Behavioral Characteristics and Neural Bases of Severe Temper Outbursts as Indicators of Pediatric Irritability

• In Event: 1-205 - Advances in Neurobiological Conceptualizations of Pediatric Irritability

Integrative Statement

Temper outbursts are intense emotional responses to frustration or blocked goal attainment. When severe and developmentally inappropriate, such outbursts can interfere with daily functioning and relatedly are observed across diverse pediatric psychological disorders. Previous research has demonstrated that temper outbursts have two underlying processes: anger and distress (Potegal & Davidson, 2003). Anger represents verbally and physically aggressive behaviors like yelling and hitting while distress includes more passive behaviors like crying and whining. We replicated these findings in a large sample of 5- 9 year old children exhibiting varying levels of temper outbursts including children with severe temper outbursts (STO), children with attention-deficit/ hyperactivity disorder (ADHD) without severe outbursts, and typically developing children, Parents completed the Temper Tantrum Questionnaire (modification of Geisbrecht et al., 2010) which asks them to rate how frequently specific behaviors are exhibited during their child’s tantrums. Using Principal Components Analysis, three factors of outburst behaviors were identified: high anger, low anger, and distress. High Anger items included “hurt,” “hit,” “throw,” “break,” “kick,” and “scream.” Low Anger items included “stamp,” “stiffen,” “withdraw,” and “walk away” and Distress items included “cry,” “whine,” and “come to parent.” External validity of these scales was demonstrated. High anger was correlated with parent-reported aggression on the BASC-2-PRS and distress was correlated with the BASC-2-PRS Depression scale. In a subsequent study, we examined how these factors may be related to unique patterns of intrinsic functional connectivity in the brains of children with STO. Analyses examined the seed-based iFC of a region of the dorsal anterior cingulate cortex (dACC) implicated in emotion and frustration tolerance in previous work (Perlman & Pelphrey, 2011). High anger scores were positively associated with dACC iFC with bilateral putamen while distress scores were positively associated with dACC iFC with regions of the default mode network (precuneus and medial prefrontal cortex). These findings suggest that these distinct types of outburst behaviors may have different underlying neural bases. A better understanding of severe temper outbursts and individual differences in them may allow for more targeted treatment approaches for irritable youth.

Authors

• Melanie Silverman, Fordham University
  Presenting Author

• Emily Hirsch, Fordham University
  Non-Presenting Author

• Amy Krain Roy, Fordham University
  Non-Presenting Author