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Hung IT, Viding E, Stringaris A, Ganiban JM, Saudino KJ. Understanding the Etiology of Externalizing Problems in Young Children: The Roles of Callous-Unemotional Traits and Irritability. J Am Acad Child Adolesc Psychiatry 2025:S0890-8567(25)00006-1. [PMID: 39824381 DOI: 10.1016/j.jaac.2025.01.005] [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: 05/10/2024] [Revised: 10/04/2024] [Accepted: 01/08/2025] [Indexed: 01/20/2025]
Abstract
OBJECTIVE Callous-unemotional traits (CU), characterized as a lack of guilt and empathy, and irritability, a tendency to show anger and frustration, are 2 risk factors for externalizing behavioral problems. Externalizing problems, CU, and irritability are all heritable. However, there is a dearth of studies examining the genetic and environmental associations between the 3 domains. The present study partitioned joint and independent etiological pathways from CU and irritability to externalizing problems. METHOD The sample consisted of 614 pairs of 3-year-old twins from the Boston University Twin Project. Primary caregivers reported twins' externalizing problems, CU, and irritability using the Child Behavior Checklist. Biometric Cholesky models were used to estimate common and unique genetic and environmental variances among the 3 domains. RESULTS There were common genetic, shared environmental and nonshared environmental factors operating across all 3 domains. In addition, there were unique genetic and nonshared environmental factors, independent of the common effects, linking externalizing problems and CU, and externalizing problems and irritability, respectively. There were also genetic and nonshared environmental influences unique to externalizing problems, independent of CU and irritability. CONCLUSION Common genetic as well as shared and nonshared environmental associations among externalizing problems, CU, and irritability suggest, to some extent, that etiological influences are common to all 3 constructs. However, distinct genetic and child-specific nonshared environmental links separately from CU and irritability to externalizing problems, reveals the heterogeneity of externalizing problems, and suggests that they should not be considered a unitary outcome. STUDY PREREGISTRATION INFORMATION Study Preregistration: Understanding the Etiology of Externalizing Problems in Young Children: The Roles of Callous-Unemotional Traits and Irritability; https://doi.org/10.1016/j.jaac.2023.09.549.
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Affiliation(s)
- I-Tzu Hung
- Boston University, Boston, Massachusetts.
| | - Essi Viding
- University College London, London, United Kingdom
| | - Argyris Stringaris
- University College London, London, United Kingdom; National and Kapodistrian University of Athens, Athens, Greece
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Niu Y, Buzzell GA, Cosmoiu A, Fox NA, Nelson CA, Zeanah CH, Humphreys KL. Foster Care Leads to Lower Irritability Among Adolescents with a History of Early Psychosocial Deprivation. Res Child Adolesc Psychopathol 2024; 52:1183-1192. [PMID: 38642277 PMCID: PMC11288996 DOI: 10.1007/s10802-024-01193-x] [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: 03/29/2024] [Indexed: 04/22/2024]
Abstract
Irritability reflects a propensity for frustration and anger, and is a transdiagnostic symptom of both externalizing and internalizing psychopathology. While early adverse experiences are associated with higher levels of irritability, experiences of early psychosocial deprivation and whether family-based placements can mitigate the impact on subsequent irritability, remain underexplored. The current study examined irritability in 107 16-year-olds with a history of institutional care from a randomized controlled trial of foster care as an alternative to institutional care and 49 community comparison children. At age 16 years, irritability was assessed using parent- and self-report forms of the Affective Reactivity Index. Compared to community adolescents, those with a history of institutional care exhibited significantly elevated irritability levels. Among those who experienced institutional care, those randomized to foster care had lower levels of irritability compared to participants randomized to the care-as-usual group, and this effect persists after controlling for baseline negative emotionality. These findings suggest a causal link between high-quality foster care and lower irritability following psychosocial deprivation. Additionally, longer duration in institutional care and non-family placement at age 16 years were associated with higher levels of irritability, highlighting the role of caregiving in explaining variation in irritability in adolescence. Policies that support long-term, high-quality family placements for children without regular caregivers should be prioritized.
