Characterizing the spectrum of irritability in preadolescence: Dimensional and pragmatic applications

IF 2.4 3区医学 Q2 PSYCHIATRY

International Journal of Methods in Psychiatric Research Pub Date : 2023-10-06 DOI:10.1002/mpr.1988

Tasmia Alam, Nathan Kirk, Emily Hirsch, Margaret Briggs-Gowan, Lauren S. Wakschlag, Amy Krain Roy, Jillian Lee Wiggins

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引用次数: 7

Abstract

Objectives

Characterize the dimensional spectrum of preadolescent (PA) irritability, a robust transdiagnostic vulnerability marker, using the youth version of the Multidimensional Assessment Profiles Temper Loss (MAPS-TL-Youth) scale including common and with developmentally specific items. Based on this, derive and validate a clinically optimized irritability screener to flag psychopathology risk in preadolescents.

Methods

The normal:abnormal irritability spectrum was modeled using MAPS-TL-Youth data from the Multidimensional Assessment of Preschoolers Study (MAPS) Study PA wave (n = 340) via item response theory. Both cross-cutting core items from the MAPS scales and developmentally specific items were used to generate this dimension. Stepwise logistic regression was then used to optimize MAPS-TL-Youth irritability items in relation to Kiddie Schedule of Affective Disorders and Schizophrenia impairment to generate a clinically optimized irritability screener. Receiver operator characteristic analysis identified the irritability threshold for the screener. For the first time, youth self-report of their own irritability on the MAPS-TL was also modeled via the MAPS-TL-Youth-Self-Report (MAPS-TL-Youth-SR).

Results

Irritability was unidimensional and ranged from mild and common to severe and rare behaviors. Developmentally specific items allowed detection of more severe irritability. Items for the screener were identified in relation to concurrent impairment. These included low frustration tolerance and pathognomonic severe behaviors. The clinically optimized screener demonstrated very good sensitively (87%) and specificity (81%) in regard to concurrent irritability-related DSM disorders. Modeling of the MAPS-TL-Youth-SR yielded similar results.

Conclusion

Characterizing the normal: abnormal spectrum of irritability in preadolescence advances application of Research Domain Criteria methods to this developmental period. This foundational work yielded two developmentally specified tools for irritability characterization in preadolescence: a nuanced dimensional scale to precisely characterize the full normal-abnormal irritability spectrum, and a pragmatic, clinically optimized screener suitable for real world use. Future application in mechanistic and clinical studies will be important for establishing validity and incremental utility.

Abstract Image

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青春期前易怒谱系的表征：维度和语用应用。

目的：使用青少年版的多维评估概况-脾气损失量表（MAPS-TL youth），包括常见项目和发育特异性项目，表征青春期前（PA）易怒的维度谱，这是一种强有力的跨诊断脆弱性标记。在此基础上，推导并验证了一种临床优化的易怒筛查器，以标记青春期前的精神病理学风险。方法：通过项目反应理论，使用来自学龄前儿童多维评估研究（MAPS）研究PA波（n=340）的MAPS TL青年数据，对正常：异常易怒谱进行建模。MAPS量表中的交叉核心项目和发展特定项目都用于生成该维度。然后使用逐步逻辑回归来优化与儿童情感障碍和精神分裂症障碍时间表相关的MAPS-TL青少年易怒项目，以生成临床优化的易怒筛查器。受试者-操作员特征分析确定了筛分机的易激惹阈值。首次通过MAPS-TL青少年自我报告（MAPS-TL youth SR）对青少年在MAPS-TL上的易怒自我报告进行建模。结果：易怒是一维的，从轻微和常见到严重和罕见的行为都有。发育特异性项目可以检测到更严重的易怒。筛选人员的项目已确定与同时发生的损害有关。其中包括低挫折容忍度和病态的严重行为。临床优化的筛查器对并发的易怒相关DSM障碍表现出非常好的敏感性（87%）和特异性（81%）。MAPS TL Youth SR的建模产生了类似的结果。结论：表征青春期前的正常：异常易怒谱，促进了研究领域标准方法在该发育时期的应用。这项基础性工作产生了两种专门用于青春期前易怒表征的开发工具：一种是精细的维度尺度，用于精确表征完全正常的异常易怒谱，另一种是适用于现实世界的实用、临床优化的筛查器。未来在机制和临床研究中的应用对于建立有效性和增量效用将非常重要。

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.