“On Being Mad, Sad and Very Young”
/“The Angry Boy” by Gustav Vigeland, Frogner Park, Oslo Norway
As parent surveys show, tantrums are a behavioral problem for up to 85 percent of 2- and 3-year-olds (we will get back to the other 15 percent bye and bye). As such, tantrums are a perennial topic for parenting magazines, web videos, etc. (I know because I am still occasionally called on to do interviews about them with journalists, documentary video producers, and other media folk). From a developmental researcher’s point of view, tantrums are a unique window on emotion processes that are sometimes so intense as to be otherwise unavailable for systematic observation (but read my essay, referenced at the end of this blog, for some amusing anecdotes about children who fake them). Tantrums are also of keen interest to child psychologists and psychiatrists in the context of diagnosing juvenile Bipolar Disorder. Children with this condition were known to have very intense and prolonged “rages.” This led to the mistaken belief that severe tantrums were diagnostic of this condition and to inappropriate treatment of children having such tantrums with antipsychotic medication. We now know better, as knowledge that is codified in the recent DSM V condition of Disruptive Mood Dysregulation Disorder (DMDD) includes tantrums as one of the diagnostic criteria. The estimated prevalence of DMDD is 8-9 percent in the middle childhood population.
Tantrum Emotions: Category and Intensity
So, what do we know about tantrums? Having done some work on them I can tell you what I think. Episodes recognizable as tantrums emerge in the second year of life, for a few children as early as 12 months, and for many more by 18 months. The two major emotional/behavioral factors of tantrums are (1) Anger, indicated by yelling, screaming, stamping and kicking, and (2) Distress, indicated by whining, crying, dropping to the floor (“down”) and comfort-seeking. (Note: read my essay, referenced at the end of this blog, to learn about stiffening/back arching as an anger-gated, reflex-like response.) Both anger and distress are easily ordered into progressive levels of intensity by their respective behaviors (e.g., Low Anger includes stamp, High Anger includes scream). Within Distress, whine and down indicate lower intensity sadness; cry and comfort seek are associated with higher intensity sadness. Discriminant analyses of the acoustic characteristics of tantrum vocalizations support both categorical and intensity classifications. Screams and shouts of anger were acoustically similar (e.g., steep frequency increase at onset, higher peak frequencies) as were the whines and cries of distress (gradual frequency increase at onset, lower peak frequencies); the two groupings differed markedly from each other. Within factors, screams were more energetic than shouts; cries more energetic than whines, consistent with the identification of these behaviors indicating higher and lower levels of emotion.
Anger and distress-related behaviors also follow different temporal trajectories. All anger behaviors are brief, all distress behaviors are prolonged and semi-continuous. Anger peaks early in the tantrum, then declines while distress remains relatively constant throughout. However, the comfort-seeking component of distress accelerates toward tantrum’s end, perhaps disinhibited by the decline in anger. Distress behaviors always outlast anger. Distress occurring at the end of a tantrum may elicit parental comfort-giving and complementary child comfort-acceptance. Such reconciliation occurs in about a third of tantrums and may function to repair parent-child bonds strained by the child’s preceding anger. In this context, the essay considers the controversial practice of “therapeutic holding,” in which deliberately triggering a hyper-intense tantrum reportedly leads to deep mother-child bonding, perhaps by amplifying the reconciliation phase. In any case, anecdotal inquiry suggests that even some adults’ episodes of anger may end with discernable feelings of regret, guilt and/or other emotions not unrelated to sadness as well as sadness itself. Consider your own experiences of anger, dear reader, how often do they end with a tinge of sadness?
Cross-Cultural Ubiquity of Tantrums
Children’s tantrums are ubiquitous, having been observed in forager and tribal groups in Africa, Australia, Malaysia, New Guinea and South America, as well as in industrialized societies. There are words or phrases equivalent to the child-connoting English “tantrum” in the major languages of the world, including Arabic, Bengali, French, German, Portugese and Spanish. A few of these conjure visual images. The Spanish “pataleta” conveys a picture of stamping or kicking legs; “rabieta” evokes the madness of rabies. The most picturesque might be the Dutch “kinderlicht driftbui” with its image of a small childhood rainstorm that comes and goes.
Tantrum Triggers
Contrary to some popular beliefs, tantrums are not usually triggered by communication difficulties, although children with actual language delays are more tantrum prone. Tantrums are associated with oppositionality. More broadly, extensive recent or contemporary evidence indicates that weaning triggers children’s tantrums in different places and cultures. In many non-industrialized cultures, weaning occurs during the mother’s pregnancy with the next child. Thus, the weaning crisis is subsequently exacerbated by family attention shifting from the child to the new baby. This can also be the point at which the mother and older siblings begin to refuse to carry the child around, so s/he must keep up with family moves and activities on his or her own. These combined stressors can trigger a period of frequent tantrums that occur with little or no additional provocation. A disposition to tantrum which develops at an age when weaning occurred over most of human history might well reflect an evolved neuro-developmental strategy to retain parental attention, if not nurturance. Presenting the evidence for tantrum-like behaviors in other primate species, the essay considers the details of such a neuro-developmental strategy involving, for example, left hemisphere anger generation and right hemisphere distress.
Now, what about the 15 percent of children who rarely or never tantrum? They are anecdotally, but consistently, described as “easy” babies and pleasant, go along-get along toddlers. So, activating a genetically wired neuro-developmental program for tantrums is not a necessity but an option that depends upon internal temperament and external circumstance (true for baboon infants as well).
Tantrum Prognoses and Management
The essay recounts the role of tantrums in a number of childhood internalizing and externalizing psychopatholgies, addresses the questions of how frequent is too frequent; how long is too long, and cites evidence suggesting that early childhood tantrums that are too frequent, too long, and/or too destructive predict anti-social behavior in later childhood and adulthood.
Interviewers asking about my tantrum work always get around to what parents should do about them. It’s a reasonable question and obviously the primary concern of most parents. My research has focused on tantrums as phenomena of early emotional life and not on intervention, so I refer them to the three functional categories of undesirable behavior proposed by Applied Behavior Analysis: demands for attention or for “tangibles” (e.g., food, objects, activities and so forth) or escape from parental demands. The essay very briefly describes appropriate responses to tantrums motivated by each of these functions.
Mike Potegal, Ph.D., is a neuroscientist and clinically trained psychologist who is an Associate Professor at the University of Minnesota.
References
Potegal, M. (2019). On being mad, sad and very young. In: Eds A.K Roy, M.A. Brotman & E. Leibenluft, Irritability in Pediatric Psychopathology. Oxford University Press pp. 105-145.
If you would like a copy of this chapter, please contact Dr. Potegal.
