Abstract
Irritability, generally conceptualized as a proneness to anger and low tolerance for frustration, accounts for a large proportion of child mental health referrals. In the past 20 years, research on irritability has emerged as a prominent area of study in clinical child psychology, due to controversy surrounding the overdiagnosis of severe irritability as pediatric bipolar disorder. Such research has yielded a new conceptualization of severe irritability as a transdiagnostic symptom of a variety of mental health disorders in childhood. Further, irritability (in the form of temper tantrums) is a common aspect of the development of emotion regulation skills in early childhood, creating challenges for caregivers in distinguishing between developmentally appropriate versus clinically significant symptoms. In an effort to understand the pathophysiological basis of pediatric irritability, psychologists have identified dysfunction in reward and threat processing as the core neural mechanisms that contribute to severe irritability. This chapter outlines the current conceptualization of pediatric irritability and its theorized neurobiological bases and details current diagnostic, assessment, and treatment considerations.
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References
Achenbach, T. M., & Rescorla, L. (2001). Manual for the ASEBA school-age forms & profiles: An integrated system of multi-informant assessment. University of Vermont, Research Center for Children, Youth, & Families.
Achenbach, T. M., & Ruffle, T. M. (2000). The Child Behavior Checklist and related forms for assessing behavioral/emotional problems and competencies. Pediatrics in Review, 21(1), 265–271. https://doi.org/10.1542/pir.21-8-265
Aebi, M., Plattner, B., Metzke, C. W., Bessler, C., & Steinhausen, H. C. (2013). Parent-and self-reported dimensions of oppositionality in youth: Construct validity, concurrent validity, and the prediction of criminal outcomes in adulthood. Journal of Child Psychology and Psychiatry, 54(9), 941–949. https://doi.org/10.1111/jcpp.12039
Aitken, M., Battaglia, M., Marino, C., Mahendran, N., & Andrade, B. F. (2019). Clinical utility of the CBCL Dysregulation Profile in children with disruptive behavior. Journal of Affective Disorders, 253, 87–95. https://doi.org/10.1016/j.jad.2019.04.034
Althoff, R. R., Ayer, L. A., Rettew, D. C., & Hudziak, J. J. (2010). Assessment of dysregulated children using the Child Behavior Checklist: A receiver operating characteristic curve analysis. Psychological Assessment, 22(3), 609–617. https://doi.org/10.1037/a0019699
Althoff, R. R., Crehan, E. T., He, J.-P., Burstein, M., Hudziak, J. J., & Merikangas, K. R. (2016). Disruptive mood dysregulation disorder at ages 13–18: Results from the National Comorbidity Survey—Adolescent Supplement. Journal of Child and Adolescent Psychopharmacology, 26(2), 107–113. https://doi.org/10.1089/cap.2015.0038
Ambrosini, P. J., Bennett, D. S., & Elia, J. (2013). Attention deficit hyperactivity disorder characteristics: II. Clinical correlates of irritable mood. Journal of Affective Disorders, 145(1), 70–76. https://doi.org/10.1016/j.jad.2012.07.014
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). APA.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). APA. https://doi.org/10.1176/appi.books.9780890425596
Amsel, A. (1958). The role of frustrative nonreward in noncontinuous reward situations. Psychological Bulletin, 55(2), 102–119. https://doi.org/10.1037/h0043125
Ashurova, M., Budman, C., & Coffey, B. J. (2021). Ticked Off: Anger outbursts and aggressive symptoms in Tourette disorder. Child and Adolescent Psychiatric Clinics of North America, 30(2), 361–373. https://doi.org/10.1016/j.chc.2020.10.006
Axelson, D., Findling, R. L., Fristad, M. A., Kowatch, R. A., Youngstrom, E. A., Horwitz, S. M., Arnold, L. E., Frazier, T. W., Ryan, N., Demeter, C., Gill, M. K., Hauser-Harrington, J. C., Depew, J., Kennedy, S. M., Gron, B. A., Rowles, B. M., & Birmaher, B. (2012). Examining the proposed disruptive mood dysregulation disorder diagnosis in children in the Longitudinal Assessment of Manic Symptoms study. The Journal of Clinical Psychiatry, 73(10), 1342–1350. https://doi.org/10.4088/JCP.12m07674
Axelson, D. A., Birmaher, B., Findling, R. L., Fristad, M. A., Kowatch, R. A., Youngstrom, E. A., Arnold, L. E., Goldstein, B. I., Goldstein, T. R., Chang, K. D., DelBello, M. P., Ryan, N. D., & Diler, R. S. (2011). Commentary: Concerns regarding the inclusion of Temper Dysregulation Disorder with Dysphoria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The Journal of Clinical Psychiatry, 72(9), 1257–1262. https://doi.org/10.4088/JCP.10com06220
Benarous, X., Renaud, J., Breton, J. J., Cohen, D., Labelle, R., & Guilé, J.-M. (2020). Are youths with disruptive mood dysregulation disorder different from youths with major depressive disorder or persistent depressive disorder? Journal of Affective Disorders, 265, 207–215. https://doi.org/10.1016/j.jad.2020.01.020
Biederman, J., Faraone, S., Wozniak, J., Mick, E., Kwon, A., & Aleardi, M. (2004). Further evidence of unique developmental phenotypic correlates of pediatric bipolar disorder: Findings from a large sample of clinically referred preadolescent children assessed over the last 7 years. Journal of Affective Disorders, 82, S45–S58. https://doi.org/10.1016/j.jad.2004.05.021
Biedzio, D., & Wakschlag, L. (2018). Developmental emergence of disruptive behaviors beginning in infancy: Delineating normal: abnormal boundaries to enhance early identification. In C. H. Zeanah (Ed.), Handbook of infant mental health (4th ed., pp. 407–425). Guilford Press.
Blader, J. C., & Carlson, G. A. (2007). Increased rates of bipolar disorder diagnoses among US child, adolescent, and adult inpatients, 1996–2004. Biological Psychiatry, 62(2), 107–114. https://doi.org/10.1016/j.biopsych.2006.11.006
Brenner, J., Pan, Z., Mazefsky, C., Smith, K. A., Gabriels, R., & Autism and Developmental Disorders Inpatient Research Collaborative (ADDIRC). (2018). Behavioral symptoms of reported abuse in children and adolescents with autism spectrum disorder in inpatient settings. Journal of Autism and Developmental Disorders, 48(11), 3727–3735. https://doi.org/10.1007/s10803-017-3183-4
Brotman, M. A., Kircanski, K., Gold, A. L., & Leibenluft, E. (2018). Exposure-based cognitive-behavioral therapy for irritability and disruptive mood dysregulation disorder [Unpublished Manual].
