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Using ecological momentary assessment to enhance irritability phenotyping in a transdiagnostic sample of