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Harold R, Hill KE, Kamat R, Perlman G, Kotov R, Ruggero CJ, Samuel DB, Foti D. Error-related brain activity shapes the association between trait neuroticism and internalizing symptomatology in two tasks. Int J Psychophysiol 2024; 204:112404. [PMID: 39047794 PMCID: PMC11384294 DOI: 10.1016/j.ijpsycho.2024.112404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 06/30/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024]
Abstract
The current study examined how individual differences in error-related brain activity might moderate the association between high trait neuroticism and internalizing symptoms. Data were collected from a sample of high-achieving young adults (N = 188) as part of a larger study on risk versus resiliency for psychopathology. Participants completed two behavioral tasks to elicit the error-related negativity (ERN): an arrow Flanker task and a Go/No-Go task. Analyses were constrained to two internalizing symptom dimensions of checking behavior and irritability. Contrary to expectations, ERN amplitude was not related to symptom severity at the bivariate level. However, ERN amplitude moderated the association between trait neuroticism and symptoms of ill temper, such that the neuroticism-irritability association was strongest among individuals with a blunted ERN. In addition, this finding was relatively consistent across tasks and across two complementary methods of scoring the ERN, suggesting an effect of ERN variance that is shared between tasks and that is relatively robust regarding processing differences. In all, the current study represents the first attempt to investigate how the ERN interacts with trait neuroticism to predict transdiagnostic symptom dimensions in adulthood.
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Affiliation(s)
| | | | - Roma Kamat
- Purdue University, United States of America
| | - Greg Perlman
- Stony Brook University, United States of America
| | - Roman Kotov
- Stony Brook University, United States of America
| | | | | | - Dan Foti
- Purdue University, United States of America
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Parker AJ, Walker JC, Jordan LS, Takarae Y, Wiggins JL, Dougherty LR. Neural mechanisms of inhibitory control in preadolescent irritability: Insights from the ABCD study. Biol Psychol 2024; 192:108856. [PMID: 39154835 DOI: 10.1016/j.biopsycho.2024.108856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/19/2024] [Accepted: 08/13/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVE Elevated pediatric irritability is a transdiagnostic symptom that predicts multiple mental health problems in adolescence and adulthood. Altered top-down regulatory networks, such as inhibitory control networks that suppress an impulse in favor of goal-directed behavior, are thought to contribute to high levels of youth irritability. Nevertheless, little work has examined links between youth irritability and neural processes supporting inhibitory control in large diverse samples, nor have they focused on the key period ramping up to adolescence (i.e., preadolescence). METHOD Functional MRI data from 5380 preadolescents (age M=9.97 years, SD=0.62) in the baseline Adolescent Brain and Cognitive Development (ABCD) Study were analyzed. Parents reported on their preadolescent's irritability. The stop signal task (SST) was leveraged to probe successful and failed inhibitory control. Activation and functional connectivity with amygdala, ventral striatum, and prefrontal seed regions were calculated during the SST and used in whole brain and region of interest (ROI) group-level analyses evaluating irritability effects. RESULTS Preadolescents with higher levels of irritability displayed decreases in functional connectivity among amygdala, ventral striatum, and prefrontal cortex regions during both successful and failed inhibitory control conditions. These results remained after adjusting for co-occurring anxiety, depression, and attention-deficit/hyperactivity symptoms. CONCLUSIONS Findings suggest neural aberrations in inhibitory control play a role in the pathophysiology of preadolescent irritability and associations are not merely due to co-occurring symptoms. Neural mechanisms of inhibitory control associated with irritability may provide novel intervention targets.
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Affiliation(s)
- Alyssa J Parker
- Department of Psychology, University of Maryland, College Park, United States.
| | - Johanna C Walker
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, United States
| | - Leslie S Jordan
- Department of Psychology, University of Maryland, College Park, United States; Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, United States; Institute for Clinical & Translational Research (ICTR), University of Maryland Baltimore, United States
| | - Yukari Takarae
- Department of Psychology, San Diego State University, United States
| | - Jillian Lee Wiggins
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, United States; Department of Psychology, San Diego State University, United States
| | - Lea R Dougherty
- Department of Psychology, University of Maryland, College Park, United States
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Thompson KI, Schneider CJ, Lopez-Roque JA, Wakschlag LS, Karim HT, Perlman SB. A network approach to the investigation of childhood irritability: probing frustration using social stimuli. J Child Psychol Psychiatry 2024; 65:959-972. [PMID: 38124618 PMCID: PMC11161318 DOI: 10.1111/jcpp.13937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Self-regulation in early childhood develops within a social context. Variations in such development can be attributed to inter-individual behavioral differences, which can be captured both as facets of temperament and across a normal:abnormal dimensional spectrum. With increasing emphasis on irritability as a robust early-life transdiagnostic indicator of broad psychopathological risk, linkage to neural mechanisms is imperative. Currently, there is inconsistency in the identification of neural circuits that underlie irritability in children, especially in social contexts. This study aimed to address this gap by utilizing a functional magnetic resonance imaging (fMRI) paradigm to investigate pediatric anger/frustration using social stimuli. METHODS Seventy-three children (M = 6 years, SD = 0.565) were recruited from a larger longitudinal study on irritability development. Caregivers completed questionnaires assessing irritable temperament and clinical symptoms of irritability. Children participated in a frustration task during fMRI scanning that was designed to induce frustration through loss of a desired prize to an animated character. Data were analyzed using both general linear modeling (GLM) and independent components analysis (ICA) and examined from the temperament and clinical perspectives. RESULTS ICA results uncovered an overarching network structure above and beyond what was revealed by traditional GLM analyses. Results showed that greater temperamental irritability was associated with significantly diminished spatial extent of activation and low-frequency power in a network comprised of the posterior superior temporal sulcus (pSTS) and the precuneus (p < .05, FDR-corrected). However, greater severity along the spectrum of clinical expression of irritability was associated with significantly increased extent and intensity of spatial activation as well as low- and high-frequency neural signal power in the right caudate (p < .05, FDR-corrected). CONCLUSIONS Our findings point to specific neural circuitry underlying pediatric irritability in the context of frustration using social stimuli. Results suggest that a deliberate focus on the construction of network-based neurodevelopmental profiles and social interaction along the normal:abnormal irritability spectrum is warranted to further identify comprehensive transdiagnostic substrates of the irritability.
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Affiliation(s)
- Khalil I Thompson
- Department of Psychiatry, Washington University in St Louis School of Medicine, St Louis, MO, USA
| | - Clayton J Schneider
- Department of Psychiatry, Washington University in St Louis School of Medicine, St Louis, MO, USA
| | - Justin A Lopez-Roque
- Department of Psychiatry, Washington University in St Louis School of Medicine, St Louis, MO, USA
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Helmet T Karim
- Department of Psychiatry, University of Pittsburg School of Medicine, Pittsburgh, PA, USA
| | - Susan B Perlman
- Department of Psychiatry, Washington University in St Louis School of Medicine, St Louis, MO, USA
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Nóblega M, Retiz O, Nuñez del Prado J, Bartra R. Maternal Stress Mediates Association of Infant Socioemotional Development with Perinatal Mental Health in Socioeconomically Vulnerable Peruvian Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:844. [PMID: 39063421 PMCID: PMC11276598 DOI: 10.3390/ijerph21070844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/22/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024]
Abstract
Increased maternal mental health during the perinatal period has been widely associated with a variety of positive outcomes for both mothers and infants. However, no studies in Peru have yet focused on studying maternal mental health and related psychological variables during this stage. Thus, the aim of this study was to test a model to associate a mother's parental stress with infant socioemotional difficulties and maternal mental health. The sample included 988 mothers of infants aged 6 to 18 months from Peru, all from socioeconomically vulnerable settings. The findings showed that infant socioemotional difficulties were associated with poorer maternal mental health through the mother's parental stress (χ2(7) = 28.89, p < 0.001, CFI = 0.98, RMSEA = 0.06, SRMR = 0.03). These results provide a better understanding of the key elements associated with maternal mental health during the perinatal period in Peru and offer valuable insights for developing interventions and support strategies for socioeconomically vulnerable mothers and their young children.
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Affiliation(s)
- Magaly Nóblega
- Department of Psychology, Pontifical Catholic University of Peru, Lima 15088, Peru; (O.R.); (J.N.d.P.); (R.B.)
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Elvin OM, Modecki KL, Waters AM. An Expanded Conceptual Framework for Understanding Irritability in Childhood: The Role of Cognitive Control Processes. Clin Child Fam Psychol Rev 2024; 27:381-406. [PMID: 38856946 PMCID: PMC11222227 DOI: 10.1007/s10567-024-00489-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 06/11/2024]
Abstract
Children prone to irritability experience significant functional impairments and internalising and externalising problems. Contemporary models have sought to elucidate the underlying mechanisms in irritability, such as aberrant threat and reward biases to improve interventions. However, the cognitive control processes that underlie threat (e.g., attention towards threats) and reward (e.g., attention towards reward-related cues) biases and the factors which influence the differential activation of positive and negative valence systems and thus leading to maladaptive activation of cognitive control processes (i.e., proactive and reactive control) are unclear. Thus, we aim to integrate extant theoretical and empirical research to elucidate the cognitive control processes underlying threat and reward processing that contribute to irritability in middle childhood and provide a guiding framework for future research and treatment. We propose an expanded conceptual framework of irritability that includes broad intraindividual and environmental vulnerability factors and propose proximal 'setting' factors that activate the negative valence and positive valence systems and proactive and reactive cognitive control processes which underpin the expression and progression of irritability. We consider the implications of this expanded conceptualisation of irritability and provide suggestions for future research.
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Affiliation(s)
- Olivia M Elvin
- School of Applied Psychology, Griffith University, Mount Gravatt Campus, Brisbane, QLD, Australia.
| | - Kathryn L Modecki
- Centre for Mental Health and School of Applied Psychology, Griffith University, Mount Gravatt Campus, Brisbane, QLD, Australia
- School of Psychological Science, University of Western Australia & Telethon Kids Institute, Perth, Australia
| | - Allison M Waters
- Centre for Mental Health and School of Applied Psychology, Griffith University, Mount Gravatt Campus, Brisbane, QLD, Australia.
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Leibenluft E, Allen LE, Althoff RR, Brotman MA, Burke JD, Carlson GA, Dickstein DP, Dougherty LR, Evans SC, Kircanski K, Klein DN, Malone EP, Mazefsky CA, Nigg J, Perlman SB, Pine DS, Roy AK, Salum GA, Shakeshaft A, Silver J, Stoddard J, Thapar A, Tseng WL, Vidal-Ribas P, Wakschlag LS, Stringaris A. Irritability in Youths: A Critical Integrative Review. Am J Psychiatry 2024; 181:275-290. [PMID: 38419494 DOI: 10.1176/appi.ajp.20230256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Irritability, defined as proneness to anger that may impair an individual's functioning, is common in youths. There has been a recent upsurge in relevant research. The authors combine systematic and narrative review approaches to integrate the latest clinical and translational findings and provide suggestions for addressing research gaps. Clinicians and researchers should assess irritability routinely, and specific assessment tools are now available. Informant effects are prominent, are stable, and vary by age and gender. The prevalence of irritability is particularly high among individuals with attention deficit hyperactivity disorder, autism spectrum disorder, and mood and anxiety disorders. Irritability is associated with impairment and suicidality risk independent of co-occurring diagnoses. Developmental trajectories of irritability (which may begin early in life) have been identified and are differentially associated with clinical outcomes. Youth irritability is associated with increased risk of anxiety, depression, behavioral problems, and suicidality later in life. Irritability is moderately heritable, and genetic associations differ based on age and comorbid illnesses. Parent management training is effective for treating psychological problems related to irritability, but its efficacy in treating irritability should be tested rigorously, as should novel mechanism-informed interventions (e.g., those targeting exposure to frustration). Associations between irritability and suicidality and the impact of cultural context are important, underresearched topics. Analyses of large, diverse longitudinal samples that extend into adulthood are needed. Data from both animal and human research indicate that aberrant responses to frustration and threat are central to the pathophysiology of irritability, revealing important translational opportunities.