Brotman, M. A., Kircanski, K., & Leibenluft, E. (2017a). Irritability in children and adolescents. Annual Review of Clinical Psychology, 13, 317–341. https://doi.org/10.1146/annurev-clinpsy-032816-044941
Brotman, M. A., Kircanski, K., Stringaris, A., Pine, D. S., & Leibenluft, E. (2017b). Irritability in youths: A translational model. American Journal of Psychiatry, 174(6), 520–532. https://doi.org/10.1176/appi.ajp.2016.16070839
Brotman, M. A., Rich, B. A., Guyer, A. E., Lunsford, J. R., Horsey, S. E., Reising, M. M., Thomas, L. A., Fromm, S. J., Towbin, K., Pine, D. S., & Leibenluft, E. (2010). Amygdala activation during emotion processing of neutral faces in children with severe mood dysregulation versus ADHD or bipolar disorder. American Journal of Psychiatry, 167(1), 61–69. https://doi.org/10.1176/appi.ajp.2009.09010043
Burke, J. D., Boylan, K., Rowe, R., Duku, E., Stepp, S. D., Hipwell, A. E., & Waldman, I. D. (2014). Identifying the irritability dimension of ODD: Application of a modified bifactor model across five large community samples of children. Journal of Abnormal Psychology, 123(4), 841–851. https://doi.org/10.1037/a0037898
Burney, D. M., & Kromrey, J. (2001). Initial development and score validation of the Adolescent Anger Rating Scale. Educational and Psychological Measurement, 61(3), 446–460. https://doi.org/10.1177/00131640121971310
Cardinale, E. M., Freitag, G. F., Brotman, M. A., Pine, D. S., Leibenluft, E., & Kircanski, K. (2021). Phasic versus tonic irritability: Differential associations with attention-deficit/hyperactivity disorder symptoms. Journal of the American Academy of Child & Adolescent Psychiatry. https://doi.org/10.1016/j.jaac.2020.11.022
Carlson, G. A., & Dyson, M. (2012). Diagnostic implications of informant disagreement about rage outbursts: Bipolar disorder or another condition? The Israel Journal of Psychiatry and Related Sciences, 49(1), 44–51.
Carver, C. S., & Harmon-Jones, E. (2009). Anger is an approach-related affect: Evidence and implications. Psychological Bulletin, 135(2), 183–204. https://doi.org/10.1037/a0013965
Chemtob, C. M., Novaco, R. W., Hamada, R. S., Gross, D. M., & Smith, G. (1997). Anger regulation deficits in combat-related posttraumatic stress disorder. Journal of Traumatic Stress, 10(1), 17–36. https://doi.org/10.1002/jts.2490100104
Chorpita, B. F., & Weisz, J. R. (2009). MATCH-ADTC: Modular approach to therapy for children with anxiety, depression, trauma, or conduct problems. PracticeWise.
Coccaro, E. F. (2018). DSM-5 intermittent explosive disorder: Relationship with disruptive mood dysregulation disorder. Comprehensive Psychiatry, 84, 118–121. https://doi.org/10.1016/j.comppsych.2018.04.011
Coccaro, E. F., Bergeman, C. S., Kavoussi, R. J., & Seroczynski, A. D. (1997). Heritability of aggression and irritability: A twin study of the Buss—Durkee Aggression Scales in adult male subjects. Biological Psychiatry, 41(3), 273–284. https://doi.org/10.1016/S0006-3223(96)00257-0
Coccaro, E. F., Lee, R. J., & Kavoussi, R. J. (2009). A double-blind, randomized, placebo-controlled trial of fluoxetine in patients with intermittent explosive disorder. The Journal of Clinical Psychiatry, 70(5), 653–662. https://doi.org/10.4088/JCP.08m04150
Cole, P. M., Michel, M. K., & Teti, L. O. (1994). The development of emotion regulation and dysregulation: A clinical perspective. Monographs of the Society for Research in Child Development, 59(2–3), 73–100. https://doi.org/10.2307/1166139
Comer, J. S., Olfson, M., & Mojtabai, R. (2010). National trends in child and adolescent psychotropic polypharmacy in office-based practice, 1996-2007. Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 1001–1010. https://doi.org/10.1016/j.jaac.2010.07.007
Copeland, W. E., Angold, A., Costello, E. J., & Egger, H. (2013). Prevalence, comorbidity, and correlates of DSM-5 proposed disruptive mood dysregulation disorder. American Journal of Psychiatry, 170(2), 173–179. https://doi.org/10.1176/appi.ajp.2012.12010132
Copeland, W. E., Brotman, M. A., & Costello, E. J. (2015). Normative irritability in youth: Developmental findings from the Great Smoky Mountains Study. Journal of the American Academy of Child & Adolescent Psychiatry, 54(8), 635–642. https://doi.org/10.1016/j.jaac.2015.05.008
Copeland, W. E., Shanahan, L., Egger, H., Angold, A., & Costello, E. J. (2014). Adult diagnostic and functional outcomes of DSM-5 disruptive mood dysregulation disorder. American Journal of Psychiatry, 171(6), 668–674. https://doi.org/10.1176/appi.ajp.2014.13091213
Cornacchio, D., Crum, K. I., Coxe, S., Pincus, D. B., & Comer, J. S. (2016). Irritability and severity of anxious symptomatology among youth with anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 55(1), 54–61. https://doi.org/10.1016/j.jaac.2015.10.007
Deault, L. C. (2010). A systematic review of parenting in relation to the development of comorbidities and functional impairments in children with attention-deficit/hyperactivity disorder (ADHD). Child Psychiatry & Human Development, 41(2), 168–192. https://doi.org/10.1007/s10578-009-0159-4
Delgado, M. R. (2007). Reward-related responses in the human striatum. Annals of the New York Academy of Sciences, 1104(1), 70–88. https://doi.org/10.1196/annals.1390.002
Derella, O. J., Burke, J. D., Romano-Verthelyi, A. M., Butler, E. J., & Johnston, O. G. (2020). Feasibility and acceptability of a brief cognitive-behavioral group intervention for chronic irritability in youth. Clinical Child Psychology and Psychiatry, 25(4), 778–789. https://doi.org/10.1177/1359104520918331
DeSousa, D. A., Stringaris, A., Leibenluft, E., Koller, S. H., Manfro, G. G., & Salum, G. A. (2013). Cross-cultural adaptation and preliminary psychometric properties of the Affective Reactivity Index in Brazilian youth: Implications for DSM-5 measured irritability. Trends in Psychiatry and Psychotherapy, 35(3), 171–180. https://doi.org/10.1590/S2237-60892013000300004
Deutz, M. H. F., Geeraerts, S. B., van Baar, A. L., Deković, M., & Prinzie, P. (2016). The Dysregulation Profile in middle childhood and adolescence across reporters: Factor structure, measurement invariance, and links with self-harm and suicidal ideation. European Child & Adolescent Psychiatry, 25(4), 431–442. https://doi.org/10.1007/s00787-015-0745-x
