The Status of Irritability in Psychiatry: A Conceptual and Quantitative Review

Pablo Vidal-Ribas, Melissa A Brotman, Isabel Valdivieso, Ellen Leibenluft, Argyris Stringaris, Pablo Vidal-Ribas, Melissa A Brotman, Isabel Valdivieso, Ellen Leibenluft, Argyris Stringaris

Abstract

Objective: Research and clinical interest in irritability have been on the rise in recent years. Yet several questions remain about the status of irritability in psychiatry, including whether irritability can be differentiated from other symptoms, whether it forms a distinct disorder, and whether it is a meaningful predictor of clinical outcomes. In this article, we try to answer these questions by reviewing the evidence on how reliably irritability can be measured and its validity.

Method: We combine a narrative and systematic review and meta-analysis of studies. For the systematic review and meta-analysis, we searched studies in PubMed and Web of Science based on preselected criteria. A total of 163 articles were reviewed, and 24 were included.

Results: We found that irritability forms a distinct dimension with substantial stability across time, and that it is specifically associated with depression and anxiety in longitudinal studies. Evidence from genetic studies reveals that irritability is moderately heritable, and its overlap with depression is explained mainly by genetic factors. Behavioral and neuroimaging studies show that youth with persistent irritability exhibit altered activations in the amygdala, striatum, and frontal regions compared with age-matched healthy volunteers. Most knowledge about the treatment of irritability is based on effects of treatment on related conditions or post hoc analyses of trial data.

Conclusion: We identify a number of research priorities including innovative experimental designs and priorities for treatment studies, and conclude with recommendations for the assessment of irritability for researchers and clinicians.

Keywords: anxiety; conduct; depression; irritability; meta-analysis.

Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1
Figure 1
The position of irritability within commonly used terminology. Note: irritability shares a negative valence with anxiety and depression but denotes approach and is therefore linked to elation in mania.
Figure 2
Figure 2
Forest plot of irritability as a predictor of future psychiatric disorders. Note: Points represent the estimated odds ratio of each study; the lines bisecting the point correspond to the 95% CI. Pooled effect sizes are represented by diamonds. Weights for each study are given in the far-right column. ADHD = attention-deficit/hyperactivity disorder; ODD = oppositional defiant disorder.

References

    1. Stringaris A., Taylor E. Oxford University Press; New York: 2015. Disruptive Mood. Irritability in Children and Adolescents.
    1. Homer. The Iliad. Harvard University Press; Cambridge, MA: 1924.
    1. Marks H. WW Norton and Company; New York: 2012. The English Bible, King James Version. The Old Testament (David's Psalms)
    1. Aristotle. Rhetoric. Oxford University Press; London: 1924.
    1. Seneca. Of Anger (De ira). Bohn's Classical Library ed. London: George Bell and Sons; 1900.
    1. Augustinus S. Libri IX.V. De Civitate Dei. Subiaco, Italy: Sweynheym and Pannartz; 1467.
    1. Burton R. JW Moore; London: 1857. The anatomy of melancholy.
    1. Bleuler E. Springer-Verlag Berlin Heidelberg; Berlin: 1918. Lehrbuch der Psychiatrie.
    1. Freud S. Fischer Taschenbuch Verlag; Frankfurt a.m.: 1915. Trauer und Melancholie.
    1. American Psychiatric Association . American Psychiatric Association; Washington, DC: 2013. Diagnostic and Statistical Manual of Mental Disorders (5th ed.)
    1. Krieger F.V., Stringaris A. Bipolar disorder and disruptive mood dysregulation in children and adolescents: assessment, diagnosis and treatment. Evid Based Ment Health. 2013;16:93–94.
    1. Leibenluft E. Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youths. Am J Psychiatry. 2011;168:129–142.
    1. Blader J.C., Carlson G.A. Increased rates of bipolar disorder diagnoses among U.S. child, adolescent, and adult inpatients, 1996-2004. Biol Psychiatry. 2007;62:107–114.
    1. Moreno C., Laje G., Blanco C., Jiang H., Schmidt A.B., Olfson M. National trends in the outpatient diagnosis and treatment of bipolar disorder in youth. Arch Gen Psychiatry. 2007;64:1032–1039.
    1. Insel T., Cuthbert B., Garvey M. Research Domain Criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry. 2010;167:748–751.