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Affiliation(s)
- Ellen Leibenluft
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Laura E Allen
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Robert R Althoff
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Melissa A Brotman
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Jeffrey D Burke
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Gabrielle A Carlson
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Daniel P Dickstein
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Lea R Dougherty
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Spencer C Evans
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Katharina Kircanski
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Daniel N Klein
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Eleanor P Malone
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Carla A Mazefsky
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Joel Nigg
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Susan B Perlman
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Daniel S Pine
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Amy Krain Roy
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Giovanni A Salum
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Amy Shakeshaft
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Jamilah Silver
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Joel Stoddard
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Anita Thapar
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Wan-Ling Tseng
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Pablo Vidal-Ribas
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Lauren S Wakschlag
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
| | - Argyris Stringaris
- Emotion and Development Branch, NIMH, Bethesda, Md. (Leibenluft, Brotman, Kircanski, Malone, Pine); Faculty of Brain Sciences, Division of Psychiatry and Division of Psychology and Language Sciences, University College London (Allen, Stringaris); Departments of Psychiatry, Pediatrics, and Psychological Science, University of Vermont, Burlington (Althoff); Department of Psychological Sciences, University of Connecticut, Storrs (Burke); Division of Child and Adolescent Psychiatry, Department of Psychiatry (Carlson), Department of Psychology (Klein, Silver), and Department of Psychiatry (Klein), Stony Brook University, Stony Brook, N.Y.; Division of Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass. (Dickstein); Department of Psychology, University of Maryland, College Park (Dougherty); Department of Psychology, University of Miami, Coral Gables, Fla. (Evans); Departments of Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh (Mazefsky); Department of Psychiatry, Oregon Health and Science University, Portland (Nigg); Department of Psychology, Washington University at St. Louis, St. Louis (Perlman); Department of Psychology, Fordham University, New York (Roy); Child Mind Institute, New York (Salum); Division of Psychological Medicine and Clinical Neurosciences, Wolfson Centre for Young People's Mental Health, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales, United Kingdom (Shakeshaft, Thapar); Division of Child and Adolescent Mental Health, Children's Hospital Colorado, University of Colorado School of Medicine, Denver (Stoddard); Yale Child Study Center, Yale School of Medicine, New Haven, Conn. (Tseng); Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (Vidal-Ribas); Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Chicago (Wakschlag); First Department of Psychiatry, National and Kapodistrian University of Athens, and Aiginiteion Hospital, Athens, Greece (Stringaris)
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7
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Sistiaga S, Tseng WL, Zhang L, Rossignol M, Bellaert N. How are irritability and anhedonia symptoms linked? A network approach. J Clin Psychol 2024. [PMID: 38497904 DOI: 10.1002/jclp.23679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/08/2024] [Accepted: 03/06/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Anhedonia and irritability are two prevalent symptoms of major depressive disorder (MDD) that predict greater depression severity and poor outcomes, including suicidality. Although both symptoms have been proposed to result from paradoxical reward processing dysfunctions, the interactions between these symptoms remain unclear. Anhedonia is a multifaceted symptom reflecting impairments in multiple dimensions of reward processing (e.g., pleasure, desire, motivation, and effort) across distinct reward types (e.g., food, sensory experiences, social activities, hobbies) that may differentially interact with irritability. This study investigated the complex associations between anhedonia and irritability using network analysis. METHOD Participants (N = 448, Mage = 33.29, SD = 14.58) reported their symptoms of irritability on the Brief Irritability Test (Holtzman et al., 2015) and anhedonia (i.e., pleasure, desire, motivation, and effort dimensions across four reward types) on the Dimensional Anhedonia Rating Scale (Rizvi et al., 2015). A regularized Gaussian Graphical Model was built to estimate the network structure between items. RESULTS Irritability was negatively related to willingness to expand effort to obtain food/drinks (estimate = -0.18), social activities (-0.13), and hobbies (-0.12) rewards. Irritability was positively associated with a desire for food/drinks (0.12). LIMITATIONS Only a small proportion (5.8%) of our sample was clinical and the study design was cross-sectional. CONCLUSION A specific link between irritability and the effort dimension of the hedonic response across three reward types was identified. Investigating effort expenditure deficits with experimental paradigms may help us understand the mechanisms underlying the comorbidity between irritability and anhedonia in the context of MDD.
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Affiliation(s)
- Sonia Sistiaga
- Cognitive Psychology and Neuropsychology Department, University of Mons, Mons, Belgium
| | - Wan-Ling Tseng
- Yale Child Study Center, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Lanting Zhang
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Mandy Rossignol
- Cognitive Psychology and Neuropsychology Department, University of Mons, Mons, Belgium
| | - Nellia Bellaert
- Cognitive Psychology and Neuropsychology Department, University of Mons, Mons, Belgium
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8
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Derella OJ, Butler EJ, Seymour KE, Burke JD. Frustration Response and Regulation Among Irritable Children: Contributions of Chronic Irritability, Internalizing, and Externalizing Symptoms. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:199-215. [PMID: 37698941 DOI: 10.1080/15374416.2023.2246557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
OBJECTIVE The need to understand and treat childhood chronic irritability (CI; i.e. frequent temper loss and angry/irritable mood) is imperative. CI predicts impairment across development and complex comorbidities with both internalizing and externalizing disorders. Research has emphasized frustration reactivity as a key mechanism of CI. However, there are understudied components of frustrative non-reward, particularly regulation-oriented frustration recovery, frustration tolerance, and cognitive control, that may further explain impairments specific to CI beyond comorbid symptoms. METHOD Sixty-three community children (N = 25 CI/38 non-CI) and a parent completed surveys and the computerized Frustration Go/No-Go (FGNG) and Mirror Tracing Persistence Task (MTPT). Analyses compared task performance and self-rated affect across youth with or without CI, with further comparison based on negative/positive screen for ADHD (N = 45-/18+). RESULTS In mixed effects models assessing change across task, the CI group did not demonstrate more intense frustration on the MTPT or rigged FGNG block but exhibited persisting frustration and inhibitory control difficulties into the FGNG recovery period; the CI+ADHD subgroup drove recovery effects. In GEE and logistic regression models including dimensional symptom clusters, only internalizing symptoms predicted child frustration intolerance and reactivity across tasks. ADHD severity was also associated with higher MTPT frustration reactivity, while oppositional behavior predicted lower frustration. Better frustration recovery was associated with lower irritability, but higher internalizing symptoms. CONCLUSIONS Co-occurring symptoms may better explain some frustration-related difficulties among youth with CI. Difficulties with postfrustration affect and inhibitory control recovery suggest the importance of characterizing CI by self-regulation impairments.
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Affiliation(s)
- Olivia J Derella
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center/Albert Einstein College of Medicine
- Department of Psychological Sciences, University of Connecticut
| | - Emilie J Butler
- Department of Psychological Sciences, University of Connecticut
| | | | - Jeffrey D Burke
- Department of Psychological Sciences, University of Connecticut
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9
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Ferrara E, Lee H, Guarecuco JS, Somekh MR, Hirsch E, Keesey R, Cham H, Hoyt LT, Roy AK. Novel Assessment of the Impact of Irritability on Physiological and Psychological Frustration Responses in Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:216-230. [PMID: 38236707 PMCID: PMC11043015 DOI: 10.1080/15374416.2024.2301753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVE Irritability, typically defined as a proneness to anger, particularly in response to frustration, falls at the intersection of emotion and disruptive behavior. Despite well-defined translational models, there are few convergent findings regarding the pathophysiology of irritability. Most studies utilize computer-based tasks to examine neural responses to frustration, with little work examining stress-related responding to frustration in social contexts. The present study is the first to utilize the novel Frustration Social Stressor for Adolescents (FSS-A) to examine associations between adolescent irritability and psychological and physiological responses to frustration. METHOD The FSS-A was completed by a predominantly male, racially, ethnically, and socioeconomically diverse sample of 64 12- to 17-year-olds, who were originally recruited as children with varying levels of irritability. Current irritability was assessed using the Multidimensional Assessment Profiles-Temper Loss scale (MAP-TL-Youth). Adolescents rated state anger and anxiety before and after the FSS-A, and usable salivary cortisol data were collected from 43 participants. RESULTS Higher MAP-TL-Youth scores were associated with greater increases in anger during the FSS-A, but not increases in anxiety, or alterations in cortisol. Pre-task state anger negatively predicted the slope of the rise in cortisol observed in anticipation of the FSS-A. CONCLUSIONS Results provide support for unique associations between adolescent irritability and anger during, and in anticipation of, frustrating social interactions. Such findings lay a foundation for future work aimed at informing physiological models and intervention targets.
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Affiliation(s)
- Erica Ferrara
- Department of Psychology, Fordham University, Bronx, USA
| | - Hyunjung Lee
- Department of Psychology, Fordham University, Bronx, USA
| | | | | | - Emily Hirsch
- Department of Psychology, Fordham University, Bronx, USA
| | - Rodolfo Keesey
- Department of Psychology, Fordham University, Bronx, USA
| | - Heining Cham
- Department of Psychology, Fordham University, Bronx, USA
| | | | - Amy Krain Roy
- Department of Psychology, Fordham University, Bronx, USA
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, USA
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10
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Naik AA, Ma X, Munyeshyaka M, Leibenluft E, Li Z. A New Behavioral Paradigm for Frustrative Nonreward in Juvenile Mice. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:31-38. [PMID: 38045768 PMCID: PMC10689275 DOI: 10.1016/j.bpsgos.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/12/2023] [Accepted: 09/27/2023] [Indexed: 12/05/2023] Open
Abstract
Background Irritability, defined as proneness to anger, can reach a pathological extent. It is a defining symptom of disruptive mood dysregulation disorder and one of the most common reasons youths present for psychiatric evaluation and care. Aberrant responses to frustrative nonreward (FNR), the response to omission of expected reward, are central to the pathophysiology of irritability. FNR is a translational construct to study irritability across species. The development of preclinical FNR models would advance mechanistic studies of the important and relatively understudied clinical phenomenon of irritability. Methods We used FNR as a conceptual framework to develop a novel mouse behavioral paradigm named alternate poking reward omission. Juvenile mice were exposed to alternate poking reward omission and then examined with a battery of behavioral tests to determine the behavioral effect of FNR. Results FNR increased locomotion and aggression regardless of sex. These behavioral changes elicited by FNR resemble the symptoms observed in youth with severe irritability. FNR had no effect on anxiety-like, depression-like, or nonaggressive social behaviors. Conclusions Our alternate poking reward omission paradigm effectively elevated aggression and locomotion in juvenile mice. These frustration effects are directly related to behavioral symptoms of youth with severe irritability. Our novel behavioral paradigm lays the groundwork for further mechanistic studies of frustration and irritability in rodents.
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Affiliation(s)
- Aijaz Ahmad Naik
- Section on Synapse Development Plasticity, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
- Center on Compulsive Behaviors, Intramural Research Program, National Institutes of Health, Bethesda, Maryland
| | - Xiaoyu Ma
- Section on Synapse Development Plasticity, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Maxime Munyeshyaka
- Section on Synapse Development Plasticity, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Ellen Leibenluft
- Section on Mood Dysregulation and Neuroscience, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Zheng Li
- Section on Synapse Development Plasticity, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
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11
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Evans SC, Shaughnessy S, Karlovich AR. Future Directions in Youth Irritability Research. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:716-734. [PMID: 37487108 DOI: 10.1080/15374416.2023.2209180] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
Research on irritability in children and adolescents has proliferated over the last 20 years. The evidence shows the clinical and developmental significance of irritable mood and behavior in youth, and it has led to significant changes in mental health classification, diagnosis, and services. At the same time, this research (including our own) has led to relatively little new in terms of practical, empirically based guidance to improve interventions and outcomes. In this article, we briefly summarize some of these developments and current evidence-based practices. We then put forth two key substantive challenges (the "whats") for future research to address: (a) the need for more effective treatments, especially evaluating and adapting evidence-based treatments that are already well-established for problems related to irritability (e.g., cognitive-behavioral therapies for internalizing and externalizing problems); and (b) the need for a better mechanistic understanding of irritability's phenomenology (e.g., phasic vs. tonic irritability, how frustration unfolds) and putative underlying mechanisms (e.g., cognitive control, threat and reward dysfunction). Lastly, we suggest three methodological approaches (the "hows") that may expedite progress in such areas: (a) ecological momentary assessment, (b) digital health applications, and (c) leveraging existing datasets. We hope this article will be useful for students and early-career researchers interested in tackling some of these important questions to better meet the needs of severely irritable youth.
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12
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Mohamed Ali O, Vandermeer MRJ, Liu P, Joanisse MF, Barch DM, Hayden EP. Associations between childhood irritability and neural reactivity to maternal feedback in adolescence. Biol Psychol 2023; 182:108645. [PMID: 37596151 DOI: 10.1016/j.biopsycho.2023.108645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/16/2023] [Accepted: 07/16/2023] [Indexed: 08/20/2023]
Abstract
Early irritability, a transdiagnostic vulnerability for psychopathology, is associated with alterations in neural reactivity to emotional stimuli and reward; however, associations between childhood irritability and neural markers of risk may be mitigated by the quality of caregiving youth receive. We examined longitudinal relationships between irritability in childhood and young adolescents' neural activity of regions typically associated with emotion regulation and reward processing during processing of maternal feedback and tested whether these associations were moderated by youth's perceptions of the parent-child relationship quality. Eighty-one adolescents (Mage = 11.1 years) listened to maternal critical and praising feedback while undergoing functional magnetic resonance imaging. Age 3 irritability, assessed observationally, was negatively associated with age 11 neural reactivity to maternal criticism in a cluster in the right dorsolateral prefrontal cortex (dlPFC), particularly for youths who reported more positive maternal parenting. Given the role of the dlPFC activation in the effortful processing of emotional stimuli, decreased activation may reflect disengagement from negatively valenced interpersonal feedback in the context of a positive caregiving environment, thereby mitigating psychopathology risk associated with irritability.