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Affiliation(s)
- Yanbin Niu
- Department of Psychology & Human Development, Peabody College, Vanderbilt University, 230 Appleton Place, Nashville, TN, 37203, USA
| | - George A Buzzell
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Ana Cosmoiu
- Department of Psychology and Cognitive Sciences, University of Bucharest, Bucharest, Romania
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Charles A Nelson
- Boston Children's Hospital of Harvard Medical School, Boston, MA, USA
- Harvard Graduate School of Education, Cambridge, MA, USA
| | - Charles H Zeanah
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA, USA
| | - Kathryn L Humphreys
- Department of Psychology & Human Development, Peabody College, Vanderbilt University, 230 Appleton Place, Nashville, TN, 37203, USA.
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Fu ZW, Wang KL, Du NY, Li YJ, Duan JJ, Zhao SX. Comparative study on emotional behavior and parental job stress of only-child and non-only-child preschool children. World J Clin Cases 2024; 12:4642-4651. [PMID: 39070806 PMCID: PMC11235493 DOI: 10.12998/wjcc.v12.i21.4642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/24/2024] [Accepted: 06/07/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Studies have revealed that Children's psychological, behavioral, and emotional problems are easily influenced by the family environment. In recent years, the family structure in China has undergone significant changes, with more families having two or three children. AIM To explore the relationship between emotional behavior and parental job stress in only preschool and non-only preschool children. METHODS Children aged 3-6 in kindergartens in four main urban areas of Shijiazhuang were selected by stratified sampling for a questionnaire and divided into only and non-only child groups. Their emotional behaviors and parental pressure were compared. Only and non-only children were paired in a 1:1 ratio by class and age (difference less than or equal to 6 months), and the matched data were compared. The relationship between children's emotional behavior and parents' job stress before and after matching was analyzed. RESULTS Before matching, the mother's occupation, children's personality characteristics, and children's rearing patterns differed between the groups (P < 0.05). After matching 550 pairs, differences in the children's parenting styles remained. There were significant differences in children's gender and parents' attitudes toward children between the two groups. The Strengths and Difficulties Questionnaire (SDQ) scores of children in the only child group and the Parenting Stress Index-Short Form (PSI-SF) scores of parents were significantly lower than those in the non-only child group (P < 0.05). Pearson's correlation analysis showed that after matching, there was a positive correlation between children's parenting style and parents' attitudes toward their children (r = 0.096, P < 0.01), and the PSI-SF score was positively correlated with children's gender, parents' attitudes toward their children, and SDQ scores (r = 0.077, 0.193, 0.172, 0.222). CONCLUSION Preschool children's emotional behavior and parental pressure were significantly higher in multi-child families. Parental pressure in differently structured families was associated with many factors, and preschool children's emotional behavior was positively correlated with parental pressure.