    1. Plomin R., Haworth C.M., Davis O.S. Common disorders are quantitative traits. Nat Rev Genet. 2009;10:872–878.
    1. Robins E., Guze S.B. Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. Am J Psychiatry. 1970;126:983–987.
    1. Cronbach L.J., Meehl P.E. Construct validity in psychological tests. Psychol Bull. 1955;52:281–302.
    1. Stringaris A., Cohen P., Pine D.S., Leibenluft E. Adult outcomes of youth irritability: a 20-year prospective community-based study. Am J Psychiatry. 2009;166:1048–1054.
    1. Leibenluft E., Stoddard J. The developmental psychopathology of irritability. Dev Psychopathol. 2013;25:1473–1487.
    1. Popper K. Verlag von Julius Springer; Vienna, Austria: 1935. Logik der Forschung.
    1. Aarts H., Ruys K.I., Veling H. The art of anger: Reward context turns avoidance responses to anger-related objects into approach. Psychol Sci. 2010;21:1406–1410.
    1. Leibenluft E., Charney D.S., Towbin K.E., Bhangoo R.K., Pine D.S. Defining clinical phenotypes of juvenile mania. Am J Psychiatry. 2003;160:430–437.
    1. Copeland W.E., Brotman M.A., Costello E.J. Normative irritability in youth: developmental findings from the Great Smoky Mountains Study. J Am Acad Child Adolesc Psychiatry. 2015;54:635–642.
    1. Carver C.S., Harmon-Jones E. Anger is an approach-related affect: evidence and implications. Psychol Bull. 2009;135:183.
    1. Berkowitz L. Frustration-aggression hypothesis: examination and reformulation. Psychol Bull. 1989;106:59.
    1. Patterson G.R. Accelerating stimuli for two classes of coercive behaviors. J Abnorm Child Psychol. 1977;5:335–350.
    1. Connor D.F. Guilford Press; New York: 2002. Aggression and Antisocial Behavior in Children and Adolescents: Research and Treatment.
    1. Rettew D. W W Norton and Company; New York: 2013. Child Temperament: New Thinking About the Boundary Between Traits and Illness.
    1. Copeland W.E., Shanahan L., Egger H., Angold A., Costello E.J. Adult diagnostic and functional outcomes of DSM-5 disruptive mood dysregulation disorder. Am J Psychiatry. 2014;171:668–674.
    1. Brotman M.A., Schmajuk M., Rich B.A. Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children. Biol Psychiatry. 2006;60:991–997.
    1. Copeland W.E., Angold A., Costello E.J., Egger H. Prevalence, comorbidity, and correlates of DSM-5 proposed disruptive mood dysregulation disorder. Am J Psychiatry. 2013;170:173–179.
    1. Stringaris A., Goodman R. Mood lability and psychopathology in youth. Psychol Med. 2009;39:1237–1245.
    1. Althoff R.R., Verhulst F.C., Rettew D.C., Hudziak J.J., van der Ende J. Adult outcomes of childhood dysregulation: a 14-year follow-up study. J Am Acad Child Adolesc Psychiatry. 2010;49:1105–1116.
    1. Pickles A., Aglan A., Collishaw S., Messer J., Rutter M., Maughan B. Predictors of suicidality across the life span: the Isle of Wight study. Psychol Med. 2010;40:1453–1466.
    1. Stringaris A., Goodman R. Three dimensions of oppositionality in youth. J Child Psychol Psychiatry. 2009;50:216–223.
    1. Stringaris A., Zavos H., Leibenluft E., Maughan B., Eley T.C. Adolescent irritability: phenotypic associations and genetic links with depressed mood. Am J Psychiatry. 2012;169:47–54.
    1. Aebi M., Plattner B., Metzke C.W., Bessler C., Steinhausen H.C. Parent- and self-reported dimensions of oppositionality in youth: construct validity, concurrent validity, and the prediction of criminal outcomes in adulthood. J Child Psychol Psychiatry. 2013;54:941–949.
    1. Burke J.D., Boylan K., Rowe R. Identifying the irritability dimension of ODD: application of a modified bifactor model across five large community samples of children. J Abnorm Psychol. 2014;123:841–851.
    1. Herzhoff K., Tackett J.L. Subfactors of oppositional defiant disorder: converging evidence from structural and latent class analyses. J Child Psychol Psychiatry. 2016;57:18–29.
