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Do early internalizing and externalizing problems predict later irritability in adolescents with
Melissa Mulraney1,2, Nardia Zendarski1,2, Fiona Mensah1,2
11 Centre for Community Child Health, Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia.
The Australian and New Zealand Journal of Psychiatry
|August 13, 2016
Summary
Early conduct problems in children with attention-deficit/hyperactivity disorder predict later irritability. Managing these issues is crucial as irritability is linked to poorer overall functioning in adolescents.
Area of Science:
- Child and Adolescent Psychiatry
- Developmental Psychology
- Behavioral Science
Background:
- Irritable mood is a frequent issue in children diagnosed with attention-deficit/hyperactivity disorder (ADHD).
- Previous research predominantly used cross-sectional designs, limiting understanding of irritability's developmental trajectory and antecedents in ADHD.
- Existing studies often overlook broader functioning and child self-report of irritability.
Purpose of the Study:
- To investigate the longitudinal antecedents of irritability in children with ADHD.
- To examine the relationship between early conduct problems and adolescent irritability.
- To explore the association of irritability with ADHD symptom severity, sleep, behavior, and parent mental health, incorporating adolescent self-reports.
Main Methods:
- A longitudinal study followed children aged 5-13 with ADHD.
- Data from adolescents (12+ years) at 3-year follow-up (n=140) were analyzed.
- Measures included parent/adolescent-reported irritability (Affective Reactivity Index), Strengths and Difficulties Questionnaire for internalizing/externalizing problems, ADHD severity, sleep, behavior, and parent mental health.
Main Results:
- Children exhibiting externalizing problems at age 10 showed significantly higher parent-reported irritability in adolescence (β=0.31, p=0.001).
- Irritability in adolescence was cross-sectionally linked to increased ADHD symptom severity and sleep disturbances.
- Adolescent irritability correlated with poorer emotional, behavioral, and social functioning, and diminished parent mental health.
Conclusions:
- Early identification and management of conduct problems in children with ADHD are essential.
- Conduct problems predict persistent irritability, which is associated with widespread functional impairments.
- Addressing irritability and its predictors can improve outcomes for adolescents with ADHD.
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