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Dimensions of irritability in adolescents: longitudinal associations with psychopathology in adulthood

Published online by Cambridge University Press:  22 October 2019

Mariah T. Hawes ,
Gabrielle A. Carlson ,
Megan C. Finsaas ,
Thomas M. Olino ,
John R. Seely  and
Daniel N. Klein
Mariah T. Hawes*
Affiliation:
Stony Brook University, Stony Brook, NY, USA
Gabrielle A. Carlson
Affiliation:
Stony Brook University Medical Center, Stony Brook, NY, USA
Megan C. Finsaas
Affiliation:
Stony Brook University, Stony Brook, NY, USA
Thomas M. Olino
Affiliation:
Temple University, Philadelphia, PA, USA
John R. Seely
Affiliation:
University of Oregon, Eugene, OR, USA
Daniel N. Klein
Affiliation:
Stony Brook University, Stony Brook, NY, USA
*
Author for correspondence: Mariah T. Hawes, E-mail: [email protected]
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Abstract

Background

There is an emerging consensus in developmental psychopathology that irritable youth are at risk for developing internalizing problems later in life. The current study explored if irritability in youth is multifactorial and the impact of irritability dimensions on psychopathology outcomes in adulthood.

Methods

We conducted exploratory factor analysis on irritability symptom items from a semi-structured diagnostic interview administered to a community sample of adolescents (ages 14–19; 42.7% male; 89.1% white). The analysis identified two factors corresponding to items from the mood disorders v. the oppositional defiant disorder (ODD) (Leibenluft and Stoddard) sections of the interview. These factors were then entered together into regression models predicting psychopathology assessed at age 24 (N = 941) and again at age 30 (N = 816). All models controlled for concurrent psychopathology in youth.

Results

The two irritability dimensions demonstrated different patterns of prospective relationships, with items from the ODD section primarily predicting externalizing psychopathology, items from the mood disorder sections predicting depression at age 24 but not 30, and both dimensions predicting borderline personality disorder symptoms.

Conclusions

These results suggest that the current standard of extracting and compositing irritability symptom items from diagnostic interviews masks distinct dimensions of irritability with different psychopathological outcomes. Additionally, these findings add nuance to the prevailing notion that irritability in youth is specifically linked to later internalizing problems. Further investigation using more sensitive and multifaceted measures of irritability are needed to parse the meaning and clinical implications of these dimensions.

Keywords

Adolescentsdevelopmental psychopathologyexternalizing disorderinternalizing disordersirritability
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 16 , December 2020 , pp. 2759 - 2767
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Copyright
Copyright © Cambridge University Press 2019

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