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Affiliation(s)
- Ola Mohamed Ali
- Department of Psychology, Brain and Mind Institute, University of Western Ontario, London, ON N6A 5B7, Canada.
| | - Matthew R J Vandermeer
- Department of Psychology, Brain and Mind Institute, University of Western Ontario, London, ON N6A 5B7, Canada; St. Joseph's Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada
| | - Pan Liu
- Department of Psychology, Brain and Mind Institute, University of Western Ontario, London, ON N6A 5B7, Canada; Department of Psychology, North Dakota State University, Fargo, ND 58102, USA
| | - Marc F Joanisse
- Department of Psychology, Brain and Mind Institute, University of Western Ontario, London, ON N6A 5B7, Canada
| | - Deanna M Barch
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Elizabeth P Hayden
- Department of Psychology, Brain and Mind Institute, University of Western Ontario, London, ON N6A 5B7, Canada
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13
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Silver J, Bufferd SJ, Dougherty LR, Goldstein BL, Carlson GA, Klein DN. Is the distinction between tonic and phasic irritability meaningful in 3-year-old children? Eur Child Adolesc Psychiatry 2023; 32:1755-1763. [PMID: 35523899 DOI: 10.1007/s00787-022-01995-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 04/16/2022] [Indexed: 11/24/2022]
Abstract
Irritability encompasses both normative misbehavior in early childhood and clinically significant problems across development. Recent studies have distinguished between tonic (i.e., persistently angry or grumpy mood) and phasic (i.e., temper tantrums or outbursts) forms of irritability and shown that they have different implications for psychopathology and functioning. However, data on this distinction in young (i.e., preschool aged) children are nonexistent. We utilized data from a longitudinal study of a community sample of 462 3-year-olds followed to age 15. We conducted confirmatory factor analysis (CFA) using items from a diagnostic interview and several parent-report inventories and examined concurrent and prospective associations with clinically relevant variables. The CFA identified dimensions consistent with tonic and phasic irritability. Tonic irritability was independently associated with concurrent parent-reported temperamental negative affectivity and surgency, and depressive and oppositional defiant (ODD) disorders, and predicted higher rates of disruptive behavior disorders (DBD) and suicidal behavior in later childhood and adolescence. Phasic irritability was independently associated with concurrent laboratory observations of child impulsivity, parent-reported temperamental negative affectivity, surgency, and low effortful control, maladaptive parenting, and generalized anxiety disorder (GAD), attention-deficit hyperactivity disorder (ADHD), and ODD, but it did not predict later psychopathology. Tonic and phasic irritability are separable in 3-year-old children, but their correlates and outcomes are not as distinct as in older youth. This may reflect the greater difficulty characterizing normative and pathological irritability in the preschool period.
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Affiliation(s)
- Jamilah Silver
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794, USA.
| | | | | | | | | | - Daniel N Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794, USA
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14
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Mateo Santana A, Grabell AS. Incongruent affect in early childhood: Neurobiological markers and links to psychopathology. Emotion 2023; 23:1562-1574. [PMID: 36355672 PMCID: PMC10169541 DOI: 10.1037/emo0001180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Researchers have long investigated emotion-related facial expressions, such as smiling and frowning, to further the field's understanding of behavior, emotions, and psychopathology. Fewer studies have examined incongruent affect; facial expressions that do not match internal emotional experiences (e.g., smiling during frustration). Although not extensive, current accounts of incongruent affect in early childhood have assumed that these expressions indicate masking, an active regulatory process. Thus, many researchers contend that incongruent affect represents an adaptive emotion regulation strategy. However, little attention has been paid to incongruent affect, and its neurobiological correlates in early childhood. The present study examined complete versus partial incongruent smiling in preschool-aged children (3.5- to 5-years-old) who completed a frustration-eliciting task. We examined simultaneous neurobiological markers of incongruent smiles using functional near-infrared spectroscopy (fNIRS) and galvanic skin response (GSR) and tested links to parent-rated emotion regulation and psychopathology. Neutral and negative expressions were assessed as comparison expressions. Results revealed that complete incongruent smiling predicted poor effortful control, whereas partial incongruent smiling was not a significant predictor of regulation, neurobiological changes, or psychopathology. Neutral expressions predicted better effortful control skills and adaptive physiological response patterns. Results suggest that incongruent affect may signal poor regulation of positive affectivity in low-interpersonal contexts, while neutral expressions may act as masking expressions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Adam S Grabell
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst
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15
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Tseng WL, Naim R, Chue A, Shaughnessy S, Meigs J, Pine DS, Leibenluft E, Kircanski K, Brotman MA. Network analysis of ecological momentary assessment identifies frustration as a central node in irritability. J Child Psychol Psychiatry 2023; 64:1212-1221. [PMID: 36977629 PMCID: PMC10615387 DOI: 10.1111/jcpp.13794] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Irritability presents transdiagnostically, commonly occurring with anxiety and other mood symptoms. However, little is known about the temporal and dynamic interplay among irritability-related clinical phenomena. Using a novel network analytic approach with smartphone-based ecological momentary assessment (EMA), we examined how irritability and other anxiety and mood symptoms were connected. METHODS Sample included 152 youth ages 8-18 years (M ± SD = 12.28 ± 2.53; 69.74% male; 65.79% White) across several diagnostic groups enriched for irritability including disruptive mood dysregulation disorder (n = 34), oppositional defiant disorder (n = 9), attention-deficit/hyperactivity disorder (n = 47), anxiety disorder (n = 29), and healthy comparisons (n = 33). Participants completed EMA on irritability-related constructs and other mood and anxiety symptoms three times a day for 7 days. EMA probed symptoms on two timescales: "since the last prompt" (between-prompt) versus "at the time of the prompt" (momentary). Irritability was also assessed using parent-, child- and clinician-reports (Affective Reactivity Index; ARI), following EMA. Multilevel vector autoregressive (mlVAR) models estimated a temporal, a contemporaneous within-subject and a between-subject network of symptoms, separately for between-prompt and momentary symptoms. RESULTS For between-prompt symptoms, frustration emerged as the most central node in both within- and between-subject networks and predicted more mood changes at the next timepoint in the temporal network. For momentary symptoms, sadness and anger emerged as the most central node in the within- and between-subject network, respectively. While anger was positively related to sadness within individuals and measurement occasions, anger was more broadly positively related to sadness, mood lability, and worry between/across individuals. Finally, mean levels, not variability, of EMA-indexed irritability were strongly related to ARI scores. CONCLUSIONS This study advances current understanding of symptom-level and temporal dynamics of irritability. Results suggest frustration as a potential clinically relevant treatment target. Future experimental work and clinical trials that systematically manipulate irritability-related features (e.g. frustration, unfairness) will elucidate the causal relations among clinical variables.
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Affiliation(s)
- Wan-Ling Tseng
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Reut Naim
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Amanda Chue
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Shannon Shaughnessy
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Jennifer Meigs
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Daniel S. Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Melissa A. Brotman
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
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16
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Yang R, Takarae Y, Adney H, Swineford C, Walker JC, Cheng P, Negash S, Wiggins JL. Neural correlates of irritability symptom relief in adolescents pre- and post-trauma-focused cognitive behavioral therapy: A pilot study on reward processing. Psychiatry Res Neuroimaging 2023; 332:111645. [PMID: 37087811 PMCID: PMC10901248 DOI: 10.1016/j.pscychresns.2023.111645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/23/2023] [Accepted: 04/13/2023] [Indexed: 04/25/2023]
Abstract
Despite that Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a first-line, evidence-based treatment for youths experiencing trauma-related symptoms, treatment responses vary and it remains unclear for whom and how this treatment works. In this context, we examined pre-treatment neural reward processing and pre- vs. post-treatment changes in neural reward processing, in relation to irritability - a transdiagnostic and dimensional feature present in multiple trauma-related syndromes, following TF-CBT. Adolescents (N = 22) with childhood trauma history completed a child-friendly monetary incentive delay task during fMRI acquisition, prior to and after the treatment, and irritability symptoms were assessed at five time points over the course of the treatment. Individual irritability slopes (i.e., irritability change rate) and intercepts (i.e., initial irritability level), generated by linear growth curve modeling, were integrated with fMRI data. Repeated ANCOVAs demonstrated that both pre-treatment neural response to reward and pre- vs. post-treatment changes in neural reward processing correlated with irritability symptom relief, such that opposite baseline neural reward processing profiles and differential changing patterns were observed in individuals showing irritability symptom relief vs. not. Together, our findings provide proof of concept that integrating brain information with clinical information has the potential to identify predictors and mechanisms of symptom relief.
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Affiliation(s)
- Ruiyu Yang
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, United States; Department of Psychology, San Diego State University, United States.
| | - Yukari Takarae
- Department of Psychology, San Diego State University, United States
| | - Hailey Adney
- Department of Psychology, San Diego State University, United States
| | - Conner Swineford
- Department of Psychology, San Diego State University, United States
| | - Johanna C Walker
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, United States; Department of Psychology, San Diego State University, United States
| | - Philip Cheng
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Hospital, United States
| | - Sesen Negash
- Department of Counseling & School Psychology, San Diego State University, United States
| | - Jillian Lee Wiggins
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, United States; Department of Psychology, San Diego State University, United States
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17
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MacSweeney N, Louvet P, Zafar S, Chan SWY, Kwong ASF, Lawrie SM, Romaniuk L, Whalley HC. Keeping up with the kids: the value of co-production in the study of irritability in youth depression and its underlying neural circuitry. Front Behav Neurosci 2023; 17:1124940. [PMID: 37397127 PMCID: PMC10310302 DOI: 10.3389/fnbeh.2023.1124940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Irritability is a core symptom of adolescent depression, characterized by an increased proneness to anger or frustration. Irritability in youth is associated with future mental health problems and impaired social functioning, suggesting that it may be an early indicator of emotion regulation difficulties. Adolescence is a period during which behavior is significantly impacted by one's environment. However, existing research on the neural basis of irritability typically use experimental paradigms that overlook the social context in which irritability occurs. Here, we bring together current findings on irritability in adolescent depression and the associated neurobiology and highlight directions for future research. Specifically, we emphasize the importance of co-produced research with young people as a means to improve the construct and ecological validity of research within the field. Ensuring that our research design and methodology accurately reflect to lives of young people today lays a strong foundation upon which to better understand adolescent depression and identify tractable targets for intervention.
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Affiliation(s)
- Niamh MacSweeney
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Perrine Louvet
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Simal Zafar
- School of Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Stella W. Y. Chan
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Alex S. F. Kwong
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Stephen M. Lawrie
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Liana Romaniuk
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Heather C. Whalley
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Generation Scotland, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
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18
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Naik AA, Ma X, Munyeshyaka M, Leibenluft E, Li Z. A New Behavioral Paradigm for Frustrative Non-reward Reveals a Global Change in Brain Networks by Frustration. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.28.530477. [PMID: 36909498 PMCID: PMC10002733 DOI: 10.1101/2023.02.28.530477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background Irritability, defined as proneness to anger, can reach a pathological extent. It is a defining symptom of Disruptive Mood Dysregulation Disorder (DMDD) and one of the most common reasons youth presents for psychiatric evaluation and care. Aberrant responses to frustrative non-reward (FNR, the response to omission of expected reward) are central to the pathophysiology of irritability. FNR is a translational construct to study irritability across species. The development of preclinical FNR models would advance mechanistic studies of the important and relatively understudied clinical phenomenon of irritability. Methods We used FNR as a conceptual framework to develop a novel mouse behavioral paradigm named Alternate Poking Reward Omission (APRO). After APRO, mice were examined with a battery of behavioral tests and processed for whole brain c-Fos imaging. FNR increases locomotion and aggression in mice regardless of sex. These behavioral changes resemble the symptoms observed in youth with severe irritability. There is no change in anxiety-like, depression-like, or non-aggressive social behaviors. FNR increases c-Fos+ neurons in 13 subregions of thalamus, iso-cortex and hippocampus including the prelimbic, ACC, hippocampus, dorsal thalamus, cuneiform nucleus, pons, and pallidum areas. FNR also shifts the brain network towards a more global processing mode. Conclusion Our novel FNR paradigm produces a frustration effect and alters brain processing in ways resembling the symptoms and brain network reconfiguration observed in youth with severe irritability. The novel behavioral paradigm and identified brain regions lay the groundwork for further mechanistic studies of frustration and irritability in rodents.
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Affiliation(s)
- Aijaz Ahmad Naik
- Section on Synapse Development Plasticity, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland 20892
- Center on Compulsive Behaviors, Intramural Research program, NIH, Bethesda, MD, USA
| | - Xiaoyu Ma
- Section on Synapse Development Plasticity, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland 20892
| | - Maxime Munyeshyaka
- Section on Synapse Development Plasticity, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland 20892
| | - Ellen Leibenluft
- Section on Mood Dysregulation and Neuroscience, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland 20892
| | - Zheng Li
- Section on Synapse Development Plasticity, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland 20892
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19
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Linke JO, Haller SP, Xu EP, Nguyen LT, Chue AE, Botz-Zapp C, Revzina O, Perlstein S, Ross AJ, Tseng WL, Shaw P, Brotman MA, Pine DS, Gotts SJ, Leibenluft E, Kircanski K. Persistent Frustration-Induced Reconfigurations of Brain Networks Predict Individual Differences in Irritability. J Am Acad Child Adolesc Psychiatry 2023; 62:684-695. [PMID: 36563874 PMCID: PMC11224120 DOI: 10.1016/j.jaac.2022.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 10/07/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Aberrant responses to frustration are central mechanisms of pediatric irritability, which is a common reason for psychiatric consultation and a risk factor for affective disorders and suicidality. This pilot study aimed to characterize brain network configuration during and after frustration and test whether characteristics of networks formed during or after frustration relate to irritability. METHOD During functional magnetic resonance imaging, a transdiagnostic sample enriched for irritability (N = 66, mean age = 14.0 years, 50% female participants) completed a frustration-induction task flanked by pretask and posttask resting-state scans. We first tested whether and how the organization of brain regions (ie, nodes) into networks (ie, modules) changes during and after frustration. Then, using a train/test/held-out procedure, we aimed to predict past-week irritability from global efficiency (Eglob) (ie, capacity for parallel information processing) of these modules. RESULTS Two modules present in the baseline pretask resting-state scan (one encompassing anterior default mode and temporolimbic regions and one consisting of frontoparietal regions) contributed most to brain circuit reorganization during and after frustration. Only Eglob of modules in the posttask resting-state scans (ie, after frustration) predicted irritability symptoms. Self-reported irritability was predicted by Eglob of a frontotemporal-limbic module. Parent-reported irritability was predicted by Eglob of ventral-prefrontal-subcortical and somatomotor-parietal modules. CONCLUSION These pilot results suggest the importance of the postfrustration recovery period in the pathophysiology of irritability. Eglob in 3 specific posttask modules, involved in emotion processing, reward processing, or motor function, predicted irritability. These findings, if replicated, could represent specific intervention targets for irritability.