Deveney, C. M., Grasso, D., Hsu, A., Pine, D. S., Estabrook, C. R., Zobel, E., Burns, J. L., Wakschlag, L. S., & Briggs-Gowan, M. J. (2020). Multi-method assessment of irritability and differential linkages to neurophysiological indicators of attention allocation to emotional faces in young children. Developmental Psychobiology, 62(5), 600–616. https://doi.org/10.1002/dev.21930
Dickstein, D. P., Towbin, K. E., Van Der Veen, J. W., Rich, B. A., Brotman, M. A., Knopf, L., Onelio, L., Pine, D. S., & Leibenluft, E. (2009). Randomized double-blind placebo-controlled trial of lithium in youths with severe mood dysregulation. Journal of Child and Adolescent Psychopharmacology, 19(1), 61–73. https://doi.org/10.1089/cap.2008.044
Diler, R. S., Birmaher, B., Axelson, D., Goldstein, B., Gill, M., Strober, M., Kolko, D. J., Goldstein, T. R., Hunt, J., Yang, M., Ryan, N. D., Iyengar, S., Dahl, R. E., Dorn, L. D., & Keller, M. B. (2009). The Child Behavior Checklist (CBCL) and the CBCL-bipolar phenotype are not useful in diagnosing pediatric bipolar disorder. Journal of Child and Adolescent Psychopharmacology, 19(1), 23–30. https://doi.org/10.1089/cap.2008.067
Dimmock, P. W., Wyatt, K. M., Jones, P. W., & O’Brien, P. M. S. (2000). Efficacy of selective serotonin-reuptake inhibitors in premenstrual syndrome: A systematic review. The Lancet, 356(9236), 1131–1136. https://doi.org/10.1016/s0140-6736(00)02754-9
Dougherty, L. R., Galano, M. M., Chad-Friedman, E., Olino, T. M., Bufferd, S. J., & Klein, D. N. (2021). Using item response theory to compare irritability measures in early adolescent and childhood samples. Assessment, 28(3), 918–927. https://doi.org/10.1177/1073191120936363
Dougherty, L. R., Schwartz, K. T. G., Kryza-Lacombe, M., Weisberg, J., Spechler, P. A., & Wiggins, J. L. (2018). Preschool- and school-age irritability predict reward-related brain function. Journal of the American Academy of Child & Adolescent Psychiatry, 57(6), 407–417. https://doi.org/10.1016/j.jaac.2018.03.012
Dougherty, L. R., Smith, V., Bufferd, S., Carlson, G., Stringaris, A., Leibenluft, E., & Klein, D. N. (2014). DSM-5 disruptive mood dysregulation disorder: Correlates and predictors in young children. Psychological Medicine, 44(11), 2339–2350. https://doi.org/10.1017/S0033291713003115
Dougherty, L. R., Smith, V. C., Bufferd, S. J., Kessel, E. M., Carlson, G. A., & Klein, D. N. (2016). Disruptive mood dysregulation disorder at age six and clinical and functional outcomes three years later. Psychological Medicine, 46(5), 1103–1114. https://doi.org/10.1017/S0033291715002809
Dougherty, L. R., Smith, V. C., Bufferd, S. J., Stringaris, A., Leibenluft, E., Carlson, G. A., & Klein, D. N. (2013). Preschool irritability: Longitudinal associations with psychiatric disorders at age 6 and parental psychopathology. Journal of the American Academy of Child & Adolescent Psychiatry, 52(12), 1304–1313. https://doi.org/10.1016/j.jaac.2013.09.007
Drabick, D. A. G., & Gadow, K. D. (2012). Deconstructing oppositional defiant disorder: Clinic-based evidence for an anger/irritability phenotype. Journal of the American Academy of Child & Adolescent Psychiatry, 51(4), 384–393. https://doi.org/10.1016/j.jaac.2012.01.010
Dvir, Y., Ford, J. D., Hill, M., & Frazier, J. A. (2014). Childhood maltreatment, emotional dysregulation, and psychiatric comorbidities. Harvard Review of Psychiatry, 22(3), 149–161. https://doi.org/10.1097/HRP.0000000000000014
Egger, H. L., Erkanli, A., Keeler, G., Potts, E., Walter, B. K., & Angold, A. (2006). Test-retest reliability of the Preschool Age Psychiatric Assessment (PAPA). Journal of the American Academy of Child & Adolescent Psychiatry, 45(5), 538–549. https://doi.org/10.1097/01.chi.0000205705.71194.b8
Ehrenreich-May, J., Kennedy, S. M., Sherman, J. A., Bilek, E. L., Buzzella, B. A., Bennett, S. M., & Barlow, D. H. (2018). Unified protocols for transdiagnostic treatment of emotional disorders in children and adolescents: Therapist guide. Oxford University Press.
Evans, S. C., Burke, J. D., Roberts, M. C., Fite, P. J., Lochman, J. E., de la Peña, F. R., & Reed, G. M. (2017). Irritability in child and adolescent psychopathology: An integrative review for ICD-11. Clinical Psychology Review, 53, 29–45. https://doi.org/10.1016/j.cpr.2017.01.004
Evans, S. C., & Santucci, L. (2021). A modular, transdiagnostic approach to treating severe irritability in children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 30(3), 623–636. https://doi.org/10.1016/j.chc.2021.04.011
Evans, S. C., Weisz, J. R., Carvalho, A. C., Garibaldi, P. M., Bearman, S. K., Chorpita, B. F., & The Research Network on Youth Mental Health. (2020). Effects of standard and modular psychotherapies in the treatment of youth with severe irritability. Journal of Consulting and Clinical Psychology, 88(3), 255–268. https://doi.org/10.1037/ccp0000456
Eyre, O., Langley, K., Stringaris, A., Leibenluft, E., Collishaw, S., & Thapar, A. (2017). Irritability in ADHD: Associations with depression liability. Journal of Affective Disorders, 215, 281–287. https://doi.org/10.1016/j.jad.2017.03.050
Eyre, O., Riglin, L., Leibenluft, E., Stringaris, A., Collishaw, S., & Thapar, A. (2019). Irritability in ADHD: Association with later depression symptoms. European Child & Adolescent Psychiatry, 28(10), 1375–1384. https://doi.org/10.1007/s00787-019-01303-x
Ezpeleta, L., Granero, R., de la Osa, N., Trepat, E., & Domènech, J. M. (2016). Trajectories of oppositional defiant disorder irritability symptoms in preschool children. Journal of Abnormal Child Psychology, 44, 115–128. https://doi.org/10.1007/s10802-015-9972-3
Ezpeleta, L., Penelo, E., de la Osa, N., Navarro, J. B., & Trepat, E. (2019). Irritability and parenting practices as mediational variables between temperament and affective, anxiety, and oppositional defiant problems. Aggressive Behavior, 45(5), 550–560. https://doi.org/10.1002/ab.21850
Ezpeleta, L., Penelo, E., de la Osa, N., Navarro, J. B., & Trepat, E. (2020). How the Affective Reactivity Index (ARI) works for teachers as informants. Journal of Affective Disorders, 261, 40–48. https://doi.org/10.1016/j.jad.2019.09.080
Faraone, S. V., Rostain, A. L., Blader, J., Busch, B., Childress, A. C., Connor, D. F., & Newcorn, J. H. (2019). Practitioner Review: Emotional dysregulation in attention-deficit/hyperactivity disorder–implications for clinical recognition and intervention. Journal of Child Psychology and Psychiatry, 60(2), 133–150. https://doi.org/10.1111/jcpp.12899
Fava, M., & Rosenbaum, J. F. (1999). Anger attacks in patients with depression. Journal of Clinical Psychiatry, 60(Suppl 15), 21–24.
