Irritability is increasingly recognized as a significant clinical problem in youth. It is a criterion for multiple diagnoses and predicts the development of a wide range of disorders. Research on its etiology suggests that genetic and family environmental factors play a role, as do abnormalities in reward and cognitive-control neural circuitry. However, many of these effects are age dependent. Threat-responsive self-regulatory systems and the degree to which irritability is tonic or phasic influence whether irritable youth exhibit more internalizing or more externalizing outcomes.
Differential outcomes of tonic and phasic irritability in adolescent girls
Irritable mood is a transdiagnostic clinical feature that is present in multiple psychiatric disorders. Although irritability is frequently examined as a unitary construct, two dimensions of irritability, tonic (i.e., irritable mood) and phasic (i.e., temper outbursts), have been hypothesized. However, few studies have examined whether tonic and phasic irritability are empirically separable and predict different forms of psychopathology.
We utilized data from a longitudinal study of a community sample of 550 girls (age 13.5–15.5 years) followed at 9‐month intervals for 3 years. We conducted exploratory factor analysis (EFA) using items from three self‐report inventories: the International Personality Item Pool Anger scale, Temperament and Affectivity Inventory Anger scale, and Buss‐Perry Aggression Questionnaire Anger scale.
The EFA identified dimensions that were consistent with tonic and phasic irritability. Tonic irritability at baseline independently predicted the development of depressive disorders and generalized anxiety disorder (GAD) in subsequent waves. Phasic irritability independently predicted a decreased probability of GAD, but an increased probability of oppositional defiant, conduct, and substance use disorder, and greater risky sexual behavior and relational aggression during the follow‐up.
Tonic and phasic irritability appear to be separable constructs with unique implications for later psychopathology and related behavior among adolescent girls. It is important to consider this distinction in research on the etiology and pathophysiology of irritability and developing effective treatments.
- PAR ID:
- 10449272
- Publisher / Repository:
- Wiley-Blackwell
- Date Published:
- Journal Name:
- Journal of Child Psychology and Psychiatry
- Volume:
- 62
- Issue:
- 10
- ISSN:
- 0021-9630
- Page Range / eLocation ID:
- p. 1220-1227
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
More Like this
-
more » « less
-
more » « less
Abstract Objective Previous work has outlined cognitive beliefs about exercise in general, but very little is known about momentary cognitions while engaging in pathological exercise. The primary aim of this study was to explore thought content during exercise and to test whether these thoughts predicted later engagement in eating disorder behaviors. We also tested associations between thoughts and specific exercise activity.
Method We monitored 31 women with clinically significant eating psychopathology for 3 weeks via ecological momentary assessment as they reported on their exercise and eating disorder behaviors, and thoughts about shape, weight, or calories during exercise. Thoughts were self‐reported upon cessation of each exercise session.
Results Thinking about weight loss during exercise predicted later engagement in body‐checking behaviors. Weight‐bearing exercise was associated with a decreased likelihood of thinking about calories but an increased likelihood of thinking about shape during exercise.
Discussion These findings show that shape and weight thoughts are present during exercise and that their influence on eating disorder behaviors may exist on a much briefer time scale (i.e., within a day) than previous studies show. Clinically, future studies may seek to test interventions aimed at changing or restructuring cognitions during exercise to help shape adaptive exercise behavior during and after treatment.
Public Significance This is the first study measuring thoughts during pathological exercise in real‐time among those with eating disorder psychopathology. The results show that thinking about weight loss during exercise might increase the likelihood of engaging in body‐checking behaviors. Findings will inform the development of treatment approaches to help those in recovery from eating disorders re‐engage with exercise.
-
more » « less
Background In recent years, epidemiological and clinical studies have revealed that depressive disorders can present in early childhood. To clarify the validity and prognostic significance of early childhood‐onset depression, we investigated diagnostic and functional outcomes in later childhood and adolescence.
Methods A community sample (
N = 516) was assessed for psychopathology at ages 3 and 6 using the Preschool Age Psychiatric Assessment. When participants were 9, 12, and 15 years old, children and parents completed the Kiddie Schedule for Affective Disorders and Schizophrenia and measures of symptoms and functioning.Results In models adjusting for covariates, depressed 3/6‐year‐old children were more likely to experience subsequent episodes of depressive disorders and exhibited significantly higher rates of later anxiety disorder, attention deficit hyperactivity disorder, and suicidality compared to children without depressive disorders at age 3/6. Early childhood depression was also associated with higher levels of mother, but not child, reported depressive symptoms at age 15 compared to children without depressive disorders at age 3/6. Finally, depression at age 3/6 predicted lower levels of global and interpersonal functioning and higher rates of treatment at age 15 compared to children without depressive disorders at age 3/6.
Conclusions Results support the clinical significance of depression in 3/6‐year‐old children, although further studies with larger samples are needed.
-
more » « less
Background Research to date has largely conceptualized irritability in terms of intraindividual differences. However, the role of interpersonal dyadic processes has received little consideration. Nevertheless, difficulties in how parent–child dyads synchronize during interactions may be an important correlate of irritably in early childhood. Innovations in developmentally sensitive neuroimaging methods now enable the use of measures of neural synchrony to quantify synchronous responses in parent–child dyads and can help clarify the neural underpinnings of these difficulties. We introduce the Disruptive Behavior Diagnostic Observation Schedule: Biological Synchrony (DB‐DOS:BioSync) as a paradigm for exploring parent–child neural synchrony as a potential biological mechanism for interpersonal difficulties in preschool psychopathology.
Methods Using functional near‐infrared spectroscopy (fNIRS) 4‐ to 5‐year‐olds (
N = 116) and their mothers completed the DB‐DOS:BioSync while assessing neural synchrony during mild frustration and recovery. Child irritability was measured using a latent irritability factor that was calculated from four developmentally sensitive indicators.Results Both the mild frustration and the recovery contexts resulted in neural synchrony. However, less neural synchrony during the recovery context only was associated with more child irritability.
Conclusions Our results suggest that recovering after a frustrating period might be particularly challenging for children high in irritability and offer support for the use of the DB‐DOS:BioSync task to elucidate interpersonal neural mechanisms of developmental psychopathology.
-
more » « less
Abstract Objective This study examined whether patterns of eating‐disorder (ED) psychopathology differed by gender across
DSM‐5 severity specifiers in anorexia nervosa (AN) and bulimia nervosa (BN).Method We tested whether ED psychopathology differed across
DSM ‐5 severity specifiers among 532 adults (76% female) in a residential treatment center with AN or BN. We hypothesized that severity of ED psychopathology would increase in tandem with increasing severity classifications for both males and females with AN and BN.Results Among females with BN,
DSM‐5 severity categories were significantly associated with increasing ED psychopathology, including Eating Disorder Examination‐Questionnaire dietary restraint, eating concern, shape concern, and weight concern; and Eating Disorder Inventory drive for thinness and bulimia. ED psychopathology did not differ acrossDSM‐5 severity levels for males with BN. For both males and females with AN, there were no differences in ED psychopathology across severity levels.Discussion Results demonstrate that
DSM‐5 severity specifiers may function differently for males versus females with BN. Taken together, data suggestDSM‐5 severity specifiers may not adequately capture severity, as intended, for males with BN and all with AN. Future research should evaluate additional clinical validators ofDSM‐5 severity categories (e.g., chronicity, treatment non‐response), and consider alternate classification schemes.
