The contribution of childhood trauma to irritability symptoms

Irritability is a transdiagnostic psychiatric phenotype defined as an increased proneness to anger relative to peers. Trauma is defined as actual or threatened death, serious injury, or sexual violence while adversity more broadly describes difficult or challenging situations including abuse, neglect, and household dysfunction. Irritability [or aggression] is symptom of posttraumatic stress disorder (PTSD) and may arise in response to trauma or traumatic events. Responses to negative early life experiences may differ based on the type of exposure, for example, threat (abuse) versus deprivation (neglect), with implications for development of psychopathology. Therefore, the objective of this study was to investigate the relation between exposure to threat and deprivation, and irritability in a predominantly Hispanic/Latin sample. We hypothesized unique effects of threat versus deprivation on irritability.

We investigated relations between threat and deprivation aspects of childhood trauma (within each dimension) and later irritability in a sample of n = 48 (26F) youth ages 9-19 (M _age  = 14.89, SD = 2.04) recruited based on trauma exposure. Multivariate regression tested the unique effects of threat and deprivation (measurement: Childhood Trauma Questionnaire) on irritability (measurement: Affective Reactivity Index).

Greater threat exposure was associated with more severe self-reported irritability, F(1,46) = 8.64, B = 0.40, R ² = 0.14, p = 0.005. Findings remained significant after controlling for values of excessive influence and the non-significant effect of gender (B = 0.25, t = 1.88, p = 0.067). When looking at the unique effects of threat adjusted for deprivation, the relation between threat and irritability remained significant, B = 0.35, t = 2.45, p = 0.019. There was no significant association between deprivation and irritability, F(1,46) = 3.35, B = 0.26, R ² = 0.05, p = 0.074.

Exposure to threat, but not deprivation, may increase risk for irritability in youth. Early life experiences should be considered in assessment and treatment of youth with clinically impairing irritability. Transdiagnostic treatments targeting irritability should be tested for youth with trauma exposure who do not meet criteria for post-traumatic stress disorder.