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Affiliation(s)
- Julia O Linke
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
| | - Simone P Haller
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Ellie P Xu
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Lynn T Nguyen
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Amanda E Chue
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Christian Botz-Zapp
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Olga Revzina
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Samantha Perlstein
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Andrew J Ross
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Wan-Ling Tseng
- Yale Child Study Center, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Philip Shaw
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, Maryland
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Stephen J Gotts
- Section on Cognitive Neuropsychology, Laboratory of Brain and Cognition, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
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20
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Li Y, Grabell AS, Perlman SB. Irritability Moderates the Association between Cognitive Flexibility Task Performance and Related Prefrontal Cortex Activation in Young Children. Brain Sci 2023; 13:882. [PMID: 37371362 PMCID: PMC10296206 DOI: 10.3390/brainsci13060882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/24/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
The association between cognitive flexibility and related neural functioning has been inconsistent. This is particularly true in young children, where previous studies have found heterogenous results linking behavior and neural function, raising the possibility of unexplored moderators. The current study explored the moderating role of dimensional irritability in the association between cognitive flexibility task performance and prefrontal activation in young children. A total of 106 3- to 7-year-old children were recruited to complete a custom-designed, child-adapted, cognitive flexibility task, and 98 of them were included in the data analysis. The children's dorsolateral prefrontal cortex activation was monitored using functional near-infrared spectroscopy, and their levels of irritability were reported by parents using the MAP-DB Temper Loss subscale. Results indicated that the mean reaction time of the cognitive flexibility task was negatively correlated with concurrent prefrontal activation. No evidence was found for the association between task accuracy and prefrontal activation. Moreover, irritability moderated the association between the mean reaction time and prefrontal activation. Children high in irritability exhibited a stronger negative association between the mean reaction time and related prefrontal activation than children low in irritability. The moderating model suggested a novel affective-cognitive interaction to investigate the associations between cognitive task performance and their neural underpinnings.
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Affiliation(s)
- Yanwei Li
- College of Early Childhood Education, Nanjing Xiaozhuang University, Nanjing 210017, China
| | - Adam S. Grabell
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA 01003, USA
| | - Susan B. Perlman
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO 63130, USA
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21
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Vogel AC, Brotman MA, Roy AK, Perlman SB. Review: Defining Positive Emotion Dysregulation: Integrating Temperamental and Clinical Perspectives. J Am Acad Child Adolesc Psychiatry 2023; 62:297-305. [PMID: 36007814 PMCID: PMC11323061 DOI: 10.1016/j.jaac.2022.06.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 05/19/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Although emotion dysregulation has been defined as a maladaptive process of emotional experiences, there is no specific reference to the emotional valence of the dysregulation. To date, child psychiatry has focused primarily on dysregulation of negative affect. Here, we suggest that positive emotion dysregulation requires additional clinical and research attention. METHOD First, we present a developmental approach to the study of positive emotion regulation within a temperament framework. Second, we describe emerging research findings regarding dysregulation of positive emotion in early childhood. Third, we integrate neuroscientific approaches to positive emotion regulation and introduce a framework for future investigations and clinical applications. RESULTS Dysregulation in positive affect can be examined from temperamental, developmental, clinical, and neuroscientific perspectives. Both temperamental surgency, which includes positive affect, and the proposed clinical extension, excitability, are associated with increased risk of externalizing symptoms and clinical impairment in youth. CONCLUSION Studying the role of both temperamental surgency and clinically impairing positive affect, or excitability, in developmental psychopathology will help to elucidate the full spectrum of emotion dysregulation and to clarify the neural basis of dysregulation. A more comprehensive conceptualization of positively valanced emotion dysregulation will provide a more nuanced understanding of developmental risk and potential targets for intervention. DIVERSITY & INCLUSION STATEMENT One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science.
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Affiliation(s)
- Alecia C Vogel
- Drs. Vogel and Perlman are with Washington University School of Medicine, St. Louis, Missouri. Dr. Brotman is with the National Institute of Mental Health, Bethesda, Maryland. Dr. Roy is with Fordham University, Bronx, New York.
| | - Melissa A Brotman
- Drs. Vogel and Perlman are with Washington University School of Medicine, St. Louis, Missouri. Dr. Brotman is with the National Institute of Mental Health, Bethesda, Maryland. Dr. Roy is with Fordham University, Bronx, New York
| | - Amy Krain Roy
- Drs. Vogel and Perlman are with Washington University School of Medicine, St. Louis, Missouri. Dr. Brotman is with the National Institute of Mental Health, Bethesda, Maryland. Dr. Roy is with Fordham University, Bronx, New York
| | - Susan B Perlman
- Drs. Vogel and Perlman are with Washington University School of Medicine, St. Louis, Missouri. Dr. Brotman is with the National Institute of Mental Health, Bethesda, Maryland. Dr. Roy is with Fordham University, Bronx, New York
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22
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Liuzzi MT, Kryza-Lacombe M, Christian IR, Owen C, Redcay E, Riggins T, Dougherty LR, Wiggins JL. Irritability in early to middle childhood: Cross-sectional and longitudinal associations with resting state amygdala and ventral striatum connectivity. Dev Cogn Neurosci 2023; 60:101206. [PMID: 36736018 PMCID: PMC9918422 DOI: 10.1016/j.dcn.2023.101206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Irritability is a common symptom that may affect children's brain development. This study aims to (1) characterize age-dependent and age-independent neural correlates of irritability in a sample of 4-8 year old children, and (2) examine early irritability as a predictor of change in brain connectivity over time. METHODS Typically developing children, ages 4-8 years, with varying levels of irritability were included. Resting state fMRI and parent-rated irritability (via Child Behavior Checklist; CBCL) were collected at up to three time points, resulting in a cross-sectional sample at baseline (N = 176, M = 6.27, SD = 1.49), and two subsamples consisting of children who were either 4 or 6 years old at baseline that were followed longitudinally for two additional timepoints, one- and two-years post-baseline. That is, a "younger" cohort (age 4 at baseline, n = 34, M age = 4.44, SD = 0.25) and an "older" cohort (age 6 at baseline, n = 29, M age = 6.50, SD = 0.30). Across our exploratory analyses, we examined how irritability related to seed-based intrinsic connectivity via whole-brain connectivity ANCOVAs using the left and right amygdala, and left and right ventral striatum as seed regions. RESULTS Cross-sectionally, higher levels of irritability were associated with greater amygdala connectivity with the posterior cingulate, controlling for child age. No age-dependent effects were observed in the cross-sectional analyses. Longitudinal analyses in the younger cohort revealed that early higher vs. lower levels of irritability, controlling for later irritability, were associated with decreases in amygdala and ventral striatum connectivity with multiple frontal and parietal regions over time. There were no significant findings in the older cohort. CONCLUSIONS Findings suggest that irritability is related to altered neural connectivity during rest regardless of age in early to middle childhood and that early childhood irritability may be linked to altered changes in neural connectivity over time. Understanding how childhood irritability interacts with neural processes can inform pathophysiological models of pediatric irritability and the development of targeted mechanistic interventions.
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Affiliation(s)
- Michael T. Liuzzi
- San Diego State University, Department of Psychology, San Diego, CA, USA,Correspondence to: 6363 Alvarado Ct., Ste 103, San Diego, CA 92120, USA.
| | - Maria Kryza-Lacombe
- San Diego State University/University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | | | - Cassidy Owen
- San Diego State University, Department of Psychology, San Diego, CA, USA
| | - Elizabeth Redcay
- University of Maryland, Department of Psychology, College Park, MD, USA
| | - Tracy Riggins
- University of Maryland, Department of Psychology, College Park, MD, USA
| | - Lea R. Dougherty
- University of Maryland, Department of Psychology, College Park, MD, USA
| | - Jillian Lee Wiggins
- San Diego State University, Department of Psychology, San Diego, CA, USA,San Diego State University/University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
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23
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Lee KS, Hagan CN, Hughes M, Cotter G, McAdam Freud E, Kircanski K, Leibenluft E, Brotman MA, Tseng WL. Systematic Review and Meta-analysis: Task-based fMRI Studies in Youths With Irritability. J Am Acad Child Adolesc Psychiatry 2023; 62:208-229. [PMID: 35944754 PMCID: PMC9892288 DOI: 10.1016/j.jaac.2022.05.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 04/22/2022] [Accepted: 07/28/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Childhood irritability, operationalized as disproportionate and frequent temper tantrums and low frustration tolerance relative to peers, is a transdiagnostic symptom across many pediatric disorders. Studies using task-dependent functional magnetic resonance imaging (fMRI) to probe neural dysfunction in irritability have increased. However, an integrated review summarizing the published methods and synthesized fMRI results remains lacking. METHOD We conducted a systematic search using irritability terms and task functional neuroimaging in key databases in March 2021, and identified 30 studies for our systematic review. Sample characteristics and fMRI methods were summarized. A subset of 28 studies met the criteria for extracting coordinate-based data for quantitative meta-analysis. Ten activation-likelihood estimations were performed to examine neural convergence across irritability measures and fMRI task domains. RESULTS Systematic review revealed small sample sizes (median = 58, mean age range = 8-16 years) with heterogeneous sample characteristics, irritability measures, tasks, and analytical procedures. Meta-analyses found no evidence for neural activation convergence of irritability across neurocognitive functions related to emotional reactivity, cognitive control, and reward processing, or within each domain. Sensitivity analyses partialing out variances driven by heterogeneous tasks, irritability measures, stimulus types, and developmental ages all yielded null findings. Results were compared with a review on irritability-related structural anomalies from 11 studies. CONCLUSION The lack of neural convergence suggests a need for common, standardized irritability assessments and more homogeneous fMRI tasks. Thoughtfully designed fMRI studies probing commonly defined neurocognitive functions may be more fruitful to elucidate the neural mechanisms of irritability. Open science practices, data mining in large neuroscience databases, and standardized analytical methods promote meaningful collaboration in irritability research.
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Affiliation(s)
- Ka Shu Lee
- Yale School of Medicine, New Haven, Connecticut; University of Oxford, United Kingdom.
| | | | - Mina Hughes
- Yale School of Medicine, New Haven, Connecticut
| | | | - Eva McAdam Freud
- Yale School of Medicine, New Haven, Connecticut; University College London, United Kingdom; Anna Freud National Centre for Children and Families, London, United Kingdom
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24
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Dimick MK, Toma S, MacIntosh BJ, Grigorian A, Fiksenbaum L, Youngstrom EA, Robertson AD, Goldstein BI. Cerebral Blood Flow and Core Mood Symptoms in Youth Bipolar Disorder: Evidence for Region-Symptom Specificity. J Am Acad Child Adolesc Psychiatry 2022; 61:1455-1465. [PMID: 35487335 DOI: 10.1016/j.jaac.2022.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 02/03/2022] [Accepted: 04/19/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Building on prior findings in adults, this study investigated regional cerebral blood flow (CBF) in relation to DSM-5 criterion A symptoms of depression and mania in youth with bipolar disorder (BD). METHOD The study recruited 81 youths with BD and 75 healthy controls 13-20 years old. CBF was ascertained using pseudocontinuous arterial spin labeling magnetic resonance imaging. Region-of-interest analyses examined the amygdala, anterior cingulate cortex (ACC), middle frontal gyrus, and global gray matter CBF. The association of criterion A depression and mania symptoms with CBF was examined dimensionally in youth with BD in regression analyses with continuous symptom severity scores. Age and sex were included as covariates. False discovery rate (FDR) was used to correct for 28 tests (4 regions by 7 symptoms; α < .0017). CBF for BD and healthy control groups was compared to give context for findings. RESULTS In youth with BD, depressed mood inversely correlated with ACC (β = -0.31, puncorrected = .004, pFDR = .056) and global (β = -0.27, puncorrected = .013, pFDR = .09) CBF. The same pattern was observed for anhedonia (ACC CBF: β = -0.33, puncorrected = .004, pFDR = .056; global CBF: β = -0.29, puncorrected = .008, pFDR = .07). There were no significant findings for manic symptoms or in BD vs healthy control contrasts. CONCLUSION The present findings, while not significant after correction for multiple testing, highlight the potential value of focusing on ACC in relation to depressed mood and anhedonia, and demonstrate that CBF is sensitive to depression symptom severity in youth. Lack of findings regarding manic symptoms may relate to the exclusion of fully manic participants in this outpatient sample.
