Irritability as a Transdiagnostic Construct Across Childhood and Adolescence: A Systematic Review and Meta-analysis.

This large study looked at irritability in over 122,000 children and teens. Researchers found that irritability is connected to many different mental health challenges, not just one specific condition. Children who are more irritable tend to have more difficulties with emotions and behavior both now and in the future. This suggests that helping children manage irritability could be beneficial across various conditions including autism, ADHD, anxiety, and behavioral problems.

This comprehensive meta-analysis of 119 studies involving 122,456 children and adolescents (ages 2-18) examined irritability as a transdiagnostic construct across various mental health conditions. The research found moderate positive associations between irritability and concurrent psychopathology symptoms, with small to moderate associations for longitudinal outcomes. The relationship varied across specific diagnostic domains including anxiety, depression, ADHD, autism spectrum disorder, and conduct disorders. Meta-regression analyses identified moderating factors including symptom domain, child age, sex, informant type, and study quality.

Findings support irritability as reflecting underlying emotion dysregulation across diverse forms of childhood psychopathology, suggesting its utility as a treatment target.

Irritability should be considered a transdiagnostic treatment target reflecting emotion dysregulation across childhood mental health conditions. Early identification and intervention for irritability may prevent or reduce severity of various psychiatric symptoms. Clinical assessment should routinely evaluate irritability across different diagnostic contexts.

The abstract does not specify methodological limitations, quality assessment details, or potential sources of heterogeneity across the 119 included studies. Information about publication bias assessment, specific effect size ranges, or demographic representation is not provided.

This meta-analytic review examined irritability across childhood and adolescence as it relates to symptoms of common mental health disorders in these periods. Of key interest was whether the relationship between irritability and symptom severity varies according to symptom domain. This was tested at the level of broad symptom dimensions (internalizing versus externalizing problems) as well as discrete diagnostic domains (e.g., anxiety, depression, oppositional defiant disorder, conduct disorder, attention deficit hyperactivity disorder; autism spectrum disorder). Following PRISMA guidelines, a systematic search of five databases was conducted to identify studies reporting on associations between irritability and mental health symptoms in samples of children aged 2-18 years.

Meta-analytic tests based on random effects models examined concurrent and longitudinal associations between irritability and symptom severity. Meta-regression tested potential moderators including symptom domain, child age, sex, informant type, and study quality. 119 studies met inclusion criteria with a total of 122,456 participants. A significant and positive association was found between irritability and severity of concurrent overall psychopathology in the order of a moderate effect size, while small to moderate effect sizes characterized the association between irritability and later mental health outcomes in prospective data. Further variation in this association was seen across specific diagnostic domains and methodological moderators.

Findings support the conceptualization of irritability as a transdiagnostic construct reflecting emotion dysregulation across diverse forms of psychopathology in childhood and adolescence. Further research into the risk mechanisms underlying irritability is needed, in addition to translational approaches to early intervention.