeated psychometric measures, and mentions that oncology and palliative care nurses are at risk of emotional distress resulting from workplace stressors. It notes use of the findings in capturing momentary distress and emotional lability among the nurses.

Background Emotional lability ( EL) is frequent in school-aged children with attention deficit hyperactivity disorder ( ADHD) and is associated with more frequent comorbidities and more severe impairment. However, little research has investigated the association between EL, ADHD and comorbid symptoms in preschoolers. This study assessed dimensional EL in preschoolers and its link with ADHD symptoms (e.g. hyperactivity-impulsivity and inattention) and behavioural and emotional problems (e.g. aggression and anxiety). Method One hundred and fifty-four preschoolers aged 3-6 years old were rated on questionnaires by parents. EL was assessed with the index from the Conners Rating Scale-Revised and behavioural and emotional problems with an adapted version of the Social Behavior Questionnaire. Multiple linear regressions analyses were conducted. Results Higher EL was associated with higher hyperactivity-impulsivity, inattention, anxiety and aggression problems. After controlling for other behavioural and emotional problems and sociodemographic variables, EL remained associated with hyperactivity-impulsivity and anxiety. Conclusions Emotional lability seems to be a potential marker for ADHD symptoms with internalizing problems in preschoolers and could be a target for diagnosis and early interventions. This finding should be treated with caution as the study was limited by the low response rate of the participants and consequently the small sample size. [ABSTRACT FROM AUTHOR]

Medulloblastoma, the most common malignant brain tumor of childhood, occurs in the posterior fossa, the part of the intracranial cavity that contains the brainstem and the cerebellum. The cerebellum is involved in many complex aspects of human behavior and function, and when it is disrupted or insulted, this can lead to significant sequelae in children with posterior fossa tumors. A constellation of impairing and distressing symptoms, including mutism, ataxia/hypotonia, and emotional lability, develops in approximately 25% of children after the surgical resection of posterior fossa tumors. These symptoms may impede treatment and frequently require intervention in order for children to be able to participate in their care. The eventual recovery of speech occurs for most, but with slowly improving dysarthria over many months. Behavioral changes and emotional lability also occur. This phenomenon has been classified differently by different investigators over the past 35 years. For the purposes of this article, the term posterior fossa syndrome is used to refer to the neuropsychiatric and behavioral features that compose this condition. The current review summarizes the development of the clinical understanding of this phenomenon with a focus on near- and long-term psychosocial and psychiatric implications. Also, clinical examples of the presentation, management, and lasting implications of this syndrome are provided. This review is intended to be a resource for clinicians who treat affected children. Cancer 2017;123:551-559. © 2016 American Cancer Society. [ABSTRACT FROM AUTHOR]

Factors that increase automatic psychological processes may result in impulsive action and, consequently, aggressive behavior. The current cross-sectional study examined the association between the five-factor model of impulsivity-like traits (negative urgency, positive urgency, premeditation, perseverance, and sensation seeking), emotional lability, and physically aggressive behaviors among college students ( n = 481) in a negative binomial hurdle model. In the logistic portion of the model, emotional lability was related to a higher likelihood of engaging in aggressive acts in the past 6 months. The association between emotional lability and the likelihood of aggressive behavior was moderated by two impulsivity-like traits: negative urgency and positive urgency. Specifically, emotional lability was related to engaging in aggressive acts among those with high negative urgency, and among those with low positive urgency. In the count portion of the model, emotional lability was uniquely related to the number of aggressive acts in the past 6 months. Our results indicate that emotional lability and facets of impulsivity interactively relate to engagement in aggressive behavior, suggesting that these variables be integrated into models of aggression. Aggr. Behav. 39 :222-228, 2013. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background: Emotional lability (EL) is commonly seen in patients with attention-deficit/hyperactivity disorder (ADHD). The reasons for this association remain currently unknown. To address this question, we examined the relationship between ADHD and EL symptoms, and performance on a range of neuropsychological tasks to clarify whether EL symptoms are predicted by particular cognitive and/or motivational dysfunctions and whether these associations are mediated by the presence of ADHD symptoms. Methods: A large multi-site sample of 424 carefully diagnosed ADHD cases and 564 unaffected siblings and controls aged 6-18 years performed a broad neuropsychological test battery, including a Go/No-Go Task, a warned four-choice Reaction Time task, the Maudsley Index of Childhood Delay Aversion and Digit span backwards. Neuropsychological variables were aggregated as indices of processing speed, response variability, executive functions, choice impulsivity and the influence of energetic and/or motivational factors. EL and ADHD symptoms were regressed on each neuropsychological variable in separate analyses controlling for age, gender and IQ, and, in subsequent regression analyses, for ADHD and EL symptoms respectively. Results: Neuropsychological variables significantly predicted ADHD and EL symptoms with moderate-to-low regression coefficients. However, the association between neuropsychological parameters on EL disappeared entirely when the effect of ADHD symptoms was taken into account, revealing that the association between the neuropsychological performance measures and EL is completely mediated statistically by variations in ADHD symptoms. Conversely, neuropsychological effects on ADHD symptoms remained after EL symptom severity was taken into account. Conclusions: The neuropsychological parameters examined, herein, predict ADHD more strongly than EL. They cannot explain EL symptoms beyond what is already accounted for by ADHD symptom severity. The association between EL and ADHD cannot be explained by these cognitive or motivational deficits. Alternative mechanisms, including overlapping genetic influences (pleiotropic effects) and/or alternative neuropsychological processes need to be considered. [ABSTRACT FROM AUTHOR]

