Irritability and Disruptive Behavior Disorders

Abstract

Chronic irritability has recently been established as an affective component of pediatric disruptive behavior disorders. In this chapter, the authors review its relationship to disruptive behaviors, with a particular focus on aggression and major disruptive behavior disorders. Defined as a decreased threshold to respond to provocation with anger and temper outbursts, chronic irritability has long been considered an important feature of emotionally driven, disruptive behavior. Recent investigations into irritability suggest that it has important prognostic value for disruptive youth. Furthermore, investigations of disruptive behaviors have informed work on irritability, yielding promising leads for understanding its pathophysiology and treatment.

On defining irritability and its relationship to affective traits and social interpretations

“…Current definitions of irritability include a proneness to anger, an increased sensitivity to provocation, and increased likelihood of behavioral outbursts that may or may not include aggressive behaviors (Holtzman, O'Connor, Barata, & Stewart, 2014;Toohey & DiGiuseppe, 2017). Trait anger and reactive aggression are also defined by a proclivity towards negative affect (Fite, Raine, Stouthamer-Loeber, Loeber, & Pardini, 2009;Xu, Farver, & Zhang, 2009) and share similar longitudinal outcomes and cognitive biases with irritability (Stoddard, Scelsa, & Hwang, 2018). However, there are important conceptual differences between these constructs.…”

“…Both reactive aggression and irritability describe extreme responses to provocations. Whereas, reactive aggression is defined by aggressive behaviors (i.e., behaviors intended to harm others), irritability is not defined as a tendency towards aggression (Stoddard et al, 2018). Recent empirical work suggests that irritability and aggression are distinct constructs (Bettencourt, Talley, Benjamin, & Valentine, 2006;Bolhuis et al, 2017).…”