    1. Krieger F.V., Polanczyk V.G., Goodman R. Dimensions of oppositionality in a Brazilian community sample: testing the DSM-5 proposal and etiological links. J Am Acad Child Adolesc Psychiatry. 2013;52:389–400 e381.
    1. Burke J.D., Hipwell A.E., Loeber R. Dimensions of oppositional defiant disorder as predictors of depression and conduct disorder in preadolescent girls. J Am Acad Child Adolesc Psychiatry. 2010;49:484–492.
    1. Rowe R., Costello E.J., Angold A., Copeland W.E., Maughan B. Developmental pathways in oppositional defiant disorder and conduct disorder. J Abnorm Psychol. 2010;119:726–738.
    1. Althoff R.R., Kuny-Slock A.V., Verhulst F.C., Hudziak J.J., van der Ende J. Classes of oppositional-defiant behavior: concurrent and predictive validity. J Child Psychol Psychiatry. 2014;55:1162–1171.
    1. Kuny A.V., Althoff R.R., Copeland W. Separating the domains of oppositional behavior: comparing latent models of the Conners' Oppositional Subscale. J Am Acad Child Adolesc Psychiatry. 2013;52:172–183 e178.
    1. Burke J.D. An affective dimension within oppositional defiant disorder symptoms among boys: personality and psychopathology outcomes into early adulthood. J Child Psychol Psychiatry. 2012;53:1176–1183.
    1. Lazarsfeld P.F., Henry N.W., Anderson T.W. Houghton Mifflin; Boston: 1968. Latent structure analysis.
    1. Bayley N. Consistency and variability in the growth of intelligence from birth to eighteen years. Pedagog Semin J Genet Psychol. 1949;75:165–196.
    1. Dougherty L.R., Smith V.C., Bufferd S.J. Preschool irritability: longitudinal associations with psychiatric disorders at age 6 and parental psychopathology. J Am Acad Child Adolesc Psychiatry. 2013;52:1304–1313.
    1. Stringaris A., Goodman R., Ferdinando S. The Affective Reactivity Index: a concise irritability scale for clinical and research settings. J Child Psychol Psychiatry. 2012;53:1109–1117.
    1. Ezpeleta L., Penelo E. Measurement invariance of oppositional defiant disorder dimensions in 3-year-old preschoolers. Eur J Psychol Assess. 2015;31:45–53.
    1. Whelan Y.M., Stringaris A., Maughan B., Barker E.D. Developmental continuity of oppositional defiant disorder subdimensions at ages 8, 10, and 13 years and their distinct psychiatric outcomes at age 16 years. J Am Acad Child Adolesc Psychiatry. 2013;52:961–969.
    1. Leadbeater B.J., Homel J. Irritable and defiant sub-dimensions of ODD: their stability and prediction of internalizing symptoms and conduct problems from adolescence to young adulthood. J Abnorm Child Psychol. 2015;43:407–421.
    1. Stringaris A. Department of Child and Adolescent Psychiatry, King's College London; London: 2011. Irritability in Developmental Psychiatry.
    1. Roberson-Nay R., Leibenluft E., Brotman M.A. Longitudinal stability of genetic and environmental influences on irritability: from childhood to young adulthood. Am J Psychiatry. 2015;172:657–664.
    1. Regier D.A., Narrow W.E., Clarke D.E. DSM-5 field trials in the United States and Canada, part II: test-retest reliability of selected categorical diagnoses. Am J Psychiatry. 2013;170:59–70.
    1. Axelson D., Findling R.L., Fristad M.A. Examining the proposed disruptive mood dysregulation disorder diagnosis in children in the Longitudinal Assessment of Manic Symptoms study. J Clin Psychiatry. 2012;73:1342–1350.
    1. Deveney C.M., Hommer R.E., Reeves E. A prospective study of severe irritability in youths: 2- and 4-year follow-up. Depress Anxiety. 2015;32:364–372.
    1. Mayes S.D., Mathiowetz C., Kokotovich C. Stability of disruptive mood dysregulation disorder symptoms (irritable-angry mood and temper outbursts) throughout childhood and adolescence in a general population sample. J Abnorm Child Psychol. 2015;43:1543–1549.
    1. Achenbach T.M., McConaughy S.H., Howell C.T. Child/adolescent behavioral and emotional problems: implications of cross-informant correlations for situational specificity. Psychol Bull. 1987;101:213.
