Irritability and Emotional Impulsivity as Core Feature of ADHD and ODD in Children

Abstract

The categorical approach of diagnosing mental disorders entails the problem of frequently occurring comorbidities, suggesting a more parsimonious structure of psychopathology. In this study, we therefore aim to assess how affective dysregulation (AD) is associated with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) in children. To assess AD in children aged 8–12 years (n = 391), we employed the parent version of a newly constructed parent rating scale. Following item reduction, we conducted exploratory and confirmatory factor analyses to establish a factorial structure of AD. One core dimension was identified, comprising irritability and emotional impulsivity, and two smaller dimensions, comprising positive emotionality and exuberance. Subsequently, we examined five different latent factor models – a unidimensional model, a first-order correlated factor model, a second-order correlated factor model, a traditional bifactor model, and a bifactor S-1 model, in which the first-order factor AD-Irritability/Emotional Impulsivity (II) was modeled as the general reference factor. A bifactor S-1 model with the a priori defined general reference domain AD-II provided the best fit to our data and was straightforward to interpret. This model showed excellent model fit and no anomalous factor loadings. This still held true, when comparing it to bifactor S-1 models with ADHD/ODD-related reference factors. Differential correlations with emotion regulation skills and the established Parent Proxy Anger Scale validate the interpretation of the different dimensions. Our results suggest that irritability/emotional impulsivity might be a common core feature of ADHD and ODD.

Vicious cycle of emotion regulation and ODD symptoms among Chinese school-age children with ODD: A random intercept cross-lagged panel model

“…Second, we were surprised to nd that this vicious circle was present only in the relationship between teacher-reported EL and ODD symptoms. This supports the view that emotion regulation, particularly EL, is a core feature of ODD [73,74]. Third, interestingly, we also found signi cant differences between teacher and parent reports, with the lack of a longitudinal association between parent reported emotion regulation and ODD symptoms.…”

Validation of a new emotion regulation self-report questionnaire for children

“…Child AD symptoms were assessed using the self- and parent report forms of the Diagnostic System for Affective Dysregulation (DADYS; German: “Diagnostikum für Affektive Dysregulation”; unpublished manuscript [ 42 ];). The self-report form (DADYS-C) comprises 28 items and the parent report form (DADYS-P) comprises 38 items.…”

Screening for affective dysregulation in school-aged children: relationship with comprehensive measures of affective dysregulation and related mental disorders

“…The DADYS [12,18,28] is a comprehensive assessment tool including the screening questionnaire (DADYS-Screen, 12 items), a diagnostic interview for parents (DADYS-PI, 13 items) and children (DADYS-CI, 10 items), and a questionnaire for parents (DADYS-PQ, 36 items) and children (DADYS-CQ, 26 items). As mentioned above, the DADYS comprises symptoms of irritability, impulsivity, temper outbursts, anger, and mood swings (e.g., "is easily annoyed by others", "exhibits wide mood swings").…”

“…The newly developed Diagnostic Tool for Affective Dysregulation in Children (DADYS; [10,12,18,28] might be suitable to fill this gap, as it focuses on the broader conceptualization of AD comprising all of the stated aspects of AD by merging the different operationalizations into one tool. To integrate different perspectives, it comprises parent, self-, and clinical ratings.…”