Background: The goal of this study was to investigate the occurrence, severity and clinical correlates of emotional lability (EL) in children with attention deficit/hyperactivity disorder (ADHD), and to examine factors contributing to EL and familiality of EL in youth with ADHD. Methods: One thousand, one hundred and eighty-six children with ADHD combined type and 1827 siblings (aged 6–18 years) were assessed for symptoms of EL, ADHD, associated psychopathology and comorbid psychiatric disorders with a structured diagnostic interview (PACS) as well as parent and teacher ratings of psychopathology (SDQ; CPRS-R:L; CTRS-R:L). Analyses of variance, regression analyses, χ2-tests or loglinear models were applied. Results: Mean age and gender-standardized ratings of EL in children with ADHD were >1.5 SD above the mean in normative samples. Severe EL (>75th percentile) was associated with more severe ADHD core symptoms, primarily hyperactive-impulsive symptoms, and more comorbid oppositional defiant, affective and substance use disorders. Age, hyperactive-impulsive, oppositional, and emotional symptoms accounted for 30% of EL variance; hyperactive-impulsive symptoms did not account for EL variance when coexisting oppositional and emotional problems were taken into account, but oppositional symptoms explained 12% of EL variance specifically. Severity of EL in probands increased the severity of EL in siblings, but not the prevalence rates of ADHD or ODD. EL and ADHD does not co-segregate within families. Conclusion: EL is a frequent clinical problem in children with ADHD. It is associated with increased severity of ADHD core symptoms, particularly hyperactivity-impulsivity, and more symptoms of comorbid psychopathology, primarily symptoms of oppositional defiant disorder (ODD), but also affective symptoms, and substance abuse. EL in ADHD seems to be more closely related to ODD than to ADHD core symptoms, and is only partly explainable by the severity of ADHD core symptoms and associated psychopathology. Although EL symptoms are transmitted within families, EL in children with ADHD does not increase the risk of ADHD and ODD in their siblings. [ABSTRACT FROM AUTHOR]

Aim: To present normative data for the Swedish version of the Conners' 10-item scale, to validate the scale by comparing children with and without attention deficit/hyperactivity disorder (ADHD), to explore the factor structure of this scale and to investigate behavioural characteristics and gender differences among 10- to 11-year-old children, as rated by parents and teachers respectively. Methods: Parents and teachers rated 509 10- to 11-year-old children (261 boys and 248 girls) from a population-based cohort in a Swedish municipality. Results: The Conners' 10-item scale discriminated very well between children with and without ADHD. Confirmatory factor analyses confirmed a two-dimensional structure of the scale with items measuring restless/impulsive behaviour in one factor and items measuring emotional lability in another. An ANOVA revealed that parents and teachers reported different behavioural characteristics in boys as compared to girls. Conclusion: The Conners' 10-item scale is a valid screening instrument for identification of ADHD. The two subscales can be used separately, in addition to the total score, to get a more detailed picture of the child's behaviour. Parents and teachers pay attention to different aspects of problem behaviour in boys and girls. The less disruptive behaviour of girls needs to be highlighted. [ABSTRACT FROM AUTHOR]

Background and purpose: Once thought to impact only voluntary motor function, ALS/Motor neuron disease (MND) is now seen as a multi-system disorder in which a minority of patients experience mild cognitive dysfunction or frontotemporal dementia. Despite clinical guidelines advocating supplying complete information to patients, educational materials on ALS often state that the mind is unaffected. We sought to establish how much patients and caregivers understand about ALS, what they have been told to expect by their physician, and if they would have appreciated more complete information. Methods: A two-part survey was administered online. An ‘ALS quiz’ gauged participants’ knowledge of physical and psychological aspects of ALS. A second questionnaire assessed which symptoms patients had discussed with their clinician and explored patients’ desire to receive information on psychological effects. Results: A total of 247 ALS patients and 87 caregivers participated. Participants knew less about psychological symptoms than physical ones (72% correct responses versus 82%; paired t(333) = −5.04, P < 0.001). Patients commonly reported being told by their doctor about physical symptoms such as problems walking (85%) or stiffness/cramps (74%) but not psychological issues like emotional lability (46%) or cognitive change (11%). The majority of patients (62%) and carers (71%) indicated a desire to be informed that cognitive change or dementia might occur. Conclusion: ALS is a multi-system disorder. However, despite a desire for more information from patients and their carers, healthcare professionals continue to primarily address only the physical consequences of the disease. [ABSTRACT FROM AUTHOR]

Focuses on depressive disorders and emotionalism following stroke in elderly. Details of research concerning the emotional changes experienced by patients following stroke; Identification of stroke as the most common cause of handicap accompanied by psychological distress; Discussion of treatment options for depression.

Psychophysiology is traditionally concerned with certain "indicators" of activation (arousal, stressstrain). The experimental investigation of general mechanisms of activation should, therefore, he supplemented by evaluating the assessment and predictabifity of individual differences in trait, state, or reaction aspects of activation. Male students (N = 125) were examined under five conditions (rest, mental arithmetic, interview, anticipation, and blood taking) on one psychological and seven physiological criterion measures of activation state and reaction. Five variables are assumed to be adequate predictors of substantial criterion variance: questionnaire scores for emotional lability, reported frequency of somatic complaints, physical capacity (02 max during ergometer test), cardiorespiratory reactivity (during breathholding and cold pressor tests), and an explicit instructional set emphasizing or deemphasizing the importance of the experimental results. Statistical analysis by correlation and multiple regression procedures reveals that these dispositional variables fail to reliably predict individual differences in state and reaction parameters of activation processes. [ABSTRACT FROM AUTHOR]