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Affiliation(s)
- Zhi-Wei Fu
- Department of Children's Health, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang 050000, Hebei Province, China
| | - Kai-Li Wang
- Department of Children's Health, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang 050000, Hebei Province, China
| | - Ning-Yu Du
- Department of Children's Health, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang 050000, Hebei Province, China
| | - Yue-Jing Li
- Department of Children's Health, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang 050000, Hebei Province, China
| | - Jing-Jing Duan
- Department of Children's Health, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang 050000, Hebei Province, China
| | - Sheng-Xia Zhao
- Department of Children's Health, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang 050000, Hebei Province, China
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Srinivasan R, Flouri E, Lewis G, Solmi F, Stringaris A, Lewis G. Changes in Early Childhood Irritability and Its Association With Depressive Symptoms and Self-Harm During Adolescence in a Nationally Representative United Kingdom Birth Cohort. J Am Acad Child Adolesc Psychiatry 2024; 63:39-51. [PMID: 37391129 PMCID: PMC11163475 DOI: 10.1016/j.jaac.2023.05.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 04/28/2023] [Accepted: 06/21/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVE This study aimed to investigate longitudinal associations between changes in early childhood irritability, and depressive symptoms and self-harm at 14 years. METHOD We used data from 7,225 children in a UK-based general population birth cohort. Childhood irritability was measured at 3, 5, and 7 years using 4 items from 2 questionnaires (the Children's Social Behaviour Questionnaire [CSBQ] and the Strengths and Difficulties Questionnaire [SDQ]). Participants reported depressive symptoms via the short Mood and Feelings Questionnaire (sMFQ) and self-harm via a single-item question, at 14 years. We used multilevel models to calculate within-child change in irritability between 3 and 7 years and examined associations between irritability, and depressive symptoms and self-harm at 14 years using linear and logistic regression models, respectively. We adjusted for child and family sociodemographic/economic characteristics, mental health difficulties, and child cognitive development. RESULTS Irritability at ages 5 and 7 years was positively associated with depressive symptoms and self-harm at age 14 years. Irritability that remained high between 3 and 7 years was associated with depressive symptoms and self-harm at 14 years in unadjusted (depressive symptoms: β coefficient = 0.22, 95 % CI = 0.08-0.37, p = .003; self-harm: odds ratio = 1.09, 95 % CI = 1.01-1.16, p = .019) and adjusted models (depressive symptoms: β coefficient = 0.31, 95 % CI = 0.17-0.45, p < .001; self-harm: odds ratio = 1.12, 95 % CI = 1.0.4-1.19, p = .004). Results were similar in imputed samples. CONCLUSION Children with irritability that remains high between 3 and 7 years are more likely to report higher depressive symptoms and self-harm during adolescence. These findings support early intervention for children with high irritability and universal interventions in managing irritability for parents of preschool-aged children.
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Affiliation(s)
| | | | - Gemma Lewis
- UCL Division of Psychiatry, London, United Kingdom
| | | | - Argyris Stringaris
- UCL Division of Psychiatry, London, United Kingdom; Emotion & Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Glyn Lewis
- UCL Division of Psychiatry, London, United Kingdom
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Lee KS, Lebowitz ER, Silverman WK, Tseng W. Transactional associations of child irritability and anxiety with parent psychological control in Taiwanese school-aged children. JCPP ADVANCES 2023; 3:e12192. [PMID: 38054061 PMCID: PMC10694542 DOI: 10.1002/jcv2.12192] [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: 11/14/2022] [Accepted: 07/13/2023] [Indexed: 12/07/2023] Open
Abstract
Background Child irritability and anxiety are associated with parent psychological control; yet their transactional relations over time are not well-characterized at the within-person level. Research addressing generalizability of past Western-based literature in non-Western, collectivist community samples is lacking. Methods Sample comprised 285 children aged 8.8-11.4 years (145 girls; Mage = 9.9 years, SD = 0.6) in Northern Taiwan. Participants were assessed at baseline (T1), 6-month (T2), and 12-month (T3) follow-ups. Child irritability and anxiety symptoms were assessed using parent-rated Child Behavior Checklist. Parent psychological control was assessed using the parent- and child-rated Psychological Control Scale. Within-person processes were specified using the random-intercept cross-lagged panel models. Results Models showed that psychological control predicted increased child irritability when analyzing parenting data from parents and children. However, the lagged effect from psychological control to child anxiety was only seen in parent-rated parenting data. We found limited evidence for a back-and-forth transactional pathway among constructs. Child irritability predicted increased child anxiety in all models. Conclusions Directional effects from psychological control to child irritability and anxiety support parent-involved interventions that prioritize collaborative parenting and positive reinforcement techniques. Future validations in combined clinical and typically developing samples and direct cross-cultural comparisons are warranted.