Fernandez de la Cruz, L., Simonoff, E., McGough, J. J., Halperin, J. M., Arnold, L. E., & Stringaris, A. (2015). Treatment of children with attention-deficit/hyperactivity disorder (ADHD) and irritability: Results from the Multimodal Treatment Study of Children with ADHD (MTA). Journal of the American Academy of Child & Adolescent Psychiatry, 54(1), 62–70. https://doi.org/10.1016/j.jaac.2014.10.006
Freeman, A. J., Youngstrom, E. A., Youngstrom, J. K., & Findling, R. L. (2016). Disruptive mood dysregulation disorder in a community mental health clinic: Prevalence, comorbidity and correlates. Journal of Child and Adolescent Psychopharmacology, 26(2), 123–130. https://doi.org/10.1089/cap.2015.0061
Frost, A., Jelinek, C., Bernard, K., Lind, T., & Dozier, M. (2018). Longitudinal associations between low morning cortisol in infancy and anger dysregulation in early childhood in a CPS-referred sample. Developmental Science, 21(3), Article e12573. https://doi.org/10.1111/desc.12573
Fung, L. K., Mahajan, R., Nozzolillo, A., Bernal, P., Krasner, A., Jo, B., Coury, D., Whitaker, A., Veenstra-Vanderweele, J., & Hardan, A. Y. (2016). Pharmacologic treatment of severe irritability and problem behaviors in autism: A systematic review and meta-analysis. Pediatrics, 137(Supplement 2), S124–S135. https://doi.org/10.1542/peds.2015-2851K
Galera, C., Orri, M., Vergunst, F., Melchior, M., Van der Waerden, J., Bouvard, M. P., Collet, O., Boivin, M., Tremblay, R. E., & Côté, S. M. (2021). Developmental profiles of childhood attention-deficit/hyperactivity disorder and irritability: Association with adolescent mental health, functional impairment, and suicidal outcomes. Journal of Child Psychology and Psychiatry, 62(2), 232–243. https://doi.org/10.1111/jcpp.13270
Grabell, A. S., Li, Y., Barker, J. W., Wakschlag, L. S., Huppert, T. J., & Perlman, S. B. (2018). Evidence of non-linear associations between frustration-related prefrontal cortex activation and the normal: abnormal spectrum of irritability in young children. Journal of Abnormal Child Psychology, 46(1), 137–147. https://doi.org/10.1007/s10802-017-0286-5
Guyer, A. E., McClure, E. B., Adler, A. D., Brotman, M. A., Rich, B. A., Kimes, A. S., Pine, D. S., Ernst, M., & Leibenluft, E. (2007). Specificity of facial expression labeling deficits in childhood psychopathology. Journal of Child Psychology and Psychiatry, 48(9), 863–871. https://doi.org/10.1111/j.1469-7610.2007.01758.x
Haller, S. P., Kircanski, K., Stringaris, A., Clayton, M., Bui, H., Agorsor, C., Cardenas, S. I., Towbin, K. E., Pine, D. S., Leibenluft, E., & Brotman, M. A. (2020). The Clinician Affective Reactivity Index: Validity and reliability of a clinician-rated assessment of irritability. Behavior Therapy, 51(2), 283–293. https://doi.org/10.1016/j.beth.2019.10.005
Hawks, J. L., Kennedy, S. M., Holzman, J. B. W., & Ehrenreich-May, J. (2020). Development and application of an innovative transdiagnostic treatment approach for pediatric irritability. Behavior Therapy, 51(2), 334–349. https://doi.org/10.1016/j.beth.2019.07.004
Hommer, R. E., Meyer, A., Stoddard, J., Connolly, M. E., Mogg, K., Bradley, B. P., Pine, D. S., Leibenluft, E., & Brotman, M. A. (2014). Attention bias to threat faces in severe mood dysregulation. Depression and Anxiety, 31(7), 559–565. https://doi.org/10.1002/da.22145
Hulvershorn, L. A., Mennes, M., Castellanos, F. X., Di Martino, A., Milham, M. P., Hummer, T. A., & Roy, A. K. (2014). Abnormal amygdala functional connectivity associated with emotional lability in children with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 53(3), 351–361. https://doi.org/10.1016/j.jaac.2013.11.012
Kalvin, C. B., Gladstone, T. R., Jordan, R., Rowley, S., Marsh, C. L., Ibrahim, K., & Sukhodolsky, D. G. (2021). Assessing irritability in children with autism spectrum disorder using the Affective Reactivity Index. Journal of Autism and Developmental Disorders, 51(5), 1496–1507. https://doi.org/10.1007/s10803-020-04627-9
Karalunas, S. L., Gustafsson, H. C., Fair, D., Musser, E. D., & Nigg, J. T. (2019). Do we need an irritable subtype of ADHD? Replication and extension of a promising temperament profile approach to ADHD subtyping. Psychological Assessment, 31(2), 236–247. https://doi.org/10.1037/pas0000664
Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., Williamson, D., & Ryan, N. (1997). Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child & Adolescent Psychiatry, 36(7), 980–988. https://doi.org/10.1097/00004583-199707000-00021
Keluskar, J., Reicher, D., Gorecki, A., Mazefsky, C., & Crowell, J. A. (2021). Understanding, assessing, and intervening with emotion dysregulation in autism spectrum disorder: A developmental perspective. Child and Adolescent Psychiatric Clinics of North America, 30(2), 335–348. https://doi.org/10.1016/j.chc.2020.10.013
Kessler, R. C., Amminger, G. P., Aguilar-Gaxiola, S., Alonso, J., Lee, S., & Üstün, T. B. (2007). Age of onset of mental disorders: A review of recent literature. Current Opinion in Psychiatry, 20(4), 359–364. https://doi.org/10.1097/YCO.0b013e32816ebc8c
Kim, J., Carlson, G. A., Meyer, S. E., Bufferd, S. J., Dougherty, L. R., Dyson, M. W., Laptook, R. S., Olino, T. M., & Klein, D. N. (2012). Correlates of the CBCL-Dysregulation Profile in preschool-aged children. Journal of Child Psychology and Psychiatry, 53(9), 918–926. https://doi.org/10.1111/j.1469-7610.2012.02546.x
Kim, S., & Boylan, K. (2016). Effectiveness of antidepressant medications for symptoms of irritability and disruptive behaviors in children and adolescents. Journal of Child and Adolescent Psychopharmacology, 26(8), 694–704. https://doi.org/10.1089/cap.2015.0127
Kircanski, K., Craske, M. G., Averbeck, B. B., Pine, D. S., Leibenluft, E., & Brotman, M. A. (2019). Exposure therapy for pediatric irritability: Theory and potential mechanisms. Behaviour Research and Therapy, 118, 141–149. https://doi.org/10.1016/j.brat.2019.04.007
Kopp, C. B. (1989). Regulation of distress and negative emotions: A developmental view. Developmental Psychology, 25(3), 343–354. https://doi.org/10.1037/0012-1649.25.3.343
Kryza-Lacombe, M., Hernandez, B., Owen, C., Reynolds, R. C., Wakschlag, L. S., Dougherty, L. R., & Wiggins, J. L. (2021). Neural mechanisms of reward processing in adolescent irritability. Developmental Psychobiology. https://doi.org/10.1002/dev.22090
Laporte, P. P., Matijasevich, A., Munhoz, T. N., Santos, I. S., Barros, A. J. D., Pine, D. S., Rohde, L. A., Leibenluft, E., & Salum, G. A. (2021). Disruptive mood dysregulation disorder: Symptomatic and syndromic thresholds and diagnostic operationalization. Journal of the American Academy of Child & Adolescent Psychiatry, 60(2), 286–295. https://doi.org/10.1016/j.jaac.2019.12.008
Leibenluft, E. (2011). Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youths. American Journal of Psychiatry, 168(2), 129–142. https://doi.org/10.1176/appi.ajp.2010.10050766
Leibenluft, E., Charney, D. S., Towbin, K. E., Bhangoo, R. K., & Pine, D. S. (2003). Defining clinical phenotypes of juvenile mania. American Journal of Psychiatry, 160(3), 430–437. https://doi.org/10.1176/appi.ajp.160.3.430
Leibenluft, E., Cohen, P., Gorrindo, T., Brook, J. S., & Pine, D. S. (2006). Chronic versus episodic irritability in youth: A community-based, longitudinal study of clinical and diagnostic associations. Journal of Child & Adolescent Psychopharmacology, 16(4), 456–466. https://doi.org/10.1089/cap.2006.16.456
Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Publications.