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Affiliation(s)
- Mikaela K Dimick
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; University of Toronto, Canada
| | - Simina Toma
- University of Toronto, Canada; Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Bradley J MacIntosh
- University of Toronto, Canada; Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Anahit Grigorian
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | | | - Eric A Youngstrom
- University of North Carolina at Chapel Hill and Helping Give Away Psychological Science, Inc., Chapel Hill, North Carolina
| | | | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; University of Toronto, Canada.
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Kryza-Lacombe M, Palumbo D, Wakschlag LS, Dougherty LR, Wiggins JL. Executive functioning moderates neural mechanisms of irritability during reward processing in youth. Psychiatry Res Neuroimaging 2022; 323:111483. [PMID: 35561577 PMCID: PMC9829104 DOI: 10.1016/j.pscychresns.2022.111483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/13/2022] [Accepted: 04/14/2022] [Indexed: 01/12/2023]
Abstract
Pediatric irritability is the most robust indicator of transdiagnostic psychopathology risk. It is associated with altered neural reward processing, including neural networks related to cognitive control, and better cognitive control has been hypothesized to mitigate irritability. We evaluated the relationship of executive functioning (EF) with irritability-related neural correlates of reward processing in youths with varying levels of irritability. Participants (N = 51, mean age=13.80 years, SD=1.94) completed a monetary incentive delay task during multiband fMRI acquisition. Irritability and EF were measured via the Affective Reactivity Index and the NIH Toolbox cognition battery, respectively. Whole-brain analyses, controlling for age, examined the moderating role of EF on irritability-related brain activation and connectivity (seeds: striatum, amygdala) during reward anticipation and performance feedback. Irritability-related neural patterns during reward processing depended on EF, in occipital areas during reward anticipation and limbic, frontal, and temporal networks during performance feedback. Higher irritability combined with higher EF was associated with neural patterns opposite to those observed for higher irritability with lower co-occurring EF. Although preliminary, findings suggest that EF may buffer irritability-related reward processing deficits. Additionally, individual differences in EF and their relation to irritability may be related to varied etiologic mechanisms of irritability with important implications for personalized prevention and intervention.
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Affiliation(s)
- Maria Kryza-Lacombe
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, United States.
| | - Danielle Palumbo
- Department of Psychology, San Diego State University, United States
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine, & Institute for Innovations in Developmental Sciences, Northwestern University, United States
| | - Lea R Dougherty
- University of Maryland, Department of Psychology, United States
| | - Jillian Lee Wiggins
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, United States; Department of Psychology, San Diego State University, United States
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Harlé KM, Ho TC, Connolly CG, Simmons AN, Yang TT. The effect of obstructed action efficacy on reward-based decision-making in healthy adolescents: a novel functional MRI task to assay frustration. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2022; 22:542-556. [PMID: 34966980 PMCID: PMC9090962 DOI: 10.3758/s13415-021-00975-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/01/2021] [Indexed: 06/03/2023]
Abstract
Frustration is common in adolescence and often interferes with executive functioning, particularly reward-based decision-making, and yet very little is known about how incidental frustrating events (independent of task-based feedback) disrupt the neural circuitry of reward processing in this important age group. While undergoing functional magnetic resonance imaging (fMRI), 45 healthy adolescents played a card game in which they had to guess between two options to earn points, in low- and high-stake conditions. Functioning of button presses through which they made decisions was intermittently blocked, thereby increasing frustration potential. Neural deactivation of the precuneus, a Default Mode Network region, was observed during obstructed action blocks across stake conditions, but less so on high- relative to low-stake trials. Moreover, less deactivation in goal-directed reward processing regions (i.e., caudate), frontoparietal "task control" regions, and interoceptive processing regions (i.e., somatosensory cortex, thalamus) were observed on high-stake relative to low-stake trials. These findings are consistent with less disruption of goal-directed reward seeking during blocked action efficacy in high-stake conditions among healthy adolescents. These results provide a roadmap of neural systems critical to the processing of frustrating events during reward-based decision-making in youths and could help to characterize how frustration regulation is altered in a range of pediatric psychopathologies.
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Affiliation(s)
- Katia M Harlé
- VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA.
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
| | - Tiffany C Ho
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Colm G Connolly
- Department of Biomedical Sciences, Florida State University, Tallahassee, FL, USA
| | - Alan N Simmons
- VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Tony T Yang
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
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Ametti MR, Crehan ET, O’Loughlin K, Schreck MC, Dube SL, Potter AS, Sigmon SC, Althoff RR. Frustration, Cognition, and Psychophysiology in Dysregulated Children: A Research Domain Criteria Approach. J Am Acad Child Adolesc Psychiatry 2022; 61:796-808.e2. [PMID: 35074486 PMCID: PMC9275749 DOI: 10.1016/j.jaac.2021.11.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/30/2021] [Accepted: 01/13/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Dysregulated children experience significant impairment in regulating their affect, behavior, and cognitions and are at risk for numerous adverse sequelae. The unclear phenomenology of their symptoms presents a barrier to evidence-based diagnosis and treatment. METHOD The cognitive, behavioral, and psychophysiological mechanisms of dysregulation were examined in a mixed clinical and community sample of 294 children ages 7-17 using the Research Domain Criteria constructs of cognitive control and frustrative nonreward. RESULTS Results showed that caregivers of dysregulated children viewed them as having many more problems with everyday executive function than children with moderate or low levels of psychiatric symptoms; however, during standardized assessments of more complex cognitive control tasks, performance of dysregulated children differed only from children with low symptoms on tests of cognitive flexibility. In addition, when frustrated, dysregulated children performed more poorly on the Go/No-Go Task and demonstrated less autonomic flexibility as indexed by low respiratory sinus arrhythmia and pre-ejection period scores. CONCLUSION The findings of this study suggest that autonomic inflexibility and impaired cognitive function in the context of frustration may be mechanisms underlying childhood dysregulation.
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Preschool Irritability Predicts Adolescent Psychopathology and Functional Impairment: A 12-Year Prospective Study. J Am Acad Child Adolesc Psychiatry 2022; 61:554-564.e1. [PMID: 34481916 PMCID: PMC9951107 DOI: 10.1016/j.jaac.2021.08.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/30/2021] [Accepted: 08/26/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The long-term clinical and functional outcomes of preschool-age irritability are unknown. This study examined longitudinal associations of preschool irritability with psychiatric disorders and functional impairment assessed in adolescence in a large community sample. METHOD A total of 453 children were assessed at age 3 and again at ages 12 and/or 15. At age 3, parents were interviewed about their child's irritability, other psychiatric symptoms, and functional impairment with the Preschool Age Psychiatric Assessment (PAPA). In adolescence, both parents and youths were interviewed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime (K-SADS-PL) to assess youth psychopathology and functional impairment; youths also completed the UCLA Life Stress Interview (LSI) to assess different domains of functioning. Lastly, youths and parents completed the Children's Depression Inventory 2 (CDI 2) and the Screen for Child Anxiety Related Disorders (SCARED). RESULTS Irritability at age 3 predicted internalizing and externalizing disorders in adolescence; parent-reported anxiety and depressive symptoms; and greater functional impairment, including poorer peer functioning, poorer physical health, and antidepressant and educational service use, even after controlling for baseline psychiatric disorders. All longitudinal associations persisted after further adjusting for well-established early life risk markers for psychopathology. CONCLUSION The findings of this study underscore the clinical significance and predictive power of preschool irritability and provide support for its use in large-scale identification and intervention efforts.
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Pacheco J, Garvey MA, Sarampote CS, Cohen ED, Murphy ER, Friedman-Hill SR. Annual Research Review: The contributions of the RDoC research framework on understanding the neurodevelopmental origins, progression and treatment of mental illnesses. J Child Psychol Psychiatry 2022; 63:360-376. [PMID: 34979592 PMCID: PMC8940667 DOI: 10.1111/jcpp.13543] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 12/22/2022]
Abstract
The National Institute of Mental Health (NIMH) proposed the Research Domain Criteria (RDoC) initiative as an alternate way to organize research of mental illnesses, by looking at dimensions of functioning rather than being tied to categorical diagnoses. This paper briefly discusses the motivation for and organization of RDoC, and then explores the NIMH portfolio and recent work to monitor the utility and progress that RDoC has afforded developmental research. To examine how RDoC has influenced the NIMH developmental research portfolio over the last decade, we employed a natural language processing algorithm to identify the number of developmental science grants classified as incorporating an RDoC approach. Additional portfolio analyses examine temporal trends in funded RDoC-relevant grants, publications and citations, and research training opportunities. Reflecting on how RDoC has influenced the focus of grant applications, we highlight examples from research on Attention-Deficit Hyperactivity Disorder (ADHD), childhood irritability, and Autism Spectrum Disorder (ASD). Lastly, we consider how the dimensional and transdiagnostic approaches emphasized in RDoC have facilitated research on personalized intervention for heterogeneous disorders and preventive/early interventions targeting emergent or subthreshold psychopathology.
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Affiliation(s)
- Jennifer Pacheco
- Division of Translational Research, National Institute of Mental Health
- RDoC Unit, National Institute of Mental Health
| | | | | | - Elan D. Cohen
- Office of Science Policy, Planning, and Communications, National Institute of Mental Health
| | - Eric R. Murphy
- Division of Translational Research, National Institute of Mental Health
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Luby J. Editorial: The Predictive Power of Preschool Irritability Comes Into Focus. J Am Acad Child Adolesc Psychiatry 2022; 61:476-477. [PMID: 34715274 DOI: 10.1016/j.jaac.2021.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 10/19/2021] [Indexed: 11/28/2022]
Abstract
In recent decades, the search for early childhood markers of risk for later psychopathology has been vigorous. It has garnered escalating interest from multiple facets of developmental science, and has extended to periods as early as prenatal development. The principle that early identification of neurodevelopmental risk to target intervention during relatively higher neuroplastic periods offers a window of opportunity for larger effects and more enduring change is one key driver of this effort. Despite this intense interest and focus, the ability to test the predictive power of early markers requires time, persistence, and patience, with the later childhood and adolescent outcomes of some key longitudinal studies starting in early childhood only now becoming available. The Stony Brook Temperament Study is one such sample, from which Sorcher et al.1 report strong relationships between preschool irritability and a variety of outcomes in early adolescence, some of them surprisingly broad. Findings from this community sample demonstrate that irritability at age 3 years predicts later internalizing and externalizing outcomes as well as poor peer relations, global impairment, and health problems, even after controlling for other key established risk factors. These findings are some of the most convincing yet available to suggest that preschool irritability should be an intervention target to prevent poor long-term outcomes. However, in contrast to prior hypotheses, these data suggest that it may not be a specific marker of later affective disorders, although differences between youth and parent report were found along these lines. Surprisingly, only parent report suggested that early irritability had greater specificity to affective disorder outcomes, whereas youth self-report did not.
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Affiliation(s)
- Joan Luby
- Washington University School of Medicine, St. Louis, Missouri.
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31
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Colonna S, Eyre O, Agha SS, Thapar A, van Goozen S, Langley K. Investigating the associations between irritability and hot and cool executive functioning in those with ADHD. BMC Psychiatry 2022; 22:166. [PMID: 35247998 PMCID: PMC8898423 DOI: 10.1186/s12888-022-03818-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 02/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Irritability is especially pertinent to those with Attention Deficit Hyperactivity Disorder (ADHD) as it is highly prevalent and associated with a more severe clinical presentation and poorer longitudinal outcomes. Preliminary evidence suggests that top-down cognitive processes taking place in emotional contexts (i.e., hot executive functions) as opposed to those evoked in abstract scenarios (i.e., cool executive functions) may be relevant to the presentation of irritability in ADHD. This study explored the cognitive mechanisms underlying irritability in young people with ADHD, hypothesising that irritability would be associated with hot, but not cool, executive function impairments. METHODS Our sample included 219 individuals with ADHD. A composite irritability score was derived extracting items from a parent interview, with scores ranging from 0 to 5. Associations were investigated using linear regression analyses, between irritability and four hot tasks measuring sensitivity to risk, risk-taking behaviour following reward or punishment, acceptance of reward delay and reaction to unfair behaviour from others, and two cool tasks measuring set-shifting and motor inhibition. RESULTS As hypothesised, there were no significant associations between irritability and cool executive functions in those with ADHD; however, contrary to expectations, there was also no significant evidence that hot executive functions were associated with irritability. CONCLUSIONS These results, in a large well characterised sample and using a comprehensive task battery, suggest that the variation in irritability in those with ADHD may not be associated with differences in hot or cool executive function performance.
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Affiliation(s)
- Silvia Colonna
- grid.5600.30000 0001 0807 5670School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT UK
| | - Olga Eyre
- grid.5600.30000 0001 0807 5670MRC Centre for Psychiatric Genetics & Genomics, Division of Psychological Medicine, School of Medicine, Cardiff University, Maindy Road, Cardiff, UK
| | - Sharifah Shameem Agha
- grid.5600.30000 0001 0807 5670MRC Centre for Psychiatric Genetics & Genomics, Division of Psychological Medicine, School of Medicine, Cardiff University, Maindy Road, Cardiff, UK ,Cwm Taf Morgannwg University Health Board, Pontypridd, Wales, UK
| | - Anita Thapar
- grid.5600.30000 0001 0807 5670School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT UK ,grid.5600.30000 0001 0807 5670MRC Centre for Psychiatric Genetics & Genomics, Division of Psychological Medicine, School of Medicine, Cardiff University, Maindy Road, Cardiff, UK
| | - Stephanie van Goozen
- grid.5600.30000 0001 0807 5670School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT UK
| | - Kate Langley
- School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK. .,MRC Centre for Psychiatric Genetics & Genomics, Division of Psychological Medicine, School of Medicine, Cardiff University, Maindy Road, Cardiff, UK.
