Irritability as a Transdiagnostic Construct Across Childhood and Adolescence: A Systematic Review and Meta-analysis

Clinical Child and Family Psychology Review, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 20, 2025

Abstract This meta-analytic review examined irritability across childhood and adolescence as it relates to symptoms of common mental health disorders in these periods. Of key interest was whether the relationship between symptom severity varies according domain. tested at level broad dimensions (internalizing versus externalizing problems) well discrete diagnostic domains (e.g., anxiety, depression, oppositional defiant disorder, conduct attention deficit hyperactivity disorder; autism spectrum disorder). Following PRISMA guidelines, a systematic search five databases conducted identify studies reporting on associations samples children aged 2–18 years. Meta-analytic tests based random effects models concurrent longitudinal severity. Meta-regression potential moderators including domain, child age, sex, informant type, study quality. 119 met inclusion criteria with total 122,456 participants. A significant positive association found overall psychopathology order moderate effect size, while small sizes characterized later outcomes prospective data. Further variation this seen specific methodological moderators. Findings support conceptualization transdiagnostic construct reflecting emotion dysregulation diverse forms adolescence. research into risk mechanisms underlying is needed, addition translational approaches early intervention.

Language: Английский

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Future Directions: The Phenomenology of Irritable Mood and Outbursts: Hang Together or Hang Separately ¹

Journal of Clinical Child & Adolescent Psychology, Journal Year: 2024, Volume and Issue: 53(2), P. 309 - 327

Published: March 3, 2024

Recognition of the importance irritable mood and outbursts has been increasing over past several decades. This "Future Directions" aims to develop a set recommendations for future research emphasizing that "hang together," but have important distinctions thus also need separately." Outbursts are

Language: Английский

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Prevalence and correlates of irritability among U.S. adults

Neuropsychopharmacology, Journal Year: 2024, Volume and Issue: 49(13), P. 2052 - 2059

Published: Aug. 24, 2024

This study aimed to characterize the prevalence of irritability among U.S. adults, and extent which it co-occurs with major depressive anxious symptoms. A non-probability internet survey individuals 18 older in 50 states District Columbia was conducted between November 2, 2023, January 8, 2024. Regression models weighting were used examine associations Brief Irritability Test (BITe5) sociodemographic clinical features. The cohort included 42,739 individuals, mean age 46.0 (SD 17.0) years; 25,001 (58.5%) identified as women, 17,281 (40.4%) men, 457 (1.1%) nonbinary. total 1218(2.8%) Asian American, 5971 (14.0%) Black, 5348 (12.5%) Hispanic, 1775 (4.2%) another race, 28,427 (66.5%) white. Mean score 13.6 5.6) on a scale from 5 30. In linear regression models, greater respondents who female, younger, had lower levels education, household income. Greater associated likelihood thoughts suicide logistic adjusted for features (OR 1.23, 95% CI 1.22-1.24). Among 1979 without initial assessed such subsequent survey, also being present (adjusted OR 1.17, 1.12-1.23). its association suggests need better understand implications adults outside acute mood episodes.

Language: Английский

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There Are No Bad Kids: An Antiracist Approach to Oppositional Defiant Disorder

PEDIATRICS, Journal Year: 2025, Volume and Issue: 155(2)

