{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T13:38:19Z","timestamp":1774100299050,"version":"3.50.1"},"reference-count":72,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Canterbury Child and Well-being Research Institute"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>Previous evidence has established that micronutrient capsules can improve emotion regulation in children. This three-phased randomized open-label waitlist-controlled study investigated the safety of a micronutrient powder absorbed by the oral mucosa and its effects on emotion dysregulation in 5-to-10-year-old children. The primary outcome measures were the Revised Clinician-rated Temper and Irritability Scale (CL-ARI) and the Clinical Global Impressions-Improvement Scale (CGI-I).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method<\/jats:title>\n<jats:p>Forty-eight children with moderate-to-severe symptoms of irritability were randomized to an initial treatment group (ITG) or waitlist control group (IWLG) (four-week delayed start), followed by the two groups alternating between taking the micronutrients for four weeks or having a four-week break. For the last three months of the trial, both groups took the micronutrients continuously.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Overall adherence rates were high (93%). At the end of RCT phase, there were large group differences (CL-ARI; <jats:italic>d<\/jats:italic> = 1.25, <jats:italic>p<\/jats:italic> &lt; .001), and 67% in the ITG and 8% in the IWLG were \u2018much\u2019 or \u2018very much\u2019 improved (CGI-I). Further, the ITG displayed a clinically meaningful reduction in Attention Deficit\/Hyperactivity Impulsivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) symptoms as measured with the Child Swanson, Nolan, and Pelham-IV Questionnaire 26 (SNAP-IV) compared to IWLG. The treatment effect regressed when participants stopped taking the micronutrients and was reinstated when participants were taking the micronutrients. The observed benefits were maintained over a sustained time period. The IWLG reported significantly more headaches (<jats:italic>p =<\/jats:italic> .040) and sweating (<jats:italic>p =<\/jats:italic> .037) at the end of RCT. By the end of the study, seven participants (14.5%) dropped out non-differentially by group (<jats:italic>p<\/jats:italic> = .22).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The findings showed that micronutrients absorbed by the oral mucosa are a safe intervention that can effectively improve emotion dysregulation in children. Future double-blinded, randomized, placebo-controlled trials are needed to support these findings.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0311794","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T18:27:34Z","timestamp":1733423254000},"page":"e0311794","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Micronutrients absorbed via the oral mucosa reduce emotion dysregulation in 5-10-year-old children: A three-phased randomized wait-list-controlled trial"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5069-9396","authenticated-orcid":true,"given":"Nurina M.","family":"Katta","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neville M.","family":"Blampied","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0199-9050","authenticated-orcid":true,"given":"Matt","family":"Eggleston","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3793-7342","authenticated-orcid":true,"given":"Julia J.","family":"Rucklidge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"issue":"3","key":"pone.0311794.ref001","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1176\/appi.ajp.2013.13070966","article-title":"Emotion dysregulation in attention deficit hyperactivity disorder","volume":"171","author":"P Shaw","year":"2014","journal-title":"Am J Psychiatry"},{"issue":"14","key":"pone.0311794.ref002","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.1177\/1087054717737162","article-title":"A measure of emotional regulation and irritability in children and adolescents: The clinical evaluation of emotional regulation\u20139","volume":"24","author":"J Pylypow","year":"2020","journal-title":"Journal of Attention Disorders"},{"issue":"2","key":"pone.0311794.ref003","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.biopsycho.2005.08.008","article-title":"Polyvagal theory and developmental psychopathology: Emotion dysregulation and conduct problems from preschool to adolescence","volume":"74","author":"TP Beauchaine","year":"2007","journal-title":"Biol Psychol"},{"issue":"3","key":"pone.0311794.ref004","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1017\/S0954579419000282","article-title":"Emotion dysregulation: A theme in search of definition","volume":"31","author":"RA Thompson","year":"2019","journal-title":"Dev Psychopathol"},{"issue":"5","key":"pone.0311794.ref005","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1080\/15374416.2015.1038827","article-title":"Future directions in emotion dysregulation and youth psychopathology","volume":"44","author":"TP Beauchaine","year":"2015","journal-title":"J Clin Child Adolesc Psychol"},{"issue":"2","key":"pone.0311794.ref006","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s00787-010-0150-4","article-title":"Irritability in children and adolescents: A challenge for DSM-5","volume":"20","author":"A. 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