    1. Higgins J.P., Thompson S.G., Deeks J.J., Altman D.G. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–560.
    1. Egger M., Davey Smith G., Schneider M., Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–634.
    1. Ezpeleta L., Granero R., de la Osa N., Trepat E., Domenech J.M. Trajectories of oppositional defiant disorder irritability symptoms in preschool children. J Abnorm Child Psychol. 2015;44:115–128.
    1. Kolko D.J., Pardini D.A. ODD dimensions, ADHD, and callous-unemotional traits as predictors of treatment response in children with disruptive behavior disorders. J Abnorm Psychol. 2010;119:713–725.
    1. Leibenluft E., Cohen P., Gorrindo T., Brook J.S., Pine D.S. Chronic versus episodic irritability in youth: a community-based, longitudinal study of clinical and diagnostic associations. J Child Adolesc Psychopharmacol. 2006;16:456–466.
    1. Stringaris A., Goodman R. Longitudinal outcome of youth oppositionality: irritable, headstrong, and hurtful behaviors have distinctive predictions. J Am Acad Child Adolesc Psychiatry. 2009;48:404–412.
    1. Barker E.D., Salekin R.T. Irritable oppositional defiance and callous unemotional traits: is the association partially explained by peer victimization? J Child Psychol Psychiatry. 2012;53:1167–1175.
    1. Lavigne J.V., Gouze K.R., Bryant F.B., Hopkins J. Dimensions of oppositional defiant disorder in young children: heterotypic continuity with anxiety and depression. J Abnorm Child Psychol. 2014;42:937–951.
    1. Savage J., Verhulst B., Copeland W., Althoff R.R., Lichtenstein P., Roberson-Nay R. A genetically informed study of the longitudinal relation between irritability and anxious/depressed symptoms. J Am Acad Child Adolesc Psychiatry. 2015;54:377–384.
    1. Whelan Y.M., Leibenluft E., Stringaris A., Barker E.D. Pathways from maternal depressive symptoms to adolescent depressive symptoms: the unique contribution of irritability symptoms. J Child Psychol Psychiatry. 2015;56:1092–1100.
    1. Stringaris A., Baroni A., Haimm C. Pediatric bipolar disorder versus severe mood dysregulation: risk for manic episodes on follow-up. J Am Acad Child Adolesc Psychiatry. 2010;49:397–405.
    1. Sterne J.A., Sutton A.J., Ioannidis J.P. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ. 2011;343:d4002.
    1. Pike A., Reiss D., Hetherington E.M., Plomin R. Using MZ differences in the search for nonshared environmental effects. J Child Psychol Psychiatry. 1996;37:695–704.
    1. Coccaro E.F., Bergeman C.S., Kavoussi R.J., Seroczynski A.D. Heritability of aggression and irritability: a twin study of the Buss−Durkee Aggression Scales in adult male subjects. Biol Psychiatry. 1997;41:273–284.
    1. Eley T.C. Behavioral genetics as a tool for developmental psychology: anxiety and depression in children and adolescents. Clin Child Fam Psychol Rev. 1999;2:21–36.
    1. Wiggins J.L., Mitchell C., Stringaris A., Leibenluft E. Developmental trajectories of irritability and bidirectional associations with maternal depression. J Am Acad Child Adolesc Psychiatry. 2014;53:1191–1205. 1205 e1191-1194.
    1. Brotman M.A., Kassem L., Reising M.M. Parental diagnoses in youth with narrow phenotype bipolar disorder or severe mood dysregulation. Am J Psychiatry. 2007;164:1238–1241.
    1. Kendler K.S. Major depression and generalised anxiety disorder. Same genes, (partly)different environments–evisited. Br J Psychiatry Suppl. 1996:68–75.
    1. Brotman M.A., Rich B.A., Guyer A.E. Amygdala activation during emotion processing of neutral faces in children with severe mood dysregulation versus ADHD or bipolar disorder. Am J Psychiatry. 2010;167:61–69.
    1. Guyer A.E., McClure E.B., Adler A.D. Specificity of facial expression labeling deficits in childhood psychopathology. J Child Psychol Psychiatry. 2007;48:863–871.
    1. Kim P., Arizpe J., Rosen B.H. Impaired fixation to eyes during facial emotion labelling in children with bipolar disorder or severe mood dysregulation. J Psychiatry Neurosci. 2013;38:407–416.
    1. Rich B.A., Grimley M.E., Schmajuk M., Blair K.S., Blair R.J., Leibenluft E. Face emotion labeling deficits in children with bipolar disorder and severe mood dysregulation. Dev Psychopathol. 2008;20:529–546.
