Development and Application of an Innovative Transdiagnostic Treatment Approach for Pediatric Irritability

Hawks, Jessica L.; Kennedy, Sarah M.; Holzman, Jacob B.; Ehrenreich–May, Jill

doi:10.1016/j.beth.2019.07.004

Cited by 38 publications

(20 citation statements)

References 32 publications

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“…With continued psychometric support in early childhood, the concise ARI-P can facilitate prospective research designs that examine temporal relationships between irritability and psychopathology across the lifespan. Moreover, in light of promising advances unfolding in the treatment of pediatric irritability (e.g., Hawks et al, 2020; Kircanski, Clayton et al, 2018; Linke et al, 2020; Roy & Comer, 2020), the ARI-P may play an increasing role in informing the treatment of young children in clinical settings.…”

Section: Discussionmentioning

confidence: 99%

Measuring Irritability in Early Childhood: A Psychometric Evaluation of the Affective Reactivity Index in a Clinical Sample of 3- to 8-Year-Old Children

et al. 2021

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The parent-report Affective Reactivity Index (ARI-P) is the most studied brief scale specifically developed to assess irritability, but relatively little is known about its performance in early childhood (i.e., ≤8 years). Support in such populations is particularly important given developmental shifts in what constitutes normative irritability across childhood. We examined the performance of the ARI-P in a diverse, treatment-seeking sample of children ages 3 to 8 years ( N = 115; mean age = 5.56 years; 58.4% from ethnic/racial minority backgrounds). In this sample, confirmatory factor analysis supported the single-factor structure of the ARI-P previously identified with older youth. ARI-P scores showed large associations with another irritability index, as well as small-to-large associations with aggression, anxiety, depression, and attention problems, supporting the convergent and concurrent validity of the ARI-P when used with children in this younger age range. Findings support the ARI-P as a promising parent-report tool for assessing irritability in early childhood, particularly in clinical samples.

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Section: Discussionmentioning

confidence: 99%

Measuring Irritability in Early Childhood: A Psychometric Evaluation of the Affective Reactivity Index in a Clinical Sample of 3- to 8-Year-Old Children

et al. 2021

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“…Prior studies have demonstrated that DBs are associated with almost all forms of psychopathology in children and adolescents and are broadly present alongside both internalizing and externalizing symptoms 12 – 14 . Therefore, DBs may be excellent candidates as trans-diagnostic markers for studying the effectiveness of interventions, as well as guide ongoing and future child and adolescent psychiatric research and clinical practice 15 .…”

Section: Introductionmentioning

confidence: 99%

Psychopharmacological treatment of disruptive behavior in youths: systematic review and network meta-analysis

Seok¹,

Soltis-Vaughan²,

Lew³

et al. 2023

Sci Rep

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To conduct a systematic review of the comparative efficacy of various psychotropic medications for the treatment of disruptive behavior (DBs) in youths. To this aim, we systematically reviewed randomized clinical trials (RCTs) of various psychotropic medications targeting symptoms of DBs and applied network meta-analysis to investigate their relative efficacy. Fifty-five RCTs meeting the inclusion criteria were selected. To predict and interpret relative treatment efficacy, we compared the efficacy of various psychotropic medications prescribed for DB symptoms based on their mechanism of action. Network meta-analysis revealed that for reducing DBs, second-generation antipsychotics, stimulants, and non-stimulant ADHD medications were more efficacious than placebo, and second-generation antipsychotics were the most efficacious. The dopaminergic modulation of top-down inhibitory process by these medications is discussed in this review. This study offers information on the relative efficacy of various psychotropic medications for the treatment of DB, and insight into a potential neurobiological underpinning for those symptoms. It also illustrates the potential utility of these neurobiological mechanisms as a target for future treatment studies.

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“…A protocol such as the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (Ehrenreich, Goldstein, Wright, & Barlow, 2009), which targets high negative emotion, emotional reactivity, and emotion regulation deficits common across emotional disorders, may be indicated for this group. This protocol has been tested in children with depression and anxiety and also has proved promising initial results in a small sample of children with disruptive behavior disorders (Hawks, Kennedy, Holzman, & Ehrenreich-May, 2020).…”

Section: Discussionmentioning

confidence: 99%

Transdiagnostic trajectories of irritability and oppositional, depression and anxiety problems from preschool to early adolescence

Ezpeleta

Penelo

Navarro

et al. 2020

Behaviour Research and Therapy

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Irritability is a transdiagnostic symptom in oppositional defiant disorder, depression, and anxiety, all highly comorbid disorders but with unknown simultaneous evolution. The aim was to obtain the developmental trajectories of simultaneous irritability and oppositional, depression, and anxiety problems from preschool age to early adolescence. A sample of 493 community children was followed up annually from ages 3 to 11 years and assessed using categorical and dimensional measures answered by parents and teachers. Latent Class Growth Analysis for four parallel processes was used to identify distinct groups of individual trajectories for irritability and oppositional, depression, and anxiety problems. Outcomes at ages 11 and 12 were compared among trajectories using regression models and multiple comparisons. A 3-class model showed the highest entropy (.961) and adequate posterior probabilities of class membership (≥ .969). Class 1 (n=331, 67.1%) was made up of children with stable low scores in all the variables; class 2 (n=55, 11.2%) of children with high depression, anxiety, and irritability and above the mean stable profiles for oppositional problems; and class 3 (n=107, 21.7%) of children with medium-high increasing irritability and oppositional problems and on the mean depression and anxiety. The classes with symptomatology and irritability (2 and 3) clearly differed from class 1 (low) at baseline and in outcomes. The course of irritability and oppositional, depression, and anxiety problems from ages 3 to 11 years differed qualitatively and quantitatively across subgroups of children. The 3 classes identified may help to guide clinicians' decision-making regarding treating irritability and its comorbid disorders.

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Development and Application of an Innovative Transdiagnostic Treatment Approach for Pediatric Irritability

Cited by 38 publications

References 32 publications

Measuring Irritability in Early Childhood: A Psychometric Evaluation of the Affective Reactivity Index in a Clinical Sample of 3- to 8-Year-Old Children

Measuring Irritability in Early Childhood: A Psychometric Evaluation of the Affective Reactivity Index in a Clinical Sample of 3- to 8-Year-Old Children

Psychopharmacological treatment of disruptive behavior in youths: systematic review and network meta-analysis

Transdiagnostic trajectories of irritability and oppositional, depression and anxiety problems from preschool to early adolescence

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