Psychological Assessment of Emotional Dysregulation in Children and Adolescents The Bipolar Spectrum and Beyond
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Anthony Bram, PhD, ABAP, FABP, is a psychologist and psychoanalyst in private practice in Lexington, MA, where he conducts psychological assessment, psychodynamic and cognitive-behavioral therapy, and psychoanalysis with children and adults. Dr. Bram is a part-time Lecturer in Psychology in the Department of Psychiatry at Cambridge Health Alliance/Harvard Medical School and is on the faculty of the Boston Psychoanalytic Society and Institute (BPSI), where he also serves as vice chair of the Child and Adolescent Psychoanalytic Training Program. He received his doctorate from the University of Kansas and is a graduate of the two-year Post-Doctoral Training Program at the Menninger Clinic in Topeka, Kansas, where he was subsequently a staff psychologist. Dr. Bram completed adult psychoanalytic training at the Greater Kansas City Psychoanalytic Institute, and child analytic training at BPSI. Dr. Bram is a board-certified diplomate in Assessment Psychology and in Child/Adolescent Psychoanalysis, and he has been a recipient of a fellowship from the American Psychoanalytic Association, the Martin Mayman Award (two times) from the Society for Personality Assessment, Scientific Writing Award from the Menninger Clinic, the Biannual Award for Research in Psychological Assessment from Psychodiagnostics, Inc., and the Johanna Tabin Book Proposal Prize from Division 39 (Psychotherapy) of the American Psychological Association. His first book, coauthored with Mary Jo Peebles, Psychological Testing that Matters: Creating a Road Map for Effective Treatment was published by APA Books in 2014. He also co-edited with Jed Yalof the book Psychoanalytic Assessment Applications for Different Settings published in 2021.Child specialists from diverse mental health backgrounds who share an interest in assessment will delight in this<i> tour de force</i>, which begins with a deep dive into conceptual issues and takes readers on a compelling journey through diversity-sensitive assessment procedures; the vexing nature of differential diagnosis [either/or vs. and/or conditions]; and implications for treatment and education—areas in which Dr. Bram has already established his expertise. It concludes with five detailed case presentations, which provide a practical road map for navigating conceptual issues, differential diagnostic and treatment-related challenges, and translating assessment findings into a more accessible language for clinical reports.
- James H. Kleiger, PsyD, ABAP, ABPP, private practice, coeditor of Psychological Assessment of Bipolar Spectrum Disorders and coauthor of Assessing Psychosis: A Clinician’s Guide, Second Edition,
Bram’s comprehensive and carefully reasoned approach to assessing emotional dysregulation in children and adolescents sets a standard of care for our profession. He provides an extensive review of relevant psychological tests and then models how to integrate them to make diagnostic decisions and useful treatment recommendations. I especially appreciated the sensitive, respectful case illustrations, which clearly reflect Bram’s clinical wisdom, humility, and years of experience.
- Stephen E. Finn, PhD, President, Therapeutic Assessment Institute, Austin, TX,
What is the young client’s capacity for emotional regulation and how might this information be used to rule in or out a diagnosis of a bipolar spectrum disorder? In his text filled with compelling clinical examples, the very first on this topic, Bram provides the assessor with the tools to answer these questions with confidence and competence. Bram’s use of a multimethod approach allows for the greatest precision in differential diagnosis. For all who assess younger clients, this text is a must-have.
- Virginia Brabender, PhD, ABPP (Cl), Emeritus Professor, Widener University, Chester, PA,
This groundbreaking psychodiagnostician’s handbook on dysregulation disorders in children and adolescents sets a new standard for evidence-based, multimethod, diversity-sensitive psychological assessment. Integrating transdiagnostic concepts, empirical data foundations, state-of-the-art evidence-based psychological assessment methods, differential diagnosis, treatment modalities, and rich case studies, <i>Psychological Assessment of Emotional Dysregulation in Children and Adolescents</i> extends, deepens, and reinvigorates the venerable Menninger tradition in personality assessment.
- Marvin W. Acklin, PhD, ABPP, ABAP, University of Hawaii School of Medicine, Honolulu,
As referrals for clinical assessment of complex children and adolescents frequently involve questions about emotional regulation in general and the possibility of bipolar spectrum conditions in particular, trainees and practitioners will find this to be an invaluable resource. Challenges with emotional regulation are common among patients of all ages who are referred for formal psychological assessment. Understanding the nature and severity of such challenges is crucial if evaluators are to make accurate formulations and develop meaningful treatment implications. This book will illuminate the process by which an assessment psychologist evaluates and reports the nature of emotional dysregulation. It will also serve as a reference book to tailor test batteries, interpret findings related to differential diagnosis, and link test findings with meaningful treatment implications.
Topics explored include detailed case examples addressing real-world referral questions, challenges around differential diagnosis, and explanations of treatment implications. Discussion of various assessment measures are considered as well, including more common measures like BASC-3 and performance-based measures as well as disorder-specific measures which may be less familiar to many clinicians. Providers will learn how to differentiate bipolar disorders from other co-occuring mental health disorders that feature dysregulated emotion, including OCD, PTSD, ADHD, and others.
Introduction: A Way of Thinking About Psychological Assessment of Emotional Regulation and Dysregulation in Children and Adolescents
I. BASIC CONSIDERATIONS
1. Emotional Regulation and Dysregulation in Children and Adolescents: What Are We Assessing?
2. Emotional Dysregulation, the Bipolar Spectrum, and Assessment Considerations With Children and Adolescents
II. EMOTIONAL DYSREGULATION AND THE BIPOLAR SPECTRUM: MULTIMETHOD, DIMENSIONAL, AND DIVERSITY-SENSITIVE ASSESSMENT
3. Basic Rationale for and Principles of Multimethod, Dimensional, and Diversity-Sensitive Assessment
4. Collateral-Report Measures to Assess Emotional Dysregulation
5. Self-Report Measures to Assess Emotional Dysregulation
6. Performance-Based Measures and Methods to Assess Emotional Dysregulation
III. EMOTIONAL DYSREGULATION AND THE BIPOLAR SPECTRUM: DSM-5-TR DIFFERENTIAL AND CO-OCCURRING DIAGNOSES
7. Orienting to Differential Diagnosis Within and Beyond the Bipolar Spectrum
8. Either/Or: Diagnoses Mutually Exclusive With the Bipolar Spectrum
9. And/Or: Conditions to Differentiate From the Bipolar Spectrum or That Co-Occur
10. Conditions More Readily Differentiated From the Bipolar Spectrum But Potentially Co-Occurring
IV. TREATMENT IMPLICATIONS AND OTHER CONSIDERATIONS FOR FOLLOW-UP
11. Treatment Implications: Broad Considerations and Level of Care
12. Treatment Modalities
13. Factors Affecting Therapeutic Engagement and Collaboration
14. Implications for School
15. Additional Considerations for Follow-Up Evaluations and Treatment Adjuncts
V. CASE ILLUSTRATIONS
16. Case 1: Denny
17. Case 2: Stevie
18. Case 3: Jillian
19. Case 4: Nicole
20. Case 5: Pedro
21. Commentary on Cases and Concluding Thoughts
References
Index
About the Author