From the Editor-in-Chief's Desk

T his issue brings a number of articles investigating some of the most contentious areas in the field of child and adolescent psychopathology. Studies like these are critical for guiding our still-emerging understanding of pediatric psychiatric disease, and welcome additions to the literature even as they will be sure to spark constructive argument and novel inquiry. I'd like to point to the work of three groups of authors in particular.

Roy et al.'s “first step” towards characterizing children with impairing temper tantrums using a dimensional approach takes as a clear impetus the recent increase in diagnoses of pediatric bipolar disorder. However, the results of their study and in particular the investigators' innovative use of the Balloons Game measure of emotional expressivity and regulation deliver results that range quite further than a refutation of a certain view of the symptomatology of pediatric mania. Findings that are sure to generate further inquiry include the relative inapplicability of severe mood dysregulation (SMD) syndrome to children with impairing outbursts, the significant heterogeneity of the study population with regards to clinical diagnosis, and the primal role of emotional regulation as opposed to increased negative affect in the generation of these outbursts.

The work of Roy et al. should be applauded as an example and an indicator of the possibilities inherent in dimensional investigations following the NIMH RDoC model. This article is also required reading for researchers and clinicians navigating the emerging landscape of pediatric mood lability, bipolar disorders in young people, and the application of the DSM-5's disruptive mood dysregulation disorder.

In another probing look at the past, present, and future of diagnostic categories and the application of symptom clusters to young patients, Dow et al. study the course and symptomology of posttraumatic stress disorder (PTSD) in children and adolescents aged 6–16. They test the utility of augmented diagnostic criteria and tools and argue convincingly that PTSD is both a real and impairing disorder in young people while still being difficult to identify and accurately diagnose. The authors' interrogation of the DSM-IV criteria C3 in particular makes both intuitive sense and is an example of excellent study design. This article, too, is required reading for professionals who work with at-risk youth and the victims of traumatic stress.

Finally, Wietecha et al. employ a novel measure in a treatment trial of a diverse population that ably demonstrates the wide ranging tenor of inquiry in this moment. The pharmacological agent—atomoxetine—is not new, but the authors' study group of children with attention-deficit/hyperactivity disorder (ADHD) and dyslexia, ADHD-only, and dyslexia-only offers up intriguing insights into the interplay of these often co-morbid disorders. And, among other scales, it is interesting to see the application of a measure of sluggish cognitive tempo (SCT), the Kiddie-SCT Interview, and how nontraditional approaches and the consideration of dimensional and not diagnostic categories can produce more robust results.

I hope you enjoy and are enlightened by this collection of articles. In particular I hope they can offer some information for clinical application.