    1. Brotman M.A., Skup M., Rich B.A. Risk for bipolar disorder is associated with face-processing deficits across emotions. J Am Acad Child Adolesc Psychiatry. 2008;47:1455–1461.
    1. Demenescu L.R., Kortekaas R., den Boer J.A., Aleman A. Impaired attribution of emotion to facial expressions in anxiety and major depression. PLoS One. 2010;5:e15058.
    1. Hommer R.E., Meyer A., Stoddard J. Attention bias to threat faces in severe mood dysregulation. Depress Anxiety. 2014;31:559–565.
    1. Stoddard J., Sharif-Askary B., Harkins E. An open pilot study of training hostile interpretation bias to treat disruptive mood dysregulation disorder. J Child Adolesc Psychopharmacol. 2016;26:49–57.
    1. Armstrong T., Olatunji B.O. Eye tracking of attention in the affective disorders: a meta-analytic review and synthesis. Clin Psychol Rev. 2012;32:704–723.
    1. Bar-Haim Y., Lamy D., Pergamin L., Bakermans-Kranenburg M.J., van I.M.H. Threat-related attentional bias in anxious and nonanxious individuals: a meta-analytic study. Psychol Bull. 2007;133:1–24.
    1. Dickstein D.P., Nelson E.E., McClure E.B. Cognitive flexibility in phenotypes of pediatric bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2007;46:341–355.
    1. Adleman N.E., Fromm S.J., Razdan V. Cross-sectional and longitudinal abnormalities in brain structure in children with severe mood dysregulation or bipolar disorder. J Child Psychol Psychiatry. 2012;53:1149–1156.
    1. Thomas L.A., Kim P., Bones B.L. Elevated amygdala responses to emotional faces in youths with chronic irritability or bipolar disorder. Neuroimage Clin. 2013;2:637–645.
    1. Thomas L.A., Brotman M.A., Muhrer E.J. Parametric modulation of neural activity by emotion in youth with bipolar disorder, youth with severe mood dysregulation, and healthy volunteers. Arch Gen Psychiatry. 2012;69:1257–1266.
    1. Thomas L.A., Brotman M.A., Bones B.L. Neural circuitry of masked emotional face processing in youth with bipolar disorder, severe mood dysregulation, and healthy volunteers. Dev Cogn Neurosci. 2014;8:110–120.
    1. Tseng W.L., Thomas L.A., Harkins E., Pine D.S., Leibenluft E., Brotman M.A. Neural correlates of masked and unmasked face emotion processing in youth with severe mood dysregulation. Soc Cogn Affect Neurosci. 2016;11:78–88.
    1. Stoddard J., Hsu D., Reynolds R.C. Aberrant amygdala intrinsic functional connectivity distinguishes youths with bipolar disorder from those with severe mood dysregulation. Psychiatry Res. 2015;231:120–125.
    1. Adleman N.E., Kayser R., Dickstein D., Blair R.J., Pine D., Leibenluft E. Neural correlates of reversal learning in severe mood dysregulation and pediatric bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2011;50:1173–1185 e1172.
    1. Deveney C.M., Connolly M.E., Jenkins S.E. Neural recruitment during failed motor inhibition differentiates youths with bipolar disorder and severe mood dysregulation. Biol Psychol. 2012;89:148–155.
    1. Deveney C.M., Connolly M.E., Haring C.T. Neural mechanisms of frustration in chronically irritable children. Am J Psychiatry. 2013;170:1186–1194.
    1. Perlman S.B., Jones B.M., Wakschlag L.S., Axelson D., Birmaher B., Phillips M.L. Neural substrates of child irritability in typically developing and psychiatric populations. Dev Cogn Neurosci. 2015;14:71–80.
    1. Rich B.A., Schmajuk M., Perez-Edgar K.E., Fox N.A., Pine D.S., Leibenluft E. Different psychophysiological and behavioral responses elicited by frustration in pediatric bipolar disorder and severe mood dysregulation. Am J Psychiatry. 2007;164:309–317.
    1. Rich B.A., Carver F.W., Holroyd T. Different neural pathways to negative affect in youth with pediatric bipolar disorder and severe mood dysregulation. J Psychiatr Res. 2011;45:1283–1294.
    1. Perlman S.B., Luna B., Hein T.C., Huppert T.J. fNIRS evidence of prefrontal regulation of frustration in early childhood. Neuroimage. 2014;85:326–334.
