The low prevalence rates, 0.8% to 3.3%, for the new diagnosis of disruptive mood dysregulation disorder in three large community samples of children suggest that the diagnosis will not be extensively applied to children with normal behavior. Copeland et al. (p. 173) found that although the core symptoms are common, the criteria regarding frequency, duration, and context exclude most children. The diagnosis is associated with high levels of social impairment, school suspension, service use, and poverty. It frequently co-occurs with other psychiatric conditions, especially oppositional defiant disorder and depressive disorders, but Axelson notes in an editorial (p. 136) that disruptive mood dysregulation disorder overlapped only partially with severe mood dysregulation, the research diagnosis on which it was based.