Understanding Irritability in Relation to Anger, Aggression, and Informant in a Pediatric Clinical Population - 25/04/22
, Christen M. Deveney, PhD b, Jarrod M. Ellingson, PhD c, Simone P. Haller, PhD d, Katharina Kircanski, PhD d, Elise M. Cardinale, PhD d, Melissa A. Brotman, PhD d, Joel Stoddard, MD, MAS aAbstract |
Objective |
Despite its clinical relevance to pediatric mental health, the relationship of irritability with anger and aggression remains unclear. We aimed to quantify the relationships between well-validated, commonly used measurements of these constructs and informant effects in a clinically relevant population.
Method |
A total of 195 children with primary diagnoses of attention-deficit/hyperactivity disorder, disruptive mood dysregulation disorder, or no major disorder and their parents rate irritability, anger, and aggression on measures of each construct. Construct and informant relationships were mapped via multi-trait, multi-method factor analysis.
Results |
Parent- and child-reported irritability and child-reported anger are highly associated (r = 0.89) but have some significant differences. Irritability overlaps with outward expression of anger but diverges from anger in anger suppression and control. Aggression has weaker associations with both irritability (r = 0.56) and anger (r = 0.49). Across measures, informant source explains a substantial portion of response variance.
Conclusion |
Irritability, albeit distinct from aggression, is highly associated with anger, with notable overlap in child-reported outward expression of anger, providing empirical support for formulations of clinical irritability as a proneness to express anger outwardly. Diagnostic and clinical intervention work on this facet of anger can likely translate to irritability. Further research on external validation of divergence of these constructs in anger suppression and control may guide future scale revisions. The proportion of response variance attributable to informant may be an under-recognized confound in clinical research and construct measurement.
Le texte complet de cet article est disponible en PDF.Key words : irritability, anger, aggression, informant discrepancy
Plan
| This article was reviewed under and accepted by ad hoc editor Manpreet Kaur Singh, MD, MS. |
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| This research was supported by the Intramural Research Program of the National Institute of Mental Health (NIMH; ZIAMH002786) via data collected under the National Institutes of Health (NIH) Clinical Study Protocols 00-M-0198 and 02-M-021 (ClinicalTrials.gov ID: NCT00006177 and NCT00025935). Drs. Stoddard and Zik were supported by the Pediatric Mental Health Institute at Children’s Hospital Colorado and the Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Colorado School of Medicine. Dr. Zik was a member of the Pathways Resident Research Track, Department of Psychiatry, University of Colorado School of Medicine, which is supported by a NIMH grant (R25MH125758). Dr. Stoddard was supported by a grant from NIMH (K23MH113731), and Dr. Ellingson by a grant from the National Institute of Alcohol Abuse and Alcoholism (NIAAA; K23AA026635). The funding sources were not involved in study design; the collection, analysis, or interpretation of data; writing of the report; or the decision to submit the article for publication. |
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| Drs. Stoddard, Ellingson, and Haller served as the statistical experts for this research. |
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| Author Contributions Conceptualization: Zik, Deveney Data curation: Zik, Kircanski, Cardinale Formal analysis: Zik, Ellingson, Stoddard Funding acquisition: Ellingson, Stoddard Methodology: Stoddard Resources: Kircanski Supervision: Deveney, Stoddard Validation: Ellingson Writing – original draft: Zik Writing – review and editing: Zik, Deveney, Haller, Kircanski, Brotman, Stoddard |
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| Disclosure: Dr. Haller has received grant support through a Brain and Behavior Research Foundation (BBRF) Young Investigator Award. Dr. Brotman has served as a principal investigator (PI) on two Bench-to-Bedside grants from NIH. Dr. Stoddard has received grant or research support from NIMH BBRF. He has served as a DSMB committee member: Threat Interpretation Bias as Cognitive Marker and Treatment Target in Pediatric Anxiety (R61 Phase). Drs. Zik, Deveney, Ellingson, Kircanski, and Cardinale have reported no biomedical financial interests or potential conflicts of interest. |
Vol 61 - N° 5
P. 711-720 - mai 2022 Retour au numéro
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