Treatment Refractory Internalizing Behaviour Across Disorders: An Aetiological Model for Severe Emotion Dysregulation in Adolescence
Child Psychiatry & Human Development, vol. 52, pp. 515–532
Abstract
Auto-aggressive behaviour, especially treatment refractory suicidality in adolescents with psychiatric disorders, may be challenging to clinicians. In search of therapeutic possibilities, we have integrated current opinions regarding causality and interdependency of suicidality and auto-aggressive behaviour across disorders within the HiTOP framework. We propose a developmental model regarding these unsettling behaviours in youths that may help to guide future directions for research and interventions. We argue that the interdependent development of biologic factors, attachment, moral reasoning and emotion regulation in an overprotective environment may lead to social anxiety and later during development to emotion dysregulation and severe internalizing behaviour disorders. To optimize treatment efficacy for both internalizing and externalizing behaviour, we emphasize the importance transdiagnostic interventions, such as addressing non-compliance, restoration of trust between parents and their child, and limitation of avoidance behaviour. These may be seen as higher order interventions within the HiTOP framework.
Authors 3
-
Pierre C. M. Herpers corresponding
Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour
Affiliation as printed
Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Kapittelweg 29, Nijmegen, 6525 EN, The Netherlands. p.herpers@karakter.com
Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, Nijmegen, 6525 GC, The Netherlands. p.herpers@karakter.com
Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, Nijmegen, 6525 GC, The Netherlands
-
Affiliation as printed
Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, Nijmegen, 6525 GC, The Netherlands
-
Leiden University · Radboud University Medical Center · Radboud University Nijmegen
Affiliation as printed
Department of Psychiatry, Radboud University Medical Centre, Geert Grooteplein 10, Nijmegen, 6525 GA, The Netherlands
Faculty of Social Sciences, Leiden Institute for Brain and Cognition, Postzone C2-5, P.O. Box 9600, Leiden, 2300 RC, The Netherlands
Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, Nijmegen, 6525 GC, The Netherlands
Cited by 11 stored of 12
11 results
No patents citing this paper on Lens.org (checked 2026-10-11).