Childhood Irritability: Predictive Validity and Mediators of Adolescent Psychopathology

• In Event: Poster Session 10
  In Poster Session: PS 10 Topic - Developmental Psychopathology

Abstract

Introduction: The construct of irritability has garnered increasing interest given its centrality to diverse forms of psychopathology including mood and disruptive behavior disorders (Stringaris et al., 2018). Despite its considerable predictive utility, little is known about the mechanistic pathways that mediate these outcomes (Brotman et al., 2017). The goal of this study is to harmonize with contemporary formulations of construct validity that require elucidation of mediating processes that explain the relation between attributes (Borsboom et al., 2004). We hypothesize that irritability initiates cascades of negative parent-child and peer relationships that are central to internalizing and externalizing problems. Identifying causal mediators in predictions of emergent psychopathology from initial irritability is necessary to interrupt risk processes and to prevent psychopathology onset (Stringaris et al., 2018). Methods: Reflecting principles of evidence-based assessment, we employed multiple methods and informants across cognitive, academic, socio-emotional, and family functioning. The sample consists of two hundred thirty ethnically diverse (51.3% Caucasian) 5-10-year-old youth (31.9% female). Parents completed structured diagnostic interviews of child psychopathology, supplemented strategically with separate parent and teacher ratings using normed measures of children’s social functioning and internalizing and externalizing problems. At Wave 1, irritability was derived from the DSM-based Disruptive Behavior Disorder rating scale. At Wave 2, familial mediators consist of: (1) negative parenting behavior from the Alabama Parenting Questionnaire and (2) parenting stress using the Parenting Stress Index. Peer-based mediators were estimated from parallel parent and teacher ratings of: (1) social preference from the Dishion Peer Relationship Questionnaire and (2) social skills using the normed Social Skills Rating System. At Wave 3, separate parent-, teacher- and youth-rated psychopathology were assessed from the Child Behavior Checklist (CBCL), Teacher Report Form (TRF), and Youth Self Report (YSR), respectively. Data Analysis: Covarying for age, sex, race-ethnicity, SES, and childhood ADHD, we will use the multiple mediation PROCESS macro (Hayes, 2013) to evaluate Wave 2 family and peer factors as mediators of Wave 1 irritability and Wave 3 internalizing and externalizing problems. Total mediation (across all facets) and unique mediation (accounting for inter-correlation) will be derived from bootstrapping. Given that the data have already been collected, completion of data analysis before the time of the conference is highly feasible. Implications: The findings from this study could lead to increased screening for impaired relationships, which would facilitate delivery of targeted interventions and reduce the development of adolescent psychopathology. Because irritability is normative early in development, it is crucial to optimize its assessment. The current study is well-positioned to improve traction on patterns of informant ratings for early irritability and their implications for clinical assessment. Moreover, identifying causal mechanisms could generate innovations in prevention and intervention. This study highlights the importance of attending to the interpersonal sequelae of significant childhood irritability and their potential role in the development of later psychopathology. Ultimately, the goal of this research is to adopt a preventive approach to reduce the burden of mental illness by identifying early risk factors and to promote well-being and healthy functioning as children transition to adolescence.

Authors

• Margot Barclay, University of California - Los Angeles
  Presenting Author

• Steve Lee, University of California, Los Angeles
  Non-Presenting Author