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The developmental psychopathology of irritability

Published online by Cambridge University Press:  17 December 2013

Ellen Leibenluft
Affiliation:
National Institute of Mental Health
Joel Stoddard*
Affiliation:
National Institute of Mental Health
*
Address correspondence and reprint requests to: Joel Stoddard, Section on Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Building 15K, Room 208, 15K North Drive, MSC-2670, Bethesda, MD 20892-2670; E-mail: joel.stoddard@nih.gov.

Abstract

Chronic, severe irritability is common in childhood and is very impairing. Furthermore, childhood irritability predicts suicidality, social impairment, and depressive and anxiety disorders in adulthood. Focusing on both normative and pathologic development, we review the construct of irritability from its origins in aggression and disruptive behavior research to its contemporary relevance for affective psychopathology. We then describe two broad neurocognitive systems that show promise in differentiating irritable from nonirritable youths: aberrant processing of emotional stimuli and impaired context-sensitive regulation. We suggest behavioral, neurocognitive, and physiologic measures that may aid in studying severe irritability and assessing its therapeutics. Finally, we argue for therapeutic trials targeting severe irritability that address emotional aspects of irritability in addition to the associated disruptive behavior.

Type
Regular Articles
Creative Commons
This is a work of the US Government and is not subject to copyright protection in the United States
Copyright
Copyright © Cambridge University Press 2013.

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