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Brænden A, Zeiner P, Coldevin M, Stubberud J, Melinder A. Underlying mechanisms of disruptive mood dysregulation disorder in children: A systematic review by means of research domain criteria. JCPP ADVANCES 2022; 2:e12060. [PMID: 37431494 PMCID: PMC10242926 DOI: 10.1002/jcv2.12060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 12/13/2021] [Indexed: 11/10/2022] Open
Abstract
Background A systematic overview of underlying mechanisms in the new disruptive mood dysregulation disorder (DMDD) diagnosis is needed. The Research Domain Criteria (RDoC) represent a system of six domains of human functioning, which aims to structure the understanding of the nature of mental illnesses. By means of the RDoC framework, the objective of this systematic review is to synthesize available data on children and youths <18 years suffering from DMDD as reported in peer reviewed papers. Methods A literature search guided by PRISMA was conducted using Medline, PsychInfo, and Embase, while the RDoC domains were employed to systematize research findings. Risk of bias in the included studies was examined. Results We identified 319 studies. After study selection, we included 29 studies. Twenty-one of these had findings relating to >1 RDoC domain. The risk of bias assessment shows limitations in the research foundation of current knowledge on mechanisms of DMDD. Discussion Reviewing self-report, behavior and neurocircuit findings by means of RDoC domains, we suggest that DMDD youths have a negative interpretation bias in social processes and valence systems. In occurrence of a negative stimuli interpretation, aberrant cognitive processing may arise. However, current knowledge of DMDD is influenced by lack of sample diversity and open science practices. Conclusion We found the six RDoC domains useful in structuring current evidence of the underlying mechanisms of DMDD. Important opportunities for future studies in this field of research are suggested. In clinical practice, this comprehensive summary on DMDD mechanisms can be used in psychoeducation and treatment plans.
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Affiliation(s)
- Astrid Brænden
- Department of Child and Adolescent PsychiatryOslo University HospitalOsloNorway
| | - Pål Zeiner
- Child and Adolescent Mental Health Research Unit, Department of Research and InnovationOslo University HospitalOsloNorway
- Institute of Clinical MedicineUniversity of OsloOsloNorway
| | - Marit Coldevin
- Nic Waals InstituteLovisenberg Diaconal HospitalOsloNorway
- Department of ResearchLovisenberg Diaconal HospitalOsloNorway
| | - Jan Stubberud
- Department of ResearchLovisenberg Diaconal HospitalOsloNorway
- Department of PsychologyUniversity of OsloOsloNorway
| | - Annika Melinder
- Department of Child and Adolescent PsychiatryOslo University HospitalOsloNorway
- Department of PsychologyUniversity of OsloOsloNorway
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33
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Trait irritability in adults is unrelated to face emotion identification. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2021.111290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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The effects of reward and frustration in patients with bipolar disorder: Evidence from a computerized task with non-contingent feedback. J Affect Disord 2022; 298:69-79. [PMID: 34715178 DOI: 10.1016/j.jad.2021.10.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 09/13/2021] [Accepted: 10/23/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is characterized by mood changes that implies alterations in reward sensitivity and frustration tolerance. This study examined the effects of monetary reward and frustration on attentional performance and on affective experience across mood states in BD. METHODS An Affective Posner Task in which the nature of contingencies are divided in the three successive blocks (baseline condition, monetary reward and non-contingent feedback) was applied to BD individuals in their different episodes: mania (n = 30), depression (n = 30), and euthymia (n = 30) as well as to a group of healthy controls (n = 30). RESULTS Monetary reward improved performance (in terms of faster response times) in the euthymic group and the control group, whereas it impaired performance in the manic group and has not significant effect in the depressed group. In addition, an increased interference of frustration on response accuracy was exhibited in the three groups of BD patients (including euthymia) compared with healthy controls. LIMITATIONS Participants' affective experience was self-informed by a Likert scale, so the reliability of this measure can be undermined in symptomatic patients in terms of stability and objectivity. Although it was statistically controlled, at the time of testing, all BD patients were medicated. CONCLUSIONS A dissociated effect of reward and frustration was found between symptomatic and euthymic states in BD: whereas the benefit from monetary reward is affected only during symptomatic episodes (i.e., a state), the notably increased interference of frustration is exhibited also during euthymia (i.e., a trait).
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35
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Harima Y, Miyawaki D, Goto A, Hirai K, Sakamoto S, Hama H, Kadono S, Nishiura S, Inoue K. Associations Between Chronic Irritability and Sensory Processing Difficulties in Children and Adolescents. Front Psychiatry 2022; 13:860278. [PMID: 35573381 PMCID: PMC9095987 DOI: 10.3389/fpsyt.2022.860278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 04/05/2022] [Indexed: 11/13/2022] Open
Abstract
Irritability is one of the most common reasons for which children and adolescents are referred for psychiatric evaluation and care. However, clinical irritability is difficult to define; thus, its prevalence varies widely. Chronic irritability may be associated with sensory processing difficulties (SPD), but little is known about the relationship between these two factors in clinical populations. In this study, we examined the prevalence of chronic irritability and its association with SPD in 166 children aged 5-16 years who were referred to the psychiatric outpatient clinic of the Osaka City University Hospital. Chronic irritability and parent-reported scores for the Short Sensory Profile, Infant Behavior Checklist-Revised, Child Behavior Checklist, and Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (Present and Lifetime version) questionnaires were used for assessment. A total of 22 children (13.2%) presented with chronic irritability (i.e., the irritability group) and were more likely to have oppositional defiant disorder, externalizing problems, and attention issues than those without chronic irritability (i.e., the control group). SPD were reported in eight (36%) patients in the irritability group and in 21 (15%) in the control group (p = 0.029). Moreover, compared to the control group, the irritability group showed a significant difference in almost all items of the Short Sensory Profile. Chronic irritability was associated with more severe overall SPD, even after adjusting for possible confounding factors (internalizing and externalizing problems, age, sex, and low income). We provide evidence to support our hypothesis that chronic irritability is associated with SPD in children and adolescents. Therefore, SPD should be assessed to provide appropriate interventions in children and adolescents with chronic irritability.
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Affiliation(s)
- Yuji Harima
- Department of Neuropsychiatry, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Dai Miyawaki
- Department of Neuropsychiatry, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Ayako Goto
- Department of Neuropsychiatry, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Kaoru Hirai
- Department of Neuropsychiatry, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.,Department of Pediatrics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Shoko Sakamoto
- Department of Neuropsychiatry, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hiroki Hama
- Department of Neuropsychiatry, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Shin Kadono
- Department of Neuropsychiatry, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Sayaka Nishiura
- Department of Neuropsychiatry, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Koki Inoue
- Department of Neuropsychiatry, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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36
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Xu S, Li M, Yang C, Fang X, Ye M, Wu Y, Yang B, Huang W, Li P, Ma X, Fu S, Yin Y, Tian J, Gan Y, Jiang G. Abnormal Degree Centrality in Children with Low-Function Autism Spectrum Disorders: A Sleeping-State Functional Magnetic Resonance Imaging Study. Neuropsychiatr Dis Treat 2022; 18:1363-1374. [PMID: 35818374 PMCID: PMC9270980 DOI: 10.2147/ndt.s367104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 06/23/2022] [Indexed: 12/04/2022] Open
Abstract
PURPOSE This study used the graph-theory approach, degree centrality (DC) to analyze whole-brain functional networks at the voxel level in children with ASD, and investigated whether DC changes were correlated with any clinical variables in ASD children. METHODS The current study included 86 children with ASD and 54 matched healthy subjects Aged 2-5.5 years. Next, chloral hydrate induced sleeping-state functional magnetic resonance imaging (ss-fMRI) datasets were acquired from these ASD and healthy subjects. For a given voxel, the DC was calculated by calculating the number of functional connections with significantly positive correlations at the individual level. Group differences were tested using two-sample t-tests (p < 0.01, AlphaSim corrected). Finally, relationships between abnormal DCs and clinical variables were investigated via Pearson's correlation analysis. RESULTS Children with ASD exhibited low DC values in the right middle frontal gyrus (MFG) (p < 0.01, AlphaSim corrected). Furthermore, significantly negative correlations were established between the decreased average DC values within the right MFG in ASD children and the total ABC scores, as well as with two ABC subscales measuring highly relevant impairments in ASD (ie, stereotypes and object-use behaviors and difficulties in language). CONCLUSION Taken together, the results of our ss-fMRI study suggest that abnormal DC may represent an important contribution to elucidation of the neuropathophysiological mechanisms of preschoolers with ASD.
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Affiliation(s)
- Shoujun Xu
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Meng Li
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Chunlan Yang
- Department of Hematology and Oncology, Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Xiangling Fang
- Department of Department of Children Healthcare, Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Miaoting Ye
- Department of Department of Children Healthcare, Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Yunfan Wu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Binrang Yang
- Department of Department of Children Healthcare, Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Wenxian Huang
- Department of Department of Children Healthcare, Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Peng Li
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Xiaofen Ma
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Shishun Fu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Yi Yin
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Junzhang Tian
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Yungen Gan
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Guihua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
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Using ecological momentary assessment to enhance irritability phenotyping in a transdiagnostic sample of youth. Dev Psychopathol 2021. [DOI: 10.1017/s0954579421000717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
AbstractIrritability is a transdiagnostic symptom dimension in developmental psychopathology, closely related to the Research Domain Criteria (RDoC) construct of frustrative nonreward. Consistent with the RDoC framework and calls for transdiagnostic, developmentally-sensitive assessment methods, we report data from a smartphone-based, naturalistic ecological momentary assessment (EMA) study of irritability. We assessed 109 children and adolescents (Mage = 12.55 years; 75.20% male) encompassing several diagnostic groups – disruptive mood dysregulation disorder (DMDD), attention-deficit/hyperactivity disorder (ADHD), anxiety disorders (ANX), healthy volunteers (HV). The participants rated symptoms three times per day for 1 week. Compliance with the EMA protocol was high. As tested using multilevel modeling, EMA ratings of irritability were strongly and consistently associated with in-clinic, gold-standard measures of irritability. Further, EMA ratings of irritability were significantly related to subjective frustration during a laboratory task eliciting frustrative nonreward. Irritability levels exhibited an expected graduated pattern across diagnostic groups, and the different EMA items measuring irritability were significantly associated with one another within all groups, supporting the transdiagnostic phenomenology of irritability. Additional analyses utilized EMA ratings of anxiety as a comparison with respect to convergent validity and transdiagnostic phenomenology. The results support new measurement tools that can be used in future studies of irritability and frustrative nonreward.
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Naim R, Goodwin MS, Dombek K, Revzina O, Agorsor C, Lee K, Zapp C, Freitag GF, Haller SP, Cardinale E, Jangraw D, Brotman MA. Cardiovascular reactivity as a measure of irritability in a transdiagnostic sample of youth: Preliminary associations. Int J Methods Psychiatr Res 2021; 30:e1890. [PMID: 34390050 PMCID: PMC8633925 DOI: 10.1002/mpr.1890] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/22/2021] [Accepted: 07/23/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Irritability is a transdiagnostic symptom in developmental psychopathology, conceptualized as a low threshold for frustration and increased proneness to anger. While central to emotion regulation, there is a vital need for empirical studies to explore the relationship between irritability and underlying physiological mechanisms of cardiovascular arousal. METHODS We examined the relationship between irritability and cardiovascular arousal (i.e., heart rate [HR] and heart rate variability [HRV]) in a transdiagnostic sample of 51 youth (M = 12.63 years, SD = 2.25; 62.7% male). Data was collected using the Empatica E4 during a laboratory stop-signal task. In addition, the impact of motion activity, age, medication, and sleep on cardiovascular responses was explored. RESULTS Main findings showed that irritability was associated with increased HR and decreased HRV during task performance. CONCLUSIONS Findings support the role of peripheral physiological dysregulation in youth with emotion regulation problems and suggest the potential use of available wearable consumer electronics as an objective measure of irritability and physiological arousal in a transdiagnostic sample of youth.