    1. Consortium C-DGotPG Identification of risk loci with shared effects on five major psychiatric disorders: a genome-wide analysis. Lancet. 2013;381:1371–1379.
    1. Habermann W., Eherer A., Lindbichler F., Raith J., Friedrich G. Ex juvantibus approach for chronic posterior laryngitis: results of short-term pantoprazole therapy. J Laryngol Otol. 1999;113:734–739.
    1. Dickstein D.P., Towbin K.E., Van Der Veen J.W. Randomized double-blind placebo-controlled trial of lithium in youths with severe mood dysregulation. J Child Adolesc Psychopharmacol. 2009;19:61–73.
    1. Krieger F.V., Pheula G.F., Coelho R. An open-label trial of risperidone in children and adolescents with severe mood dysregulation. J Child Adolesc Psychopharmacol. 2011;21:237–243.
    1. Fernandez de la Cruz L., Simonoff E., McGough J.J., Halperin J.M., Arnold L.E., Stringaris A. Treatment of children with attention-deficit/hyperactivity disorder (ADHD) and irritability: results from the multimodal treatment study of children with ADHD (MTA) J Am Acad Child Adolesc Psychiatry. 2015;54:62–70 e63.
    1. Group TMC A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry. 1999;56:1073–1086.
    1. Connor D.F., Glatt S.J., Lopez I.D., Jackson D., Melloni R.H. Psychopharmacology and aggression. I: a meta-analysis of stimulant effects on overt/covert aggression–related behaviors in ADHD. J Am Acad Child Adolesc Psychiatry. 2002;41:253–261.
    1. Ipser J., Stein D.J. Systematic review of pharmacotherapy of disruptive behavior disorders in children and adolescents. Psychopharmacology (Berl) 2007;191:127–140.
    1. Waxmonsky J., Pelham W.E., Gnagy E. The efficacy and tolerability of methylphenidate and behavior modification in children with attention-deficit/hyperactivity disorder and severe mood dysregulation. J Child Adolesc Psychopharmacol. 2008;18:573–588.
    1. Shaw P., Stringaris A., Nigg J., Leibenluft E. Emotion dysregulation in attention deficit hyperactivity disorder. Am J Psychiatry. 2014;171:276–293.
    1. Blader J.C., Schooler N.R., Jensen P.S., Pliszka S.R., Kafantaris V. Adjunctive divalproex versus placebo for children with ADHD and aggression refractory to stimulant monotherapy. Am J Psychiatry. 2009;166:1392–1401.
    1. Fava M., Rosenbaum J.F. Anger attacks in patients with depression. J Clin Psychiatry. 1999;60:21–24.
    1. Dimmock P.W., Wyatt K.M., Jones P.W., O'Brien P.S. Efficacy of selective serotonin-reuptake inhibitors in premenstrual syndrome: a systematic review. Lancet. 2000;356:1131–1136.
    1. Coccaro E.F., Lee R.J., Kavoussi R.J. A double-blind, randomized, placebo-controlled trial of fluoxetine in patients with intermittent explosive disorder. J Clin Psychiatry. 2009;70:653–662.
    1. Aman M.G., De Smedt G., Derivan A., Lyons B., Findling R.L., Group R.D.B.S. Double-blind, placebo-controlled study of risperidone for the treatment of disruptive behaviors in children with subaverage intelligence. Am J Psychiatry. 2002;159:1337–1346.
    1. Marcus R.N., Owen R., Kamen L. A placebo-controlled, fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorder. J Am Acad Child Adolesc Psychiatry. 2009;48:1110–1119.
    1. Arnold L.E., Vitiello B., McDougle C. Parent-defined target symptoms respond to risperidone in RUPP autism study: customer approach to clinical trials. J Am Acad Child Adolesc Psychiatry. 2003;42:1443–1450.
    1. Mikita N., Hollocks M.J., Papadopoulos A.S. Irritability in boys with autism spectrum disorders: an investigation of physiological reactivity. J Child Psychol Psychiatry. 2015;56:1118–1126.
    1. Scott S., O'Connor T.G. An experimental test of differential susceptibility to parenting among emotionally-dysregulated children in a randomized controlled trial for oppositional behavior. J Child Psychol Psychiatry. 2012;53:1184–1193.
    1. Bearss K., Johnson C., Smith T. Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: a randomized clinical trial. JAMA. 2015;313:1524–1533.