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Affiliation(s)
- Ka Shu Lee
- Department of Experimental PsychologyUniversity of OxfordOxfordUK
- Yale Child Study CenterYale School of MedicineNew HavenConnecticutUSA
| | - Eli R. Lebowitz
- Yale Child Study CenterYale School of MedicineNew HavenConnecticutUSA
| | | | - Wan‐Ling Tseng
- Yale Child Study CenterYale School of MedicineNew HavenConnecticutUSA
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Sorcher LK, Mennies RJ, Robeson M, Seeley JR, Klein DN, Dougherty LR, Olino TM. Offspring irritability: associations with parental psychopathology and personality. Eur Child Adolesc Psychiatry 2023; 32:1691-1699. [PMID: 35416605 DOI: 10.1007/s00787-022-01985-w] [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: 12/16/2021] [Accepted: 04/02/2022] [Indexed: 12/01/2022]
Abstract
Although there are well-established correlates and outcomes of irritability, there are fewer studies reporting on predictors of the longitudinal course of irritability in youth. The current report examined parent internalizing and externalizing psychopathology and dimensions of personality as predictors of the developmental course of irritability in youth. Offspring irritability was assessed between ages 2 and 10 years using the Irritability Factor from the parent-reported Child Behavior Checklist (N = 570, 53.51% female). Parental psychopathology was assessed with a clinical interview; parents also completed the General Temperament Survey as a measure of personality. Results demonstrated that offspring irritability decreased with age. Offspring irritability was associated with parental depressive and anxiety disorders, higher levels of negative emotionality/neuroticism (NE) and disinhibition, and lower levels of positive emotionality; parental NE and disinhibition remained unique predictors of offspring irritability in a multivariate model. Finally, parental externalizing disorders were associated with more stable trajectories of offspring irritability, whereas offspring of parents without a history of externalizing disorders showed decreasing irritability across time. Findings demonstrate that different aspects of parental personality and psychopathology have differential impacts on levels and course of offspring irritability.
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Affiliation(s)
- Leah K Sorcher
- Department of Psychology, University of Maryland, College Park, MD, 20742, USA
| | - Rebekah J Mennies
- Department of Psychology, Temple University, Philadelphia, PA, 19122, USA
| | - Mackenzie Robeson
- Department of Psychology, University of Maryland, College Park, MD, 20742, USA
| | - John R Seeley
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, USA
| | - Daniel N Klein
- Department of Psychology, Stony Brook University, Stony Brook, USA
| | - Lea R Dougherty
- Department of Psychology, University of Maryland, College Park, MD, 20742, USA.
| | - Thomas M Olino
- Department of Psychology, Temple University, Philadelphia, PA, 19122, USA.
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De Raeymaecker K, Dhar M. The Influence of Parents on Emotion Regulation in Middle Childhood: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1200. [PMID: 36010090 PMCID: PMC9406957 DOI: 10.3390/children9081200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/31/2022] [Accepted: 08/04/2022] [Indexed: 11/28/2022]
Abstract
Emotion regulation (ER) has been identified as a transdiagnostic risk factor for psychopathology, making it an ideal target for prevention and treatment. This study explores how parents can nurture the development of child ER. In April 2022, a systematic review was executed focusing on malleable factors in the parental emotion-socialization process during middle childhood. Papers in PubMed, Web of Science and Medline were screened on content-related and methodological criteria. Their methodological quality was assessed. Knowledge was assembled using a summarizing framework encompassing four factors involved in emotion socialization. Fifty papers shed light on modifiable factors at the level of parental meta-emotion philosophy, emotion-related socialization behaviors, the ER skills of parents and the emotional climate of the family. Adaptive socialization appears to be context- and child-specific, thereby taxing parents' ER skills and their ability to put them into practice flexibly. The four changeable factors in the emotion-socialization process are highly intertwined, resulting in four possible entries for parent-directed interventions. Importantly, time should be devoted to the ER capacities of parents and their ability to attune to the situation and their child. Regarding the latter, replication studies are necessary. Recommendations for clinical interventions are provided.
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Affiliation(s)
- Karen De Raeymaecker
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Monica Dhar
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
- ZNA University Centre for Child & Adolescent Psychiatry Antwerp, University of Antwerp, Lindendreef 1, 2020 Antwerp, Belgium
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