Developmentally specified characterization of the irritability spectrum at early school age: Implications for pragmatic mental health screening

IF 2.4 3区医学 Q2 PSYCHIATRY

International Journal of Methods in Psychiatric Research Pub Date : 2023-09-15 DOI:10.1002/mpr.1985

Emily Hirsch, Tasmia Alam, Nathan Kirk, Katherine B. Bevans, Margaret Briggs-Gowan, Lauren S. Wakschlag, Jillian L. Wiggins, Amy K. Roy

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引用次数: 7

Abstract

Objectives

Developmentally specified measures that identify clinically salient irritability are needed for early school-age youth to meaningfully capture this transdiagnostic risk factor for psychopathology. Thus, the current study modeled the normal:abnormal irritability spectrum and generated a clinically optimized screening tool for this population.

Methods

The irritability spectrum was modeled via the youth version of the Multidimensional Assessment Profile Scales—Temper Loss Scale (MAPS-TL-Youth) in children (n = 474; 6.0–8.9 years) using item response theory (IRT). Both cross-cutting core irritability items from the early childhood version and new developmentally specific items were included. Items uniquely associated with impairment were identified and used to derive a brief, clinically optimized irritability screener. Longitudinal data were then utilized to test the predictive utility of this clinically optimized screener in preadolescence (n = 348; 8.0–12.9 years).

Results

Most children exhibit irritability regularly, but daily occurrence was rare. Of the top 10 most severe items from the IRT analyses, 9 were from the developmentally specific items added for the MAPS-TL Youth version. Two items associated with concurrent impairment were identified for the clinically optimized irritability screener (“Become frustrated easily” and “Act irritable”). The MAPS-TL-Youth clinically optimized screener demonstrated good sensitivity (69%) and specificity (84%) in relation to concurrent DSM 5 irritability-related diagnoses. Youth with elevated scores on the screener at early school age (ESA) had more than 7x greater odds of irritability-related psychopathology at pre-adolescence.

Conclusions

The MAPS-TL-Youth characterized the developmental spectrum of irritability at ESA and a clinically optimized screener showed promise at predicting psychopathology risk. Rigorous testing of clinical applications is a critical next step.

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学龄期早期易怒谱的发育特异性特征:对实用心理健康筛查的影响。

目的:早期学龄青少年需要发展特定的措施来识别临床显著的易怒，以有意义地捕捉这种精神病理学的跨诊断风险因素。因此，目前的研究模拟了正常和异常的易怒谱，并为这一人群产生了临床优化的筛查工具。方法:采用青少年版多维评估量表-脾气损失量表(MAPS-TL-Youth)对儿童(n = 474;6.0-8.9岁)，使用项目反应理论(IRT)。包括早期儿童版本的交叉核心易怒项目和新的发展特定项目。识别出与损伤唯一相关的项目，并用于得出一个简短的、临床优化的易怒筛选。然后利用纵向数据来检验这种临床优化的筛查方法在青春期前的预测效用(n = 348;8.0 - -12.9年)。结果:多数患儿有规律地表现出烦躁不安，但每日出现的少见。在IRT分析的前10个最严重的项目中，有9个是为MAPS-TL Youth版本添加的发展特定项目。在临床优化的易怒筛选中，确定了两个与并发损伤相关的项目(“容易沮丧”和“易怒”)。MAPS-TL-Youth临床优化筛选器在诊断DSM 5易怒相关症状时表现出良好的敏感性(69%)和特异性(84%)。在早期学龄(ESA)筛查中得分较高的青少年在青春期前出现易怒相关精神病理的几率要高出7倍以上。结论:map - tl - youth表征了ESA中易怒的发育谱，临床优化的筛选器在预测精神病理风险方面有希望。严格的临床应用测试是下一步的关键。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Methods in Psychiatric Research 医学-精神病学

CiteScore

5.20

自引率

6.50%

发文量

审稿时长

>12 weeks

期刊介绍： The International Journal of Methods in Psychiatric Research (MPR) publishes high-standard original research of a technical, methodological, experimental and clinical nature, contributing to the theory, methodology, practice and evaluation of mental and behavioural disorders. The journal targets in particular detailed methodological and design papers from major national and international multicentre studies. There is a close working relationship with the US National Institute of Mental Health, the World Health Organisation (WHO) Diagnostic Instruments Committees, as well as several other European and international organisations. MPR aims to publish rapidly articles of highest methodological quality in such areas as epidemiology, biostatistics, generics, psychopharmacology, psychology and the neurosciences. Articles informing about innovative and critical methodological, statistical and clinical issues, including nosology, can be submitted as regular papers and brief reports. Reviews are only occasionally accepted. MPR seeks to monitor, discuss, influence and improve the standards of mental health and behavioral neuroscience research by providing a platform for rapid publication of outstanding contributions. As a quarterly journal MPR is a major source of information and ideas and is an important medium for students, clinicians and researchers in psychiatry, clinical psychology, epidemiology and the allied disciplines in the mental health field.