Emotional and Behavioral Dysregulation in Severe Mental Illness

Child Adolesc Psychiatr Clin N Am. 2021 Apr;30(2):415-429. doi: 10.1016/j.chc.2020.10.010. Epub 2021 Feb 15.


Emotional and behavioral dysregulation are common in severe mental illnesses, including schizophrenia, bipolar disorder, and borderline personality disorder. Emotional instability and behavioral outbursts can be driven by internal processes and/or environmental triggers and interpersonal interactions. Understanding the underlying diagnosis is important in determining the best course of treatment. Disorder-specific treatments are important in addressing underlying drivers of emotional dysregulation, irritability, and aggression. Coping skills training and behavioral modification strategies have broad applicability and are useful for aggression and irritability. Treatment planning to address emotion dysregulation and aggression in severe mental illness should address psychiatric comorbidities, substance use, and medication adherence.

Keywords: Adolescent; Aggression; Bipolar disorder; Borderline personality disorder; Dysregulation; Schizophrenia.

Publication types

  • Review

MeSH terms

  • Aggression
  • Bipolar Disorder* / therapy
  • Borderline Personality Disorder* / therapy
  • Emotions
  • Humans
  • Mood Disorders