Linke, J., Kircanski, K., Brooks, J., Perhamus, G., Gold, A. L., & Brotman, M. A. (2020). Exposure-based cognitive-behavioral therapy for disruptive mood dysregulation disorder: An evidence-based case study. Behavior Therapy, 51(2), 320–333. https://doi.org/10.1016/j.beth.2019.05.007
Lochman, J. E., Evans, S. C., Burke, J. D., Roberts, M. C., Fite, P. J., Reed, G. M., De La Peña, F. R., Matthys, W., Ezpeleta, L., Siddiqui, S., & Garralda, M. E. (2015). An empirically based alternative to DSM-5’s disruptive mood dysregulation disorder for ICD-11. World Psychiatry, 14(1), 30–33. https://doi.org/10.1002/wps.20176
Manning, B. L., Roberts, M. Y., Estabrook, R., Petitclerc, A., Burns, J. L., Briggs-Gowan, M., Wakschlag, L. S., & Norton, E. S. (2019). Relations between toddler expressive language and temper tantrums in a community sample. Journal of Applied Developmental Psychology, 65, Article 101070. https://doi.org/10.1016/j.appdev.2019.101070
Martin, F., Pinnow, M., Getzmann, S., Hans, S., Holtmann, M., & Legenbauer, T. (2021). Turning to the negative: Attention allocation to emotional faces in adolescents with dysregulation profile–An event-related potential study. Journal of Neural Transmission, 128(3), 381–392. https://doi.org/10.1007/s00702-021-02319-x
Masi, G., Pisano, S., Milone, A., & Muratori, P. (2015). Child Behavior Checklist Dysregulation Profile in children with disruptive behavior disorders: A longitudinal study. Journal of Affective Disorders, 186, 249–253. https://doi.org/10.1016/j.jad.2015.05.069
Massey, S. H., Clark, C. A. C., Sun, M. Y., Burns, J. L., Mroczek, D. K., Espy, K. A., & Wakschlag, L. S. (2020). Dimension- and context-specific expression of preschoolers’ disruptive behaviors associated with prenatal tobacco exposure. Neurotoxicology and Teratology, 81, Article 106915. https://doi.org/10.1016/j.ntt.2020.106915
Mayes, S. D., Calhoun, S. L., Murray, M. J., Ahuja, M., & Smith, L. A. (2011). Anxiety, depression, and irritability in children with autism relative to other neuropsychiatric disorders and typical development. Research in Autism Spectrum Disorders, 5(1), 474–485. https://doi.org/10.1016/j.rasd.2010.06.012
Mayes, S. D., Lockridge, R., & Tierney, C. D. (2017). Tantrums are not associated with speech or language deficits in preschool children with autism. Journal of Developmental and Physical Disabilities, 29(4), 587–596. https://doi.org/10.1007/s10882-017-9546-0
Mayes, S. D., Mathiowetz, C., Kokotovich, C., Waxmonsky, J., Baweja, R., Calhoun, S. L., & Bixler, E. O. (2015a). Stability of disruptive mood dysregulation disorder symptoms (irritable-angry mood and temper outbursts) throughout childhood and adolescence in a general population sample. Journal of Abnormal Child Psychology, 43(8), 1543–1549. https://doi.org/10.1007/s10802-015-0033-8
Mayes, S. D., Waxmonsky, J., Calhoun, S. L., Kokotovich, C., Mathiowetz, C., & Baweja, R. (2015b). Disruptive mood dysregulation disorder (DMDD) symptoms in children with autism, ADHD, and neurotypical development and impact of co-occurring ODD, depression, and anxiety. Research in Autism Spectrum Disorders, 18, 64–72. https://doi.org/10.1016/j.rasd.2015.07.003
Mayes, S. D., Waxmonsky, J. D., Calhoun, S. L., & Bixler, E. O. (2016). Disruptive mood dysregulation disorder symptoms and association with oppositional defiant and other disorders in a general population child sample. Journal of Child and Adolescent Psychopharmacology, 26(2), 101–106. https://doi.org/10.1089/cap.2015.0074
Mazefsky, C. A., Herrington, J., Siegel, M., Scarpa, A., Maddox, B. B., Scahill, L., & White, S. W. (2013). The role of emotion regulation in autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 52(7), 679–688. https://doi.org/10.1016/j.jaac.2013.05.006
Mbekou, V., Gignac, M., MacNeil, S., Mackay, P., & Renaud, J. (2014). The CBCL dysregulated profile: An indicator of pediatric bipolar disorder or of psychopathology severity? Journal of Affective Disorders, 155, 299–302. https://doi.org/10.1016/j.jad.2013.10.033
McClellan, J., Kowatch, R., Findling, R. L., & Work Group on Quality Issues. (2007). Practice parameter for the assessment and treatment of children and adolescents with bipolar disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 46(1), 107–125. https://doi.org/10.1097/01.chi.0000242240.69678.c4
McDonnell, C. G., Boan, A. D., Bradley, C. C., Seay, K. D., Charles, J. M., & Carpenter, L. A. (2019). Child maltreatment in autism spectrum disorder and intellectual disability: Results from a population-based sample. Journal of Child Psychology and Psychiatry, 60(5), 576–584. https://doi.org/10.1111/jcpp.12993
McGuire, K., Fung, L. K., Hagopian, L., Vasa, R. A., Mahajan, R., Bernal, P., Silberman, A. E., Wolfe, A., Coury, D. L., Hardan, A. Y., Veenstra-Vanderweele, J., & Whitaker, A. H. (2016). Irritability and problem behavior in autism spectrum disorder: A practice pathway for pediatric primary care. Pediatrics, 137(Supplement 2), S136–S148. https://doi.org/10.1542/peds.2015-2851L
McLaughlin, K. A., Green, J. G., Hwang, I., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2012). Intermittent explosive disorder in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(11), 1131–1139. https://doi.org/10.1001/archgenpsychiatry.2012.592
Melvin, G. A., Tonge, B. J., Mulraney, M., Gordon, M., Taffe, J., & Klimkeit, E. (2018). The Cranky Thermometers: Visual analogue scales measuring irritability in youth. Journal of Adolescence, 64, 146–154. https://doi.org/10.1016/j.adolescence.2018.02.008
Moreno, C., Laje, G., Blanco, C., Jiang, H., Schmidt, A. B., & Olfson, M. (2007). National trends in the outpatient diagnosis and treatment of bipolar disorder in youth. Archives of General Psychiatry, 64(9), 1032–1039. https://doi.org/10.1001/archpsyc.64.9.1032
Mroczkowski, M. M., McReynolds, L. S., Fisher, P., & Wasserman, G. A. (2018). Disruptive mood dysregulation disorder in juvenile justice. The Journal of the American Academy of Psychiatry and the Law, 46(3), 329–338.