Published: Jan. 9, 2025

Oppositional defiant disorder (ODD) is a childhood disruptive, impulse control, and conduct characterized by anger or irritability, argumentativeness defiance, vindictiveness (Table 1).1 Black, Hispanic, American Indian/Alaska Native children—hereafter referred to as racially minoritized children—are more likely be diagnosed with ODD than white children.2–4 One recent large-scale analysis found that the diagnosis of 35% prevalent in Black people people.5 These disparities worsen juvenile detention child welfare settings, where youth are overrepresented.6,7ODD describes presence unwanted behaviors suggests they features child, rather manifestations underlying neurodevelopmental difference (eg, autism), prior history trauma), co-occurring mental health challenges depression).1 The becomes racist when applied indiscriminately children "bad kid" label, placing blame on them for these behaviors. Doing so especially problematic serve reactions adaptations racism. This misattribution can incite adverse outcomes, including missed treatment opportunities from misdiagnosis, failure protect against racism, harsher school disciplinary practices.2,3,8–10However, there no specific guidelines take an antiracist approach this harm.11,12 addresses void, urging clinicians recognize historical legacy racism shaping overdiagnosis; influencing treatment; key documentation, psychoeducation, clinical activism strategies.13,14 Two real-life cases illustrate how it confronts practical contexts (Tables 2 3).Aggression defiance powerful transgenerational histories systems oppression. Yet organized has historically pathologized people's resistance racial violence at expense denouncing itself.15 For drapetomania, "runaway slave syndrome," coined Dr Samuel Cartwright 1851, recommended was whipping.16 During Civil Rights Movement, psychiatrists labeled men championing their human rights "protest psychosis" diagnosis.17 In both cases, humane alternatives, like abolishing slavery, instead whipping enslaved people, were disregarded. Notably, 1960s, other professionals racism's eradication, diagnosing protest psychosis, definitive pathology discontent.18,19 Both diagnoses reneged duty advocate social injustice.Mental care's while distinctly anti-Black due its intertwinement not spared racialized groups. Intelligence testing created psychologists justified 20th-century eugenics mass sterilization campaigns targeting Indian girls women.20,21 contributed children's overrepresentation special education placement.22 ODD's overdiagnosis today perpetuates legacy's normalization oppression, pathologizing resistance, behavioral control intervention, advocacy violence.13 Because diagnostic labels remain enduring weapon choice normativity, should think twice about applying children. Repairing involves challenging it, perpetuating it.13,14An mandates analyzing shapes misdiagnosis—not automatically implementing adult supervision, discipline, parent training practice parameters.11,12 Recognizing pertinent inequities helps pediatric avoid following: Perpetuating adultification biases: Adults perceive stronger, adultlike, less innocent, deserving attention children.23–25 biases, derived ideologies legitimizing abuse, persist through overpunishment, criminalization, neglect pain, emotional physical.26–28 When oppositional, contextualization follow. It includes scrutinizing authority figures (clinicians, teachers, administrators, police officers) assessing them; conducting impartial assessments emotions behaviors; making ample attempts identify dehumanization discrimination.Ignoring intersecting oppression: Adultification biases impact unique ways.25 Negative stereotypes women being angry, aggressive, hypersexual lead adults treat inappropriately, punishing subjective infractions, disruption disobedience, peers evade.23–25 They suspended 5 times rate girls, experience suspension over rate.29,30 Racially lesbian, gay, bisexual, transgender, questioning (LGBTQ) students often endure multiple forms bullying harassment punishment clothing, gender presentation, public displays affection, leading increased rates actions within environments.31 LGBTQ particular disproportionately punished normative societal expectations sexual behavior identity.32,33 warrant exploring differential (case 2) noting differences. Girls internalizing symptomatology boys. common boys during childhood, but gap narrows adolescence.34Misdiagnosing: Mitigating discrimination's harm considering alternative diagnoses, attention-deficit/hyperactivity (ADHD) autism spectrum disorder, which present similarly ODD.2,35 Although defining feature ODD, irritability diagnostic. A nonspecific indicator, warrants checking mood anxiety disorders posttraumatic stress disorder.36 Clinicians requiring billing lacking time probe trauma, attentional challenges, symptoms might consider stigmatizing various adjustment unspecified onset usually occurring adolescence. widespread copying pasting without proper assessment, perpetuate bias, discouraged.37Advancing school-to-prison trajectory: An label heighten already elevated risks suspension, expulsion, justice involvement.27 face higher arrest youth. Hispanic highest incarceration rates, followed then youth.38,39 Racism profoundly impacts children, resulting anxiety, depression, problems.40–42 who also disabled, undocumented, otherwise marginalized additional toxic intersectional discrimination victimization.43,44 Explaining come validating thereby facilitating pushout into carceral settings same garnering care referrals diversion youth.39,45Justifying coercion: Diagnosing tantamount calling kid," amplifying established patterns coercion, excessive expulsions, seclusion restraint, stops involvement.28,46,47 supplants individualized constructions structural analyses assailing recognizing latter core problem driving former. Moreover, calls protection it.13,14 Assessing across relationships helps. Putting onus caused therapeutic could improve service engagement.Pediatric have connected child's context assessed primed following strategies.Antiracist psychoeducation14: strategy explaining families arc (step 1) thwart healthy developmental outcomes 2). full informed consent process illuminates diagnosis' risks, underscoring objective markers disease highly shaped sociopolitical context.15Antiracist documentation14: scanning charts pejorative language portraying aggressive defiant, difficult, uncooperative48) examining whether been explored form distress stemming trauma document role plays behavior, figures' perceptions cause obscuring vulnerability, sadness, 2).2 Highlighting strengths concern mistreatment humanizes rewrites narratives, reconfigures "good kids" care. Documenting longer meets criteria better explained different precipitating circumstance, further mitigates bias.Clinical activism14: Pediatric extend beyond redirecting psychoeducational measures toward officers, court representatives shifting documentation strategies medical letters reports. highlights trajectory's detriment oppositional adaptive, problematic, racism.A color-blind49 uses race-neutral orientation minimize formative responses it.14,15 approach, contrast, centers harm. Illuminating rehumanizing bias degradation, violence, individuals' adaptive cornerstones.16,17ODD example condemnation whereby indict standing up injustice defense. Other include psychotic disruptive disorders.2,50 function race-based medicine51 race unnamed variable. More research needed does contextualize amid punitive reliability, depicted 3). Exploring issue illuminate exist all. meantime, insists upholds our oath all.Dr Legha acknowledges Ms Akima Aiken Brown, read, revised, provided feedback initial first revision paper. Without her support, paper would possible. Nathalie Martinek, expertly reviewed

