Understanding Phasic Irritability: Anger and Distress in Children’s Temper Outbursts

Hirsch, Emily; Davis, Kaley; Cao, Zihuan; Roy, Amy Krain

doi:10.1007/s10578-021-01126-5

Cited by 18 publications

(11 citation statements)

References 49 publications

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“…Edges connecting irritability to both ADHD domains and depression were all of similar magnitude. There is ongoing debate regarding whether irritability should be conceptualized in terms of distinct tonic negative mood and phasic temper outburst components that may have unique associations with psychopathology (Cardinale et al, 2021;Hirsch, Davis, Cao, & Roy, 2021). Future studies, particularly those using momentary assessment to differentiate these components, will be critical to further clarifying which facets of the construct are most influential on different forms of psychopathology.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal network model of the co-development of temperament, executive functioning, and psychopathology symptoms in youth with and without ADHD

et al. 2021

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Attention-deficit hyperactivity disorder (ADHD) is a common, chronic, and impairing disorder, yet presentations of ADHD and clinical course are highly heterogeneous. Despite substantial research efforts, both (a) the secondary co-occurrence of ADHD and complicating additional clinical problems and (b) the developmental pathways leading toward or away from recovery through adolescence remain poorly understood. Resolving these requires accounting for transactional influences of a large number of features across development. Here, we applied a longitudinal cross-lagged panel network model to a multimodal, multilevel dataset in a well-characterized sample of 488 children (nADHD = 296) to test Research Domain Criteria initiative-inspired hypotheses about transdiagnostic risk. Network features included Diagnostic and Statistical Manual of Mental Disorders symptoms, trait-based ratings of emotional functioning (temperament), and performance-based measures of cognition. Results confirmed that ADHD symptom domains, temperamental irritability, and working memory are independent transdiagnostic risk factors for psychopathology based on their direct associations with other features across time. ADHD symptoms and working memory each had direct, independent associations with depression. Results also demonstrated tightly linked co-development of ADHD symptoms and temperamental irritability, consistent with the possibility that this type of anger dysregulation is a core feature that is co-expressed as part of the ADHD phenotype for some children.

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Section: Discussionmentioning

confidence: 99%

Longitudinal network model of the co-development of temperament, executive functioning, and psychopathology symptoms in youth with and without ADHD

et al. 2021

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“…(2015) failed to find differences in outcomes after applying thresholds to account for differences in the prevalence of tonic and phasic irritability. Finally, in cross‐sectional studies of children between the ages of 5 and 18, phasic irritability was associated with ADHD symptoms (Cardinale et al., 2021) and externalizing, but not internalizing, problems (Hirsch, Davis, Cao, & Roy, 2022).…”

Section: Introductionmentioning

confidence: 95%

Tonic and phasic irritability in 6‐year‐old children: differential correlates and outcomes

Silver

Mackin

Bufferd

et al. 2022

Child Psychology Psychiatry

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Objective Irritability is a common and clinically important problem in children and adolescents and a risk factor for later psychopathology and impairment. Irritability can manifest in both tonic (e.g., irritable, touchy mood) and phasic (e.g., temper outburst) forms, and recent studies of adolescents suggest that they predict different outcomes. However, no studies have examined whether tonic and phasic irritability are empirically distinguishable in 6‐year‐old children and whether they have distinct correlates and outcomes. Method We utilized data from a longitudinal study of an unselected community sample of four hundred fifty‐two 6‐year‐olds followed at 3‐year intervals to age 15. We conducted confirmatory factor analysis (CFA) using relevant items from a diagnostic interview and several parent‐report inventories. Results The CFA identified dimensions that were consistent with tonic and phasic irritability. Tonic irritability was independently associated with concurrent parent‐reported temperamental negative affectivity and internalizing and externalizing disorders at age 6 and predicted higher rates of internalizing psychopathology, and suicidal ideation, in adolescence. Phasic irritability was independently associated with concurrent parent‐reported temperamental negative affectivity, surgency, and low effortful control, maladaptive parenting styles and practices, and externalizing disorders at age 6, and predicted higher rates of externalizing psychopathology in adolescence. Conclusions Tonic and phasic irritability in 6‐year‐old children appear to be distinguishable constructs with different temperament and parenting correlates and psychopathological outcomes. Distinguishing these components has implications for research on the etiology and pathophysiology of irritability and developing effective treatments.

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“…The push for viewing psychopathology dimensionally, rather than categorically, encourages the possibility of viewing chosen dimensions as being transdiagnostic and potentially modifiable across a broad range of clinical disorders (McLaughlin et al, 2021, Hopwood et al, 2020. Moving forward, hopefully dimensions of known processes such as learned helplessness, negative cognitive biases, anhedonia, excessive sadness and irritability, and emotional dysregulation (Chad-Friedman et al, 2021, Brislin et al, 2021, Bufferd et al, 2019, Buffered et al, 2021, Hirsch et al, 2021, Hodgdon et al, 2021, could be the future targets of intervention that lead to deeper insights to why and how internalizing disorders develop, persists, and ultimately remit within a spectrum of dysfunctionality and adaptive functioning for growing adolescents and youth. Recently, there has been a massive push for adopting new approaches to examine psychopathology and to reach new conceptualizations about the nosology, underlying etiology, and subsequent treatments of clinical disorders.…”

Section: Personalizing Psychotherapy On Transdiagnostic Symptomsmentioning

confidence: 99%

The Future of Psychotherapy for Youth

Economou

Spiro²

2022

Adv. J Social Sci.

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Despite countless modifications to adapt adult psychotherapy to treat pediatric populations, recent meta-analytic findings have found only modest effect sizes for the treatment of pediatric depression. Additionally, recent neuroscientific evidence suggests that most mental health disorders share greater comorbidity with other distinct mental health disorders and also have greater within-disorder heterogeneity than previously thought. This review aims to integrate recent findings of analytic reviews with developments in neuroscience to encourage the field to think differently about how to best improve pediatric psychotherapy and our understanding of the developing brain. This article examines why our approach to treating mood disorders in the pediatric population must change based on our current understanding of the neurocognitive and psychosocial etiologies of these disorders and to highlight the importance transdiagnostic perspectives. Perhaps, neuroscientific methods can one day become adjunctive to psychotherapy to help personalize approaches, and to help provide valuable insight into emerging psychopathology even before symptoms manifest.

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Understanding Phasic Irritability: Anger and Distress in Children’s Temper Outbursts

Cited by 18 publications

References 49 publications

Longitudinal network model of the co-development of temperament, executive functioning, and psychopathology symptoms in youth with and without ADHD

Longitudinal network model of the co-development of temperament, executive functioning, and psychopathology symptoms in youth with and without ADHD

Tonic and phasic irritability in 6‐year‐old children: differential correlates and outcomes

The Future of Psychotherapy for Youth

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