Mulraney, M. A., Melvin, G. A., & Tonge, B. J. (2014). Psychometric properties of the Affective Reactivity Index in Australian adults and adolescents. Psychological Assessment, 26(1), 148–155. https://doi.org/10.1037/a0034891
Nickerson, A., Aderka, I. M., Bryant, R. A., & Hofmann, S. G. (2012). The relationship between childhood exposure to trauma and intermittent explosive disorder. Psychiatry Research, 197(1-2), 128–134. https://doi.org/10.1016/j.psychres.2012.01.012
Nigg, J. T., Karalunas, S. L., Gustafsson, H. C., Bhatt, P., Ryabinin, P., Mooney, M. A., Faraone, S. V., Fair, D. A., & Wilmot, B. (2020). Evaluating chronic emotional dysregulation and irritability in relation to ADHD and depression genetic risk in children with ADHD. Journal of Child Psychology and Psychiatry, 61(2), 205–214. https://doi.org/10.1111/jcpp.13132
Olfson, M., Blanco, C., Liu, L., Moreno, C., & Laje, G. (2006). National trends in the outpatient treatment of children and adolescents with antipsychotic drugs. Archives of General Psychiatry, 63(6), 679–685. https://doi.org/10.1001/archpsyc.63.6.679
Pan, P.-Y., Fu, A.-T., & Yeh, C.-B. (2018). Aripiprazole/methylphenidate combination in children and adolescents with disruptive mood dysregulation disorder and attention-deficit/hyperactivity disorder: An open-label study. Journal of Child and Adolescent Psychopharmacology, 28(10), 682–689. https://doi.org/10.1089/cap.2018.0068
Pan, P.-Y., & Yeh, C.-B. (2019). Irritability and maladaptation among children: The utility of Chinese versions of the Affective Reactivity Index and Aberrant Behavior Checklist-Irritability Subscale. Journal of Child and Adolescent Psychopharmacology, 29(3), 213–219. https://doi.org/10.1089/cap.2018.0070
Papachristou, E., Schulz, K., Newcorn, J., Bédard, A.-C. V., Halperin, J. M., & Frangou, S. (2016). Comparative evaluation of Child Behavior Checklist-derived scales in children clinically referred for emotional and behavioral dysregulation. Frontiers in Psychiatry, 7, Article 146. https://doi.org/10.3389/fpsyt.2016.00146
Patterson, G. R. (1982). Coercive family process. Castalia.
Perepletchikova, F., Nathanson, D., Axelrod, S. R., Merrill, C., Walker, A., Grossman, M., Rebeta, J., Scahill, L., Kaufman, J., Flye, B., Mauer, E., & Walkup, J. (2017). Randomized clinical trial of dialectical behavior therapy for preadolescent children with disruptive mood dysregulation disorder: Feasibility and outcomes. Journal of the American Academy of Child & Adolescent Psychiatry, 56(10), 832–840. https://doi.org/10.1016/j.jaac.2017.07.789
Perlman, S. B., Jones, B. M., Wakschlag, L. S., Axelson, D., Birmaher, B., & Phillips, M. L. (2015). Neural substrates of child irritability in typically developing and psychiatric populations. Developmental Cognitive Neuroscience, 14, 71–80. https://doi.org/10.1016/j.dcn.2015.07.003
Perlman, S. B., Luna, B., Hein, T. C., & Huppert, T. J. (2014). fNIRS evidence of prefrontal regulation of frustration in early childhood. Neuroimage, 85, 326–334. https://doi.org/10.1016/j.neuroimage.2013.04.057
Peterson, B. S., Zhang, H., Santa Lucia, R., King, R. A., & Lewis, M. (1996). Risk factors for presenting problems in child psychiatric emergencies. Journal of the American Academy of Child & Adolescent Psychiatry, 35(9), 1162–1173. https://doi.org/10.1097/00004583-199609000-00014
Potegal, M. (2019). On being mad, sad, and very young. In A. K. Roy, M. A. Brotman, & E. Leibenluft (Eds.), Irritability in pediatric psychopathology (pp. 105–145). Oxford University Press. https://doi.org/10.1093/med-psych/9780190846800.003.0007
Radwan, K., & Coccaro, E. F. (2020). Comorbidity of disruptive behavior disorders and intermittent explosive disorder. Child and Adolescent Psychiatry and Mental. Health, 14, Article 24. https://doi.org/10.1186/s13034-020-00330-w
Regier, D. A., Narrow, W. E., Clarke, D. E., Kraemer, H. C., Kuramoto, S. J., Kuhl, E. A., & Kupfer, D. J. (2013). DSM-5 field trials in the United States and Canada, Part II: Test-retest reliability of selected categorical diagnoses. American Journal of Psychiatry, 170(1), 59–70. https://doi.org/10.1176/appi.ajp.2012.12070999
Rich, B. A., Grimley, M. E., Schmajuk, M., Blair, K. S., Blair, R. J. R., & Leibenluft, E. (2008). Face emotion labeling deficits in children with bipolar disorder and severe mood dysregulation. Development and Psychopathology, 20(2), 529–546. https://doi.org/10.1017/S0954579408000266
Riglin, L., Eyre, O., Cooper, M., Collishaw, S., Martin, J., Langley, K., Leibenluft, E., Stringaris, A., Thapar, A. K., Maughan, B., O’Donovan, M. C., & Thapar, A. (2017). Investigating the genetic underpinnings of early-life irritability. Translational Psychiatry, 7(9), Article e1241. https://doi.org/10.1038/tp.2017.212
Rowe, R., Costello, E. J., Angold, A., Copeland, W. E., & Maughan, B. (2010). Developmental pathways in oppositional defiant disorder and conduct disorder. Journal of Abnormal Psychology, 119(4), 726–738. https://doi.org/10.1037/a0020798
Roy, A. K., Bennett, R., Posner, J., Hulvershorn, L., Castellanos, F. X., & Klein, R. G. (2018). Altered intrinsic functional connectivity of the cingulate cortex in children with severe temper outbursts. Development and Psychopathology, 30(2), 571–579. https://doi.org/10.1017/S0954579417001080
Roy, A. K., & Comer, J. S. (2020). Advances in the conceptualization, assessment, and treatment of pediatric irritability. Behavior Therapy, 51(2), 207–210. https://doi.org/10.1016/j.beth.2019.10.010
Roy, A. K., Lopes, V., & Klein, R. G. (2014). Disruptive mood dysregulation disorder: A new diagnostic approach to chronic irritability in youth. American Journal of Psychiatry, 171(9), 918–924. https://doi.org/10.1176/appi.ajp.2014.13101301