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Affiliation(s)
- Reut Naim
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Matthew S Goodwin
- Department of Health Sciences, Khoury College of Computer Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Kelly Dombek
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Olga Revzina
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Courtney Agorsor
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Kyunghun Lee
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Christian Zapp
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Gabrielle F Freitag
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Simone P Haller
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Elise Cardinale
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - David Jangraw
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
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Crum KI, Hwang S, Blair KS, Aloi JM, Meffert H, White SF, Tyler PM, Leibenluft E, Pope K, Blair RJR. Interaction of irritability and anxiety on emotional responding and emotion regulation: a functional MRI study. Psychol Med 2021; 51:2778-2788. [PMID: 32584213 PMCID: PMC7759590 DOI: 10.1017/s0033291720001397] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 04/17/2020] [Accepted: 04/29/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Irritability and anxiety frequently co-occur in pediatric populations. Studies separately looking at the neural correlates of these symptoms have identified engagement of similar neural systems - particularly those implicated in emotional processing. Both irritability and anxiety can be considered negative valence emotional states that might relate to emotion dysregulation. However, previous work has not examined the neural responding during the performance of an emotion regulation task as a function of interaction between irritability and anxiety simultaneously. METHODS This fMRI study involved 155 participants (90 with significant psychopathologies and 92 male) who performed the Affective Stroop Task, designed to engage emotion regulation as a function of task demands. The Affective Reactivity Index (ARI) was used to index irritability and the Screen for Child Anxiety Related Emotional Disorders (SCARED) was used to index anxiety. RESULTS Levels of irritability, but not anxiety, was positively correlated with responses to visual images within the right rostro-medial prefrontal cortex and left anterior cingulate cortex during view trials. The second region of ventral anterior cingulate cortex showed a condition-by-emotion-by-ARI score-by-SCARED score interaction. Specifically, anxiety level was significantly correlated with a decreased differential BOLD response to negative relative to neutral view trials but only in the presence of relatively high irritability. CONCLUSIONS Atypical maintenance of emotional stimuli within the rostro-medial prefrontal cortex may exacerbate the difficulties faced by adolescents with irritability. Moreover, increased anxiety combined with significant irritability may disrupt an automatic emotional conflict-based form of emotion regulation that is particularly associated with the ventral anterior cingulate cortex.
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Affiliation(s)
- Kathleen I. Crum
- Medical University of South Carolina, Charleston, South Carolina, USA
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Soonjo Hwang
- University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Karina S. Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | | | | | - Stuart F. White
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Patrick M. Tyler
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Kayla Pope
- Medical College of Wisconsin, Northeastern Wisconsin Psychiatry Training Program, Winnebago, Wisconsin, USA
| | - R. J. R. Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska, USA
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40
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Sukhodolsky DG, Ibrahim K, Kalvin CB, Jordan RP, Eilbott J, Hampson M. Increased amygdala and decreased frontolimbic r esting- s tate functional connectivity in children with aggressive behavior. Soc Cogn Affect Neurosci 2021; 17:634-644. [PMID: 34850939 PMCID: PMC9250305 DOI: 10.1093/scan/nsab128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 10/08/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Childhood maladaptive aggression is associated with disrupted functional connectivity within amygdala-prefrontal circuitry. In this study, neural correlates of childhood aggression were probed using the intrinsic connectivity distribution, a voxel-wise metric of global resting-state brain connectivity. This sample included 38 children with aggressive behavior (26 boys, 12 girls) ages 8-16 years and 21 healthy controls (14 boys, 6 girls) matched for age and IQ. Functional MRI data were acquired during resting state, and differential patterns of intrinsic functional connectivity were tested in a priori regions of interest implicated in the pathophysiology of aggressive behavior. Next, correlational analyses tested for associations between functional connectivity and severity of aggression measured by the Reactive-Proactive Aggression Questionnaire in children with aggression. Children with aggressive behavior showed increased global connectivity in the bilateral amygdala relative to controls. Greater severity of aggressive behavior was associated with decreasing global connectivity in the dorsal anterior cingulate and ventromedial prefrontal cortex. Follow-up seed analysis revealed that aggression was also positively correlated with left amygdala connectivity with the dorsal anterior cingulate, ventromedial and dorsolateral prefrontal cortical regions. These results highlight the potential role of connectivity of the amygdala and medial prefrontal and anterior cingulate cortices in modulating the severity of aggressive behavior in treatment-seeking children.
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Affiliation(s)
- Denis G Sukhodolsky
- Correspondence should be addressed to Denis G. Sukhodolsky, Child Study Center, Yale School of Medicine, 230 South Frontage Road, New Haven, CT 06520, USA. E-mail:
| | - Karim Ibrahim
- Child Study Center, Yale School of Medicine, New Haven, CT 06520, USA
| | - Carla B Kalvin
- Child Study Center, Yale School of Medicine, New Haven, CT 06520, USA
| | - Rebecca P Jordan
- Child Study Center, Yale School of Medicine, New Haven, CT 06520, USA
| | - Jeffrey Eilbott
- Child Study Center, Yale School of Medicine, New Haven, CT 06520, USA,SurveyBott Consulting, Guilford, CT 06437, USA
| | - Michelle Hampson
- Child Study Center, Yale School of Medicine, New Haven, CT 06520, USA,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06520, USA,Department of Psychiatry, Yale School of Medicine, New Haven, CT 06520, USA,Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA
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41
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MacNeill LA, Allen NB, Poleon RB, Vargas T, Osborne KJ, Damme KSF, Barch DM, Krogh-Jespersen S, Nielsen AN, Norton ES, Smyser CD, Rogers CE, Luby JL, Mittal VA, Wakschlag LS. Translating RDoC to Real-World Impact in Developmental Psychopathology: A Neurodevelopmental Framework for Application of Mental Health Risk Calculators. Dev Psychopathol 2021; 33:1665-1684. [PMID: 35095215 PMCID: PMC8794223 DOI: 10.1017/s0954579421000651] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The National Institute of Mental Health Research Domain Criteria's (RDoC) has prompted a paradigm shift from categorical psychiatric disorders to considering multiple levels of vulnerability for probabilistic risk of disorder. However, the lack of neurodevelopmentally-based tools for clinical decision-making has limited RDoC's real-world impact. Integration with developmental psychopathology principles and statistical methods actualize the clinical implementation of RDoC to inform neurodevelopmental risk. In this conceptual paper, we introduce the probabilistic mental health risk calculator as an innovation for such translation and lay out a research agenda for generating an RDoC- and developmentally-informed paradigm that could be applied to predict a range of developmental psychopathologies from early childhood to young adulthood. We discuss methods that weigh the incremental utility for prediction based on intensity and burden of assessment, the addition of developmental change patterns, considerations for assessing outcomes, and integrative data approaches. Throughout, we illustrate the risk calculator approach with different neurodevelopmental pathways and phenotypes. Finally, we discuss real-world implementation of these methods for improving early identification and prevention of developmental psychopathology. We propose that mental health risk calculators can build a needed bridge between RDoC's multiple units of analysis and developmental science.
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Affiliation(s)
- Leigha A MacNeill
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
| | - Norrina B Allen
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Roshaye B Poleon
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
| | - Teresa Vargas
- Department of Psychology, Northwestern University, Evanston, IL
| | | | | | - Deanna M Barch
- Department of Psychological and Brain Sciences, Washington University in St. Louis, MO
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Sheila Krogh-Jespersen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
| | - Ashley N Nielsen
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - Elizabeth S Norton
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Christopher D Smyser
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Vijay A Mittal
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
- Department of Psychology, Northwestern University, Evanston, IL
- Department of Psychiatry, Northwestern University, Chicago, IL
- Institute for Policy Research, Northwestern University, Evanston, IL
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
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42
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Ostlund B, Myruski S, Buss K, Pérez-Edgar KE. The centrality of temperament to the research domain criteria (RDoC): The earliest building blocks of psychopathology. Dev Psychopathol 2021; 33:1584-1598. [PMID: 34365985 PMCID: PMC10039756 DOI: 10.1017/s0954579421000511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The research domain criteria (RDoC) is an innovative approach designed to explore dimensions of human behavior. The aim of this approach is to move beyond the limits of psychiatric categories in the hope of aligning the identification of psychological health and dysfunction with clinical neuroscience. Despite its contributions to adult psychopathology research, RDoC undervalues ontogenetic development, which circumscribes our understanding of the etiologies, trajectories, and maintaining mechanisms of psychopathology risk. In this paper, we argue that integrating temperament research into the RDoC framework will advance our understanding of the mechanistic origins of psychopathology beginning in infancy. In illustrating this approach, we propose the incorporation of core principles of temperament theories into a new "life span considerations" subsection as one option for infusing development into the RDoC matrix. In doing so, researchers and clinicians may ultimately have the tools necessary to support emotional development and reduce a young child's likelihood of psychological dysfunction beginning in the first years of life.
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Affiliation(s)
- Brendan Ostlund
- Department of Psychology, The Pennsylvania State University, University Park, US
| | - Sarah Myruski
- Department of Psychology, The Pennsylvania State University, University Park, US
| | - Kristin Buss
- Department of Psychology, The Pennsylvania State University, University Park, US
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, US
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43
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Krogh-Jespersen S, Kaat AJ, Petitclerc A, Perlman SB, Briggs-Gowan MJ, Burns JL, Adam H, Nili A, Gray L, Wakschlag LS. Calibrating temper loss severity in the transition to toddlerhood: Implications for developmental science. APPLIED DEVELOPMENTAL SCIENCE 2021; 26:785-798. [PMID: 36387581 PMCID: PMC9648691 DOI: 10.1080/10888691.2021.1995386] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The integration of neurodevelopmental perspectives into clinical science has identified irritability as an early dimensional marker of lifespan mental health risk. Elucidating the developmental patterning of irritable behavior is key to differentiating normative variation from risk markers. Accounting for dysregulation and contextual features of irritability is useful for differentiation at preschool age, laying the groundwork for even earlier characterization. We provide initial evidence for the validity of the Multidimensional Assessment Profile of Disruptive Behavior Temper Loss Scale, Infant-Toddler version in two independent samples of 12-18-month-olds from the US. We calibrated the measure using item response theory in a large representative sample, then validated within an independent sample. We characterized the developmental patterning of irritable behaviors and their dimensional spectrum, and demonstrated test-retest reliability, and convergent validity. The MAP-DB-IT is a standardized, dimensional survey assessing irritability that serves as a tool for characterizing the developmental expression of early mental health risk.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Larry Gray
- Northwestern University
- Ann and Robert H. Lurie Children’s Hospital of Chicago
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44
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Hodgdon EA, Yu Q, Kryza-Lacombe M, Liuzzi MT, Aspe GI, Menacho VC, Bozzetto L, Dougherty L, Wiggins JL. Irritability-related neural responses to frustrative nonreward in adolescents with trauma histories: A preliminary investigation. Dev Psychobiol 2021; 63:e22167. [PMID: 34292612 DOI: 10.1002/dev.22167] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/08/2021] [Accepted: 06/27/2021] [Indexed: 11/08/2022]
Abstract
Irritability, conceptualized as a lowered frustration response threshold to blocked goal attainment (i.e., frustrative nonreward), is a common, detrimental symptom in adolescence. Yet, neural mechanisms of irritability are not well understood. This preliminary study aims to identify irritability-related neural patterns using a novel frustrative nonreward paradigm. Our study used a diverse sample of N = 31 non-White adolescent participants (mean age 14.53 years, SD = 1.74; 83.87% Hispanic/Latinx) to improve generalizability. During fMRI acquisition, participants performed a child-friendly monetary incentive delay task, modified to provide incorrect, negative feedback on performance. Irritability was associated with alterations in amygdala connectivity with basal ganglia, prefrontal, temporal, and parietal regions, and in activation of prefrontal and posterior cortical structures. Across clusters, youths with greater irritability showed activation/connectivity differences between reward blocked versus received conditions in the opposite direction compared to youths with lowered irritability. Alterations in amygdala-temporoparietal connectivity and lingual gyrus activation demonstrated an altered irritability-related recovery effect from the previous trial. These findings support the central role of frustrative nonreward as a key irritability pathway. Our work is one of the first to document neural correlates of difficult recovery from frustration characteristic of irritability and provides insight into novel treatment targets for irritability in diverse populations.
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Affiliation(s)
- Elizabeth A Hodgdon
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Qiongru Yu
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, California, USA
| | - Maria Kryza-Lacombe
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, California, USA
| | - Michael T Liuzzi
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Gabriela Ibarra Aspe
- Department of Psychology, San Diego State University, San Diego, California, USA
| | | | - Lauren Bozzetto
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Lea Dougherty
- Department of Psychology, University of Maryland, College Park, Maryland, USA
| | - Jillian Lee Wiggins
- Department of Psychology, San Diego State University, San Diego, California, USA.,Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, California, USA
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45
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Carter Leno V, Forth G, Chandler S, White P, Yorke I, Charman T, Pickles A, Simonoff E. Behavioural and physiological response to frustration in autistic youth: associations with irritability. J Neurodev Disord 2021; 13:27. [PMID: 34275441 PMCID: PMC8287810 DOI: 10.1186/s11689-021-09374-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 06/29/2021] [Indexed: 11/26/2022] Open
Abstract
Background Irritability is a common and impairing occurrence in autistic youth, yet the underlying mechanisms are not well-known. In typically developing populations, differences in frustration response have been suggested as important driver of the behavioural symptoms of irritability. Research exploring the role of frustration response as a risk factor for irritability in autistic populations is limited and often uses parent report or observer ratings; objective measures of frustration response appropriate for use in autistic populations are required to advance the field. Methods In the current study, fifty-two autistic adolescents aged 13–17 years from a population-based longitudinal study completed an experimental task designed to induce frustration through exposure to periods of unexpected delay. Behavioural (number of button presses) and physiological (heart rate; HR) metrics were collected during delay periods. Irritability was measured using the parent-rated Affective Reactivity Index (ARI). Analyses used mixed-level models to test whether irritability was associated with different slopes of behavioural and physiological response to experimentally induced frustration during the task. Age and baseline HR (for the physiological data only) were included as covariates. Results Analyses showed a marginal association between irritability and the slope of behavioural response (incident rate ratio (IRR) =.98, p=.06), and a significant association with the slope of physiological response (b=−.10, p=.04); higher levels of irritability were associated with a dampened behavioural and physiological response, as indicated by flatter slopes of change over the course of the task. The pattern of results largely remained in sensitivity analyses, although the association with physiological response became non-significant when adjusting for IQ, autism symptom severity, and medication use (b=−.10, p=.10). Conclusions Results suggest that the current experimental task may be a useful objective measure of frustration response for use with autistic populations, and that a non-adaptive response to frustration may be one biological mechanism underpinning irritability in autistic youth. This may represent an important target for future intervention studies. Supplementary Information The online version contains supplementary material available at 10.1186/s11689-021-09374-1.
