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Child Psychiatry & Human Development
Gepubliceerd in: Child Psychiatry & Human Development 4/2023

22-01-2022 | Original Article

Is Irritability a Top Problem in Youth Mental Health Care? A Multi-informant, Multi-method Investigation

Auteurs: Spencer C. Evans, Katherine A. Corteselli, Audrey Edelman, Hannah Scott, John R. Weisz

Gepubliceerd in: Child Psychiatry & Human Development | Uitgave 4/2023

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Abstract

Irritability is often described as a common problem affecting youth referred for mental health services; however, little is known about the prevalence and nature of irritability as a focus of treatment. We examined assessment data from a diverse sample of youths (N = 206; ages 7–15; 52% male, 48% female; 33% White, 27% Black, 25% Latinx) referred for outpatient treatment of emotional and behavioral concerns. Caregivers and youths completed nomothetic (standardized checklist) and idiographic (free response) measures at intake. Irritability was identified as a top problem (TP) in 58% of cases, commonly reported by caregivers (38%), youths (42%), or both (23%)—rates that were significantly greater than those of other TP domains (depression, anxiety, ADHD, conduct, and defiance). Further analyses identified clinical correlates of irritability TPs, with results supporting the incremental utility of multiple informants and methods. Findings suggest that irritability is among the most common problems for which families seek youth treatment.
vorige artikel Children's Resilience to Ongoing Border Attacks: The Role of Father, Mother, and Child Resources
volgende artikel Measuring Parental Reflective Functioning: Further Validation of the Parental Reflective Functioning Questionnaire in Portuguese Mothers of Infants and Young Children
Voetnoten
1
Accuracy of clinical diagnoses warrants some attention here. Chronic irritability as a referral problem relates to the much-discussed increase in pediatric mood disorder diagnoses—especially pediatric bipolar disorder—seen in administrative data in the 1990s and 2000s [38‐40]. Although more recent meta-analyses have confirmed that the true epidemiologic prevalence of pediatric bipolar disorder is not increasing [41], it is now commonly accepted that a major contributor to local upticks in pediatric bipolar disorder diagnoses was the convention of diagnosing severe irritability and outbursts in children and adolescents as bipolar disorder [4, 42].
 
2
Various approaches have been used to consolidate 0–1-2 response scales. One alternative approach is to treat any non-zero response as a positive result, collapsing 1 (sometimes) and 2 (very/often) into the same category. However, because we were interested in problems considered severe and relevant for treatment, we focused on the highest response category. To use the non-zero response approach would result in irritability items being considered endorsed in a large majority of cases: 98.1% [95.1, 99.5] of cases endorsed a CBCL/YSR irritability item at 1 or 2 per either informant, and 77.7% [71.4, 83.2] per both informants.
 
3
Against this backdrop of interactions for the first three variables, informant-specific main effects for irritability TPs remained: caregiver (F = 5.93, p < .05) and youth (F = 5.69, p < .05) report played a role in predicting CBCL-irritability; caregiver marginally (F = 3.22, p < .10) and youth (F = 7.15, p < .01) reports predicted emotional lability/negativity; and caregiver (F = 3.20, p < .10) and youth (F = 3.84, p < .10) both marginally predicted BPM-C externalizing problems.
 
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Metagegevens
Titel
Is Irritability a Top Problem in Youth Mental Health Care? A Multi-informant, Multi-method Investigation
Auteurs
Spencer C. Evans
Katherine A. Corteselli
Audrey Edelman
Hannah Scott
John R. Weisz
Publicatiedatum
22-01-2022
Uitgeverij
Springer US
Gepubliceerd in
Child Psychiatry & Human Development / Uitgave 4/2023
Print ISSN: 0009-398X
Elektronisch ISSN: 1573-3327
DOI
https://doi.org/10.1007/s10578-021-01301-8

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