Which of the following is required for a DMDD diagnosis regarding symptom setting?

For a diagnosis of Disruptive Mood Dysregulation Disorder (DMDD), the requirement that symptoms must be present in at least two settings is crucial. This criterion is intended to ensure that the emotional dysregulation and temper outbursts are not merely a reflection of stressors in one particular environment, such as home or school, but are pervasive across different contexts. This multi-setting requirement helps to confirm the severity and consistency of symptoms, indicating that the individual is experiencing this pattern of behavior in various aspects of their life, which aids in making a more reliable diagnosis.

By requiring symptoms to manifest in multiple settings, the diagnosis minimizes the risk of misattribution of symptoms to isolated environmental factors and reinforces the notion that DMDD is a substantial and chronic condition, not just situationally triggered episodes. This criteria ultimately underscores the disorder's impact on the individual's overall functioning.