Salum, G. A., Mogg, K., Bradley, B. P., Stringaris, A., Gadelha, A., Pan, P. M., Rohde, L. A., Polanczyk, G. V., Manfro, G. G., Pine, D. S., & Leibenluft, E. (2017). Association between irritability and bias in attention orienting to threat in children and adolescents. Journal of Child Psychology and Psychiatry, 58(5), 595–602. https://doi.org/10.1111/jcpp.12659
Savage, J., Verhulst, B., Copeland, W., Althoff, R. R., Lichtenstein, P., & Roberson-Nay, R. (2015). A genetically informed study of the longitudinal relation between irritability and anxious/depressed symptoms. Journal of the American Academy of Child & Adolescent Psychiatry, 54(5), 377–384. https://doi.org/10.1016/j.jaac.2015.02.010
Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotion dysregulation in attention deficit hyperactivity disorder. American Journal of Psychiatry, 171(3), 276–293. https://doi.org/10.1176/appi.ajp.2013.13070966
Shimshoni, Y., Lebowitz, E. R., Brotman, M. A., Pine, D. S., Leibenluft, E., & Silverman, W. K. (2020). Anxious-irritable children: A distinct subtype of childhood anxiety? Behavior Therapy, 51(2), 211–222. https://doi.org/10.1016/j.beth.2019.06.005
Snaith, R. P., & Taylor, C. M. (1985). Irritability: Definition, assessment and associated factors. The British Journal of Psychiatry, 147(2), 127–136. https://doi.org/10.1192/bjp.147.2.127
Steinberg, E. A., & Drabick, D. A. G. (2015). A developmental psychopathology perspective on ADHD and comorbid conditions: The role of emotion regulation. Child Psychiatry & Human Development, 46(6), 951–966. https://doi.org/10.1007/s10578-015-0534-2
Stoddard, J., Stringaris, A., Brotman, M. A., Montville, D., Pine, D. S., & Leibenluft, E. (2014). Irritability in child and adolescent anxiety disorders. Depression and Anxiety, 31(7), 566–573. https://doi.org/10.1002/da.22151
Stoddard, J., Tseng, W.-L., Kim, P., Chen, G., Yi, J., Donahue, L., Brotman, M. A., Towbin, K. E., Pine, D. S., & Leibenluft, E. (2017). Association of irritability and anxiety with the neural mechanisms of implicit face emotion processing in youths with psychopathology. JAMA Psychiatry, 74(1), 95–103. https://doi.org/10.1001/jamapsychiatry.2016.3282
Storch, E. A., Jones, A. M., Lack, C. W., Ale, C. M., Sulkowski, M. L., Lewin, A. B., De Nadai, A. S., & Murphy, T. K. (2012). Rage attacks in pediatric obsessive-compulsive disorder: Phenomenology and clinical correlates. Journal of the American Academy of Child & Adolescent Psychiatry, 51(6), 582–592. https://doi.org/10.1016/j.jaac.2012.02.016
Stringaris, A., Cohen, P., Pine, D. S., & Leibenluft, E. (2009). Adult outcomes of youth irritability: A 20-year prospective community-based study. American Journal of Psychiatry, 166(9), 1048–1054. https://doi.org/10.1176/appi.ajp.2009.08121849
Stringaris, A., & Goodman, R. (2009a). Longitudinal outcome of youth oppositionality: Irritable, headstrong, and hurtful behaviors have distinctive predictions. Journal of the American Academy of Child & Adolescent Psychiatry, 48(4), 404–412. https://doi.org/10.1097/CHI.0b013e3181984f30
Stringaris, A., & Goodman, R. (2009b). Three dimensions of oppositionality in youth. Journal of Child Psychology and Psychiatry, 50(3), 216–223. https://doi.org/10.1111/j.1469-7610.2008.01989.x
Stringaris, A., Goodman, R., Ferdinando, S., Razdan, V., Muhrer, E., Leibenluft, E., & Brotman, M. A. (2012a). The Affective Reactivity Index: A concise irritability scale for clinical and research settings. Journal of Child Psychology and Psychiatry, 53(11), 1109–1117. https://doi.org/10.1111/j.1469-7610.2012.02561.x
Stringaris, A., Maughan, B., Copeland, W. S., Costello, E. J., & Angold, A. (2013). Irritable mood as a symptom of depression in youth: Prevalence, developmental, and clinical correlates in the Great Smoky Mountains Study. Journal of the American Academy of Child & Adolescent Psychiatry, 52(8), 831–840. https://doi.org/10.1016/j.jaac.2013.05.017
Stringaris, A., Vidal-Ribas, P., Brotman, M. A., & Leibenluft, E. (2018). Practitioner review: Definition, recognition, and treatment challenges of irritability in young people. Journal of Child Psychology and Psychiatry, 59(7), 721–739. https://doi.org/10.1111/jcpp.12823
Stringaris, A., Zavos, H., Leibenluft, E., Maughan, B., & Eley, T. C. (2012b). Adolescent irritability: Phenotypic associations and genetic links with depressed mood. American Journal of Psychiatry, 169(1), 47–54. https://doi.org/10.1176/appi.ajp.2011.10101549
Sugaya, L. S., Kircanski, K., Stringaris, A., Polanczyk, G. V., & Leibenluft, E. (2021). Validation of an irritability measure in preschoolers in school-based and clinical Brazilian samples. European Child & Adolescent Psychiatry. https://doi.org/10.1007/s00787-020-01701-6
Sukhodolsky, D. G., Smith, S. D., McCauley, S. A., Ibrahim, K., & Piasecka, J. B. (2016). Behavioral interventions for anger, irritability, and aggression in children and adolescents. Journal of Child and Adolescent Psychopharmacology, 26(1), 58–64. https://doi.org/10.1089/cap.2015.0120
Thomas, L. A., Kim, P., Bones, B. L., Hinton, K. E., Milch, H. S., Reynolds, R. C., Adleman, N. E., Marsh, A. A., Blair, R. J. R., Pine, D. S., & Leibenluft, E. (2013). Elevated amygdala responses to emotional faces in youths with chronic irritability or bipolar disorder. NeuroImage: Clinical, 2, 637–645. https://doi.org/10.1016/j.nicl.2013.04.007
Tseng, W.-L., Deveney, C. M., Stoddard, J., Kircanski, K., Frackman, A. E., Yi, J. Y., Hsu, D., Moroney, E., Machlin, L., Donahue, L., Roule, A. L., Permahus, G., Reynolds, R. C., Roberson-Nay, R., Hettema, J. M., Towbin, K. E., Stringaris, A., Pine, D. S., Brotman, M. A., & Leibenluft, E. (2019). Brain mechanisms of attention orienting following frustration: Associations with irritability and age in youths. American Journal of Psychiatry, 176(1), 67–76. https://doi.org/10.1176/appi.ajp.2018.18040491