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Affiliation(s)
- Virginia Carter Leno
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Georgia Forth
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Susie Chandler
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Philippa White
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Isabel Yorke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust (SLaM), London, UK
| | - Andrew Pickles
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Maudsley Biomedical Research Centre for Mental Health, London, UK
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust (SLaM), London, UK.,Maudsley Biomedical Research Centre for Mental Health, London, UK
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46
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Bell E, Boyce P, Porter RJ, Bryant RA, Malhi GS. Irritability in Mood Disorders: Neurobiological Underpinnings and Implications for Pharmacological Intervention. CNS Drugs 2021; 35:619-641. [PMID: 34019255 DOI: 10.1007/s40263-021-00823-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 12/28/2022]
Abstract
Feeling irritable is a common experience, both in health and disease. In the context of psychiatric illnesses, it is a transdiagnostic phenomenon that features across all ages, and often causes significant distress and impairment. In mood disorders, irritability is near ubiquitous and plays a central role in diagnosis and yet, despite its prevalence, it remains poorly understood. A neurobiological model of irritability posits that, in children and adolescents, it is consequent upon deficits in reward and threat processing, involving regions such as the amygdala and frontal cortices. In comparison, in adults with mood disorders, the few studies that have been conducted implicate the amygdala, orbitofrontal cortices, and hypothalamus; however, the patterns of activity in these areas are at variance with the findings in youth. These age-related differences seem to extend to the neurochemistry of irritability, with links between increased monoamine transmission and irritability evident in adults, but aberrant levels of, and responses to, dopamine in youth. Presently, there are no specific treatments that have significant efficacy in reducing irritability in mood disorders. However, treatments that hold some potential and warrant further exploration include agents that act on serotonergic and dopaminergic systems, especially as irritability may serve as a prognostic indicator for overall clinical responsiveness to specific medications. Therefore, for understanding and treatment of irritability to advance meaningfully, it is imperative that an accurate definition and means of measuring irritability are developed. To achieve this, it is necessary that the subjective experience of irritability, both in health and illness, is better understood. These insights will inform an accurate, comprehensive, and valid interrogation of the qualities of irritability in health and illness, and allow not only a clinical appreciation of the phenomenon, but also a deeper understanding of its important role within the development and manifestation of mood disorders.
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Affiliation(s)
- Erica Bell
- Department of Psychiatry, Faculty of Medicine and Health, Northern Clinical School, The University of Sydney, Sydney, NSW, Australia.
- Academic Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, 2065, Australia.
- Department of Psychiatry, CADE Clinic, Royal North Shore Hospital, Level 3, Main Hospital Building, Northern Sydney Local Health District, St Leonards, NSW, 2065, Australia.
| | - Phil Boyce
- Department of Psychiatry, Westmead Hospital and the Westmead Clinical School, Wentworthville, NSW, 2145, Australia
- Discipline of Psychiatry, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Richard J Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Gin S Malhi
- Department of Psychiatry, Faculty of Medicine and Health, Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
- Academic Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, 2065, Australia
- Department of Psychiatry, CADE Clinic, Royal North Shore Hospital, Level 3, Main Hospital Building, Northern Sydney Local Health District, St Leonards, NSW, 2065, Australia
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Functional connectivity during frustration: a preliminary study of predictive modeling of irritability in youth. Neuropsychopharmacology 2021; 46:1300-1306. [PMID: 33479511 PMCID: PMC8134471 DOI: 10.1038/s41386-020-00954-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/17/2020] [Accepted: 12/23/2020] [Indexed: 01/30/2023]
Abstract
Irritability cuts across many pediatric disorders and is a common presenting complaint in child psychiatry; however, its neural mechanisms remain unclear. One core pathophysiological deficit of irritability is aberrant responses to frustrative nonreward. Here, we conducted a preliminary fMRI study to examine the ability of functional connectivity during frustrative nonreward to predict irritability in a transdiagnostic sample. This study included 69 youths (mean age = 14.55 years) with varying levels of irritability across diagnostic groups: disruptive mood dysregulation disorder (n = 20), attention-deficit/hyperactivity disorder (n = 14), anxiety disorder (n = 12), and controls (n = 23). During fMRI, participants completed a frustrating cognitive flexibility task. Frustration was evoked by manipulating task difficulty such that, on trials requiring cognitive flexibility, "frustration" blocks had a 50% error rate and some rigged feedback, while "nonfrustration" blocks had a 10% error rate. Frustration and nonfrustration blocks were randomly interspersed. Child and parent reports of the affective reactivity index were used as dimensional measures of irritability. Connectome-based predictive modeling, a machine learning approach, with tenfold cross-validation was conducted to identify networks predicting irritability. Connectivity during frustration (but not nonfrustration) blocks predicted child-reported irritability (ρ = 0.24, root mean square error = 2.02, p = 0.03, permutation testing, 1000 iterations, one-tailed). Results were adjusted for age, sex, medications, motion, ADHD, and anxiety symptoms. The predictive networks of irritability were primarily within motor-sensory networks; among motor-sensory, subcortical, and salience networks; and between these networks and frontoparietal and medial frontal networks. This study provides preliminary evidence that individual differences in irritability may be associated with functional connectivity during frustration, a phenotype-relevant state.
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Camacho MC, Williams EM, Ding K, Perlman SB. Multimodal examination of emotion processing systems associated with negative affectivity across early childhood. Dev Cogn Neurosci 2021; 48:100917. [PMID: 33493849 PMCID: PMC7823207 DOI: 10.1016/j.dcn.2021.100917] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 12/19/2020] [Accepted: 01/08/2021] [Indexed: 12/01/2022] Open
Abstract
High Temperamental Negative Affectivity in early childhood has been found to predict later emotion dysregulation. While much work has been conducted to separately probe bio-behavioral systems associated with Negative Affectivity, very little work has examined the relations among multiple systems across age. In this study, we use multi-modal methods to index neurobiological systems associated with Negative Affectivity in 53 4-7-year-old children. Prefrontal activation during emotion regulation was measured using functional near-infrared spectroscopy over the lateral prefrontal cortex (PFC) while children played a game designed to elicit frustration in Social (Happy and Angry faces) and Nonsocial contexts. Gaze behaviors while free-viewing Happy and Angry faces were also measured. Finally, Negative Affectivity was indexed using a score composite based on factor analysis of parent-reported temperament. Using mixed-effects linear models, we found an age-dependent association between Negative Affectivity and both PFC activation during frustration and fixation duration on the mouth area of Happy faces, such that older children high in Negative Affectivity spent less time looking at the mouths of Happy faces and had lower PFC activation in response to frustration (ps<0.034). These results provide further insight to how Negative Affectivity may be associated with changes in affective neurobiological systems across early childhood.
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Affiliation(s)
- M Catalina Camacho
- Division of Biology and Biomedical Science (Neurosciences), Washington University in St. Louis, St. Louis, MO, USA.
| | - Elizabeth M Williams
- Division of Child and Adolescent Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Keya Ding
- Division of Child and Adolescent Psychiatry, Washington University in St. Louis, St. Louis, MO, USA; Key Laboratory of Child Development & Learning Science, Ministry of Education, Department of Biomedical Engineering, Southeast University, Nanjing, China
| | - Susan B Perlman
- Division of Biology and Biomedical Science (Neurosciences), Washington University in St. Louis, St. Louis, MO, USA; Division of Child and Adolescent Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
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Naim R, Kircanski K, Gold A, German RE, Davis M, Perlstein S, Clayton M, Revzina O, Brotman MA. Across-subjects multiple baseline trial of exposure-based cognitive-behavioral therapy for severe irritability: a study protocol. BMJ Open 2021; 11:e039169. [PMID: 33692176 PMCID: PMC7949376 DOI: 10.1136/bmjopen-2020-039169] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 12/12/2020] [Accepted: 12/19/2020] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Irritability is defined as a tendency towards anger in response to frustration. Clinically, impairing irritability is a significant public health problem. There is a need for mechanism-based psychotherapies targeting severe irritability as it manifests in the context of disruptive mood dysregulation disorder (DMDD). This study protocol describes a randomised multiple baseline design testing the preliminary efficacy of a new treatment, exposure-based cognitive-behavioral therapy for severe irritability in youth, which also integrates components of parent management training. We will investigate associations of this intervention with primary clinical measures, as well as ecological momentary assessment measures. METHODS AND ANALYSIS Forty youth will be enrolled. Participants, aged 8-17 years, must present at least one of two core symptoms of DMDD: abnormal mood or increased reactivity to negative emotional stimuli, with severe impairment in one domain (home, school, peers) and moderate in another, or moderate impairment in at least two domains. Each participant is randomised to a 2-week, 4-week or 6-week baseline observation period, followed by 12 active treatment sessions. Clinical ratings are conducted at baseline, biweekly (clinician), weekly (parent/child) throughout treatment, post-treatment, and 3-month and 6-month follow-up (clinician). Clinician ratings on the Affective Reactivity Index and Clinical Global Impressions-Improvement scale for DMDD are our primary outcome measures. Secondary outcome measures include parent and child reports of irritability. Post hoc additional symptom measures include clinician, parent and self-ratings of depression, anxiety and overall functional impairment. Prospective, digitally based event sampling of symptoms is acquired for a week pre-treatment, mid-treatment and post-treatment. Based on our pathophysiological model of irritability implicating frustrative non-reward, aberrant threat processing and instrumental learning, we probe these three brain-based targets using functional MRI paradigms to assess target engagement. ETHICS AND DISSEMINATION The research project and all related materials were submitted and approved by the appropriate Institutional Review Board (IRB) of the National Institute of Mental Health (NIMH). TRIAL REGISTRATION NUMBERS NCT02531893 and NCT00025935.
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Affiliation(s)
- Reut Naim
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrea Gold
- Pediatric Anxiety Research Center, Bradley Hospital, Riverside, Rhode Island, USA
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Ramaris E German
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Mollie Davis
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Samantha Perlstein
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Michal Clayton
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Olga Revzina
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
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Wiggins JL, Briggs-Gowan MJ, Brotman MA, Leibenluft E, Wakschlag LS. Toward a Developmental Nosology for Disruptive Mood Dysregulation Disorder in Early Childhood. J Am Acad Child Adolesc Psychiatry 2021; 60:388-397. [PMID: 32599006 PMCID: PMC7769590 DOI: 10.1016/j.jaac.2020.04.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/30/2020] [Accepted: 06/17/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Disruptive mood dysregulation disorder (DMDD) in DSM, characterized by severe, chronic irritability, currently excludes children <6 years of age. However, capitalizing on a burgeoning developmental science base to differentiate clinically salient irritability in young children may enable earlier identification. The objective of this study was to advance an empirically derived framework for early childhood DMDD (EC-DMDD) by modeling and validating DMDD patterns in early childhood and generating clinically informative, optimized behaviors with thresholds. METHOD Data (N = 425) were from 3 longitudinal assessments of the MAPS Study, spanning preschool (means = 4.7 and 5.5 years) to early school age (mean = 6.8 years). The Multidimensional Assessment Profile of Disruptive Behavior (MAP-DB) Temper Loss scale captured irritability, the Family Life Impairment Scale (FLIS) assessed cross-domain impairment at the preschool time points and the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) was used to assess clinical status at early school age. Latent transition analyses differentiated children with EC-DMDD from children with low, transient, or nonimpairing irritability. RESULTS Developmental patterning of irritability proved important for normal:abnormal differentiation. Of children, 27% had initially high irritability, but only two-thirds of these were persistently highly irritable. Thus, "false positives" based on a single screen would be substantial. Yet, "false negatives" are low, as <1% of children with baseline low irritability demonstrated later high irritability. Based on the sequential preschool-age time points, 6.7% of children were identified with EC-DMDD, characterized by persistent irritability with pervasive impairment, similar to prevalence at older ages. Specific behaviors included low frustration tolerance; dysregulated, developmentally unexpectable tantrums; and sustained irritable mood, all of which sensitively (0.85-0.96) and specifically (0.80-0.91) identified EC-DMDD. EC-DMDD predicted irritability-related syndromes (DMDD, oppositional defiant disorder) at early school age better than downward extension of DSM DMDD criteria to preschool age. CONCLUSION These findings provide empirical thresholds for preschool-age clinical identification of DMDD patterns. The results lay the foundation for validation of DMDD in early childhood and inform revision of DSM criteria.
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Affiliation(s)
- Jillian Lee Wiggins
- San Diego State University and the San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, California.
| | | | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Lauren S Wakschlag
- Feinberg School of Medicine and Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, Illinois
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