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

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Abstract

Pediatric irritability can be highly impairing and is implicated in adverse outcomes. The phasic component, characterized by temper outbursts, is a frequent impetus to seek treatment. This study tested whether a previously described anger-distress model of tantrums applies to an outpatient sample of school-age children with clinically impairing temper outbursts (TO; 5.0–9.9 years; N = 86), and examined the clinical relevance of resulting factors through associations with measures of psychopathology, and differences between children with TO and two groups without: children with ADHD (n = 60) and healthy controls (n = 45). Factor analyses established a three-factor model: High Anger, Low Anger, Distress. These factors had unique associations with measures of irritability, externalizing problems, and internalizing problems in the TO group. Additionally, an interaction between groups and outburst factors emerged. Results provide evidence for the presence and clinical utility of the anger-distress model in children’s outbursts and suggest avenues for future pediatric irritability research.

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Acknowledgements

We would like to thank Heining Cham, PhD, and Leah Feuerstahler, PhD, for their additional statistical assistance. We would also like to thank the families who participated in the research study.

Funding

This study was funded by the National Institutes of Health (R01 MH091140-01).

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Authors and Affiliations

  1. Psychology Department, Fordham University, 441 East Fordham Road, Dealy Hall, Bronx, NY, 10458, USA

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

  2. Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, 10016, USA

    Amy Krain Roy

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  1. Emily Hirsch
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Correspondence to Emily Hirsch.

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Hirsch, E., Davis, K., Cao, Z. et al. Understanding Phasic Irritability: Anger and Distress in Children’s Temper Outbursts. Child Psychiatry Hum Dev 53, 317–329 (2022). https://doi.org/10.1007/s10578-021-01126-5

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