    1. Sukhodolsky D.G., Golub A., Stone E.C., Orban L. Dismantling anger control training for children: a randomized pilot study of social problem-solving versus social skills training components. Behav Ther. 2005;36:15–23.
    1. Sukhodolsky D.G., Vitulano L.A., Carroll D.H., McGuire J., Leckman J.F., Scahill L. Randomized trial of anger control training for adolescents with Tourette's syndrome and disruptive behavior. J Am Acad Child Adolesc Psychiatry. 2009;48:413–421.
    1. Krebs G., Bolhuis K., Heyman I., Mataix-Cols D., Turner C., Stringaris A. Temper outbursts in paediatric obsessive-compulsive disorder and their association with depressed mood and treatment outcome. J Child Psychol Psychiatry. 2013;54:313–322.
    1. Waxmonsky J.G., Wymbs F.A., Pariseau M.E. A novel group therapy for children with ADHD and severe mood dysregulation. J Atten Disord. 2013;17:527–541.
    1. Waxmonsky J.G., Waschbusch D.A., Belin P. A randomized clinical trial of an integrative group therapy for children with severe mood dysregulation. J Am Acad Child Adolesc Psychiatry. 2016;55:196–207.
    1. Penton-Voak I.S., Bate H., Lewis G., Munafo M.R. Effects of emotion perception training on mood in undergraduate students: randomised controlled trial. Br J Psychiatry. 2012;201:71–72.
    1. Penton-Voak I.S., Thomas J., Gage S.H., McMurran M., McDonald S., Munafo M.R. Increasing recognition of happiness in ambiguous facial expressions reduces anger and aggressive behavior. Psychol Sci. 2013;24:688–697.
    1. Carlson GA. A new diagnosis for explosive behavior. The pros and cons of what's called disruptive mood dysregulation disorder. 2012. Available at: . Accessed November 11, 2015.
    1. Wakschlag L.S., Choi S.W., Carter A.S. Defining the developmental parameters of temper loss in early childhood: implications for developmental psychopathology. J Child Psychol Psychiatry. 2012;53:1099–1108.
    1. Gunnar M.R., Talge N.M., Herrera A. Stressor paradigms in developmental studies: what does and does not work to produce mean increases in salivary cortisol. Psychoneuroendocrinology. 2009;34:953–967.
    1. Dickerson S.S., Kemeny M.E. Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research. Psychol Bull. 2004;130:355–391.
    1. Lobbestael J., Arntz A., Wiers R.W. How to push someone's buttons: a comparison of four anger-induction methods. Cognit Emot. 2008;22:353–373.
    1. Amsel A. The role of frustrative nonreward in noncontinuous reward situations. Psychol Bull. 1958;55:102–119.
    1. Blair R.J. Considering anger from a cognitive neuroscience perspective. Wiley Interdiscip Rev Cogn Sci. 2012;3:65–74.
    1. Rolls E.T. Oxford University Press; New York: 2007. Emotion Explained.
    1. Stringaris A., Vidal-Ribas Belil P., Artiges E. The brain's response to reward anticipation and depression in adolescence: dimensionality, specificity, and longitudinal predictions in a community-based sample. Am J Psychiatry. 2015;172:1215–1223.
    1. Sonuga-Barke E.J., Cortese S., Fairchild G., Stringaris A. Annual research review: Transdiagnostic neuroscience of child and adolescent mental disorders–differentiating decision making in attention-deficit/hyperactivity disorder, conduct disorder, depression, and anxiety. J Child Psychol Psychiatry. 2016;57:321–349.
    1. Scott S., Sylva K., Doolan M. Randomised controlled trial of parent groups for child antisocial behaviour targeting multiple risk factors: the SPOKES project. J Child Psychol Psychiatry. 2010;51:48–57.
    1. Vidal-Ribas P., Goodman R., Stringaris A. Positive attributes in children and reduced risk of future psychopathology. Br J Psychiatry. 2015;206:17–25.
    1. Aebi M., Muller U.C., Asherson P. Predictability of oppositional defiant disorder and symptom dimensions in children and adolescents with ADHD combined type. Psychol Med. 2010;40:2089–2100.
    1. Ezpeleta L., Granero R., de la Osa N., Penelo E., Domenech J.M. Dimensions of oppositional defiant disorder in 3-year-old preschoolers. J Child Psychol Psychiatry. 2012;53:1128–1138.

Source: PubMed

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