Heritability, stability, and prevalence of tonic and phasic irritability as indicators of disruptive mood dysregulation disorder

Abstract

Background Little is known about genetic and environmental influences on the components of disruptive mood dysregulation disorder (DMDD), tonic irritability (i.e., irritable mood) and phasic irritability (i.e., temper outbursts). This study examined prevalence, stability, and heritability of tonic irritability, phasic irritability, and a DMDD proxy (pDMDD) based on DSM‐5 criteria. Methods pDMDD was derived using data from clinical interviews of parents and their twins (N = 1,431 twin pairs), ages 8–17, participating in Waves 1 and 2 of the Virginia Twin Study of Adolescent Behavioral Development. Biometrical modeling was used to compare a common pathway model (CPM) and an independent pathway model (IPM), and heritability estimates were obtained for pDMDD using the symptoms of irritable mood (tonic irritability; DMDD Criterion D), intense temper outbursts (phasic irritability; DMDD Criterion A), and frequent temper outbursts (phasic irritability; DMDD Criterion C). Results Lifetime prevalence of pDMDD was 7.46%. The stability of DMDD symptoms and the pDMDD phenotype across approximately one year were moderate (.30–.69). A CPM was a better fit to the data than an IPM. Phasic irritability loaded strongly onto the pDMDD latent factor (.89–.96) whereas tonic irritability did not (.28). Genetic influences accounted for approximately 59% of the variance in the latent pDMDD phenotype, with the remaining 41% of the variance due to unique environmental effects. The heritability of tonic irritability (54%) was slightly lower than that of frequent and intense temper (components of phasic irritability; 61% and 63%, respectively). Conclusions Compared to tonic irritability, phasic irritability appears to be slightly more stable and heritable, as well as a stronger indicator of the latent factor. Furthermore, environmental experiences appear to play a substantial role in the development of irritability and DMDD, and researchers should seek to elucidate these mechanisms in future work.

Differential outcomes of tonic and phasic irritability in adolescent girls

“…Finally, the present study did not examine the factors that contribute to the development of tonic and phasic irritability. Consistent with Hawes et al (2019) and Moore et al (2019), our findings suggest that tonic and phasic irritability may have somewhat different etiologies. Hence, future research should extend these findings by examining genetic, environmental, and pathophysiological influences on these dimensions.…”

“…The two components were highly correlated, and after applying thresholds to account for differences in the prevalence of phasic and tonic irritability, they predicted similar outcomes. Moore and colleagues (Moore et al, 2019) examined the prevalence, stability, and heritability of tonic irritability, phasic irritability, and a DMDD proxy based on DSM-5 criteria in a sample of 8-to 17-year-old twins. They reported that, compared to tonic irritability, phasic irritability was slightly more stable and heritable, and was a stronger indicator of the DMDD latent factor.…”

Additional Evidence for Neuropsychiatric Manifestations in Mosaic Trisomy 20: A Case Report and Brief Review

“…In addition, studies support developmentally dynamic genetic effects on core features of the disorder, such as irritability, with genetic influences being higher in the female gender and as compared to environmental features [31]. However, the environment is still believed to exert a modulatory effect [32]. Consistently, evidence from gene-by-environment-interaction studies suggests that genetic variation in the hypothalamic-pituitary-adrenal (HPA) axis may interact with the effect of chronic stress in increasing the risk of presenting with a negative affect [33].…”

Online-Elterntraining für die Behandlung von Kindern mit externalisierenden Verhaltensproblemen und affektiver Dysregulation

“…Ätiologische Modelle messen -neben personalen Faktoren wie Temperament und neuropsychologischenBesonderheiten -sozialen Faktoren eine besondere Bedeutung bei der Entstehung affektiver Dysregulation bei [22]. In der Interaktion mit Eltern, Gleichaltrigen und Erwachsenen außerhalb der Familie er-werbenKinderEmotionsregulationsstrategien und erproben diese Strategien im Hinblick auf die Erreichung individueller Ziele.…”