Language: Английский

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Drift‐Diffusion Modeling of Attentional Shifting During Frustration: Associations With State Frustration and Trait Irritability

Depression and Anxiety, Journal Year: 2025, Volume and Issue: 2025(1)

Published: Jan. 1, 2025

Irritability, a prevalent and impairing symptom in many mood anxiety disorders, is characterized by aberrant responses to frustrative nonreward. Past research investigating irritability have used cued‐attention task with rigged feedback, the affective Posner (AP), induce Previous studies not been successful linking differences self‐reported traditional AP metrics (i.e., reaction time accuracy). Computational modeling, via estimation of parameters reflecting latent cognitive processes, may provide insight into mechanisms reveal potential targets for mechanism‐based interventions. This study applied drift‐diffusion model (DDM) determine if DDM are associated individual irritability. Young adults ( N = 152, M age 20.93 ± 1.98) completed state frustration trait Multiple linear regressions were evaluate whether better predict over metrics. Higher was predicted lower decision threshold during block larger decrease this parameter between nonfrustration blocks, These findings demonstrate applying nonreward healthy adult populations. The utility awaits validation populations clinical levels

Language: Английский

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On the regulation and dysregulation of emotions in child psychopathology: commentary on Blader et al. (2025)

Journal of Child Psychology and Psychiatry, Journal Year: 2025, Volume and Issue: unknown

Published: March 3, 2025

Blader et al.'s (2025) recent annual review article makes an important contribution to the literature on emotion dysregulation in child and adolescent mental health. In addition synthesizing current evidence base, authors put forth a cogent formalized view of regulatory processes how they go awry. Much has been written (dys)regulation psychopathology (for overviews, see Lincoln al., 2022; Paulus 2021; Sheppes 2015). It would therefore be reasonable ask what novel could made by new at this time. But for all that written, there is much work still done. al. admirably rise meet challenge. We hope commentary amplifies adds their effort. Below, we reflect few aspects offer some further thoughts may inform future area.

Language: Английский

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Many Roads to Irritability: How Developmental Change and Multiple Risk Pathways Can Impact Negative Findings in Resting-State Connectivity

Biological Psychiatry Global Open Science, Journal Year: 2025, Volume and Issue: 5(2), P. 100451 - 100451

Published: March 1, 2025

Language: Английский

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Development and Validation of a Multi-Informant Scale for Assessing Youth Tonic and Phasic Irritability

Research on Child and Adolescent Psychopathology, Journal Year: 2025, Volume and Issue: unknown

Published: April 15, 2025

Language: Английский

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Genetic and Environmental Influences on the Development of Irritability from Ages 3 to 5 Years

Journal of Clinical Child & Adolescent Psychology, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 12

Published: April 22, 2025

Irritability is genetically influenced and associated with internalizing externalizing psychopathology. However, little known about the etiology of development irritability in preschool period. The present study examined this from rank-order stability developmental trajectories perspectives. 310 same-sex twin pairs (monozygotic = 123; dizygotic 187; 51% female) was longitudinally assessed at ages 3, 4 5 years via parent-reports on Child Behavior Checklist. Biometric Cholesky models latent growth curve were used to examine genetic environmental influences both instability, within individual changes levels across age (i.e. trajectories), respectively. heritability ranged 53% 60%, remaining variances explained by nonshared influences. Age-to-age largely due Novel effects emerged 5, indicating contributions instability. Approximately 42% 22% respectively, independent prior ages, over 85% age-specific. Individual differences entirely within-individual change are governed different etiological processes, emphasizing importance examining multiple Both perspectives highlight role factors early development. Interventions could benefit leveraging these redirect

Language: Английский

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Psychometric Evaluation of a Caregiver- and Self-Report Youth Adaptation of the Overall Depression Severity and Impairment Scale (ODSIS)

Journal of Psychopathology and Behavioral Assessment, Journal Year: 2025, Volume and Issue: 47(1)

Published: Jan. 24, 2025

Language: Английский

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