Tseng, W.-L., Moroney, E., Machlin, L., Roberson-Nay, R., Hettema, J. M., Carney, D., Stoddard, J., Towbin, K. A., Pine, D. S., Leibenluft, E., & Brotman, M. A. (2017). Test-retest reliability and validity of a frustration paradigm and irritability measures. Journal of Affective Disorders, 212, 38–45. https://doi.org/10.1016/j.jad.2017.01.024
Vidal-Ribas, P., Brotman, M. A., Valdivieso, I., Leibenluft, E., & Stringaris, A. (2016). The status of irritability in psychiatry: A conceptual and quantitative review. Journal of the American Academy of Child & Adolescent Psychiatry, 55(7), 556–570. https://doi.org/10.1016/j.jaac.2016.04.014
Vidal-Ribas, P., & Stringaris, A. (2021). How and why are irritability and depression linked? Child and Adolescent Psychiatric Clinics of North America, 30(2), 401–414. https://doi.org/10.1016/j.chc.2020.10.009
Wakschlag, L. S., Briggs-Gowan, M. J., Choi, S. W., Nichols, S. R., Kestler, J., Burns, J. L., Carter, A. S., & Henry, D. (2014). Advancing a multidimensional, developmental spectrum approach to preschool disruptive behavior. Journal of the American Academy of Child & Adolescent Psychiatry, 53(1), 82–96. https://doi.org/10.1016/j.jaac.2013.10.011
Wakschlag, L. S., Briggs-Gowan, M. J., Hill, C., Danis, B., Leventhal, B. L., Keenan, K., Egger, H. L., Cicchetti, D., Burns, J., & Carter, A. S. (2008a). Observational assessment of preschool disruptive behavior, Part II: Validity of the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS). Journal of the American Academy of Child & Adolescent Psychiatry, 47(6), 632–641. https://doi.org/10.1097/CHI.0b013e31816c5c10
Wakschlag, L. S., Choi, S. W., Carter, A. S., Hullsiek, H., Burns, J., McCarthy, K., Leibenluft, E., & Briggs-Gowan, M. J. (2012). Defining the developmental parameters of temper loss in early childhood: Implications for developmental psychopathology. Journal of Child Psychology and Psychiatry, 53(11), 1099–1108. https://doi.org/10.1111/j.1469-7610.2012.02595.x
Wakschlag, L. S., Hill, C., Carter, A. S., Danis, B., Egger, H. L., Keenan, K., Leventhal, B. L., Cicchetti, D., Maskowitz, K., Burns, J., & Briggs-Gowan, M. J. (2008b). Observational assessment of preschool disruptive behavior, Part I: Reliability of the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS). Journal of the American Academy of Child & Adolescent Psychiatry, 47(6), 622–631. https://doi.org/10.1097/CHI.0b013e31816c5bdb
Wakschlag, L. S., Krogh-Jespersen, S., Estabrook, R., Hlutkowsky, C. O., Anderson, E. L., Burns, J., Briggs-Gowan, M. J., Petitclerc, A., & Perlman, S. B. (2020). The Early Childhood Irritability-Related Impairment Interview (E-CRI): A novel method for assessing young children’s developmentally impairing irritability. Behavior Therapy, 51(2), 294–309. https://doi.org/10.1016/j.beth.2019.07.008
Wakschlag, L. S., Leventhal, B. L., Briggs-Gowan, M. J., Danis, B., Keenan, K., Hill, C., Egger, H. L., Cicchetti, D., & Carter, A. S. (2005). Defining the “disruptive” in preschool behavior: What diagnostic observation can teach us. Clinical Child and Family Psychology Review, 8(3), 183–201. https://doi.org/10.1007/s10567-005-6664-5
Walkup, J. T., Friedland, S. J., Peris, T. S., & Strawn, J. R. (2021). Dysregulation, catastrophic reactions, and the anxiety disorders. Child and Adolescent Psychiatric Clinics of North America, 30(2), 431–444. https://doi.org/10.1016/j.chc.2020.10.011
Waxmonsky, J. G., Waschbusch, D. A., Belin, P., Li, T., Babocsai, L., Humphery, H., Pariseau, M. E., Babinski, D. E., Hoffman, M. T., Haak, J. L., Mazzant, J. R., Fabiano, G. A., Pettit, J. W., Fallahazad, N., & Pelham, W. E. (2016). A randomized clinical trial of an integrative group therapy for children with severe mood dysregulation. Journal of the American Academy of Child & Adolescent Psychiatry, 55(3), 196–207. https://doi.org/10.1016/j.jaac.2015.12.011
Whelan, Y. M., Leibenluft, E., Stringaris, A., & Barker, E. D. (2015). Pathways from maternal depressive symptoms to adolescent depressive symptoms: The unique contribution of irritability symptoms. Journal of Child Psychology and Psychiatry, 56(10), 1092–1100. https://doi.org/10.1111/jcpp.12395
Wiggins, J. L., Briggs-Gowan, M. J., Brotman, M. A., Leibenluft, E., & Wakschlag, L. S. (2021). Toward a developmental nosology for disruptive mood dysregulation disorder in early childhood. Journal of the American Academy of Child & Adolescent Psychiatry, 60(3), 388–397. https://doi.org/10.1016/j.jaac.2020.04.015
Wiggins, J. L., Briggs-Gowan, M. J., Estabrook, R., Brotman, M. A., Pine, D. S., Leibenluft, E., & Wakschlag, L. S. (2018). Identifying clinically significant irritability in early childhood. Journal of the American Academy of Child & Adolescent Psychiatry, 57(3), 191–199. https://doi.org/10.1016/j.jaac.2017.12.008
Wiggins, J. L., Mitchell, C., Stringaris, A., & Leibenluft, E. (2014). Developmental trajectories of irritability and bidirectional associations with maternal depression. Journal of the American Academy of Child & Adolescent Psychiatry, 53(11), 1191–1205. https://doi.org/10.1016/j.jaac.2014.08.005
World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.). WHO. https://icd.who.int/en
Wozniak, J., Biederman, J., Kiely, K., Ablon, J. S., Faraone, S. V., Mundy, E., & Mennin, D. (1995). Mania-like symptoms suggestive of childhood-onset bipolar disorder in clinically referred children. Journal of the American Academy of Child & Adolescent Psychiatry, 34(7), 867–876. https://doi.org/10.1097/00004583-199507000-00010
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Hirsch, E., Benda, M., Garvey, R.W., Roy, A.K. (2023). Irritability. In: Matson, J.L. (eds) Handbook of Clinical Child Psychology. Autism and Child Psychopathology Series. Springer, Cham. https://doi.org/10.1007/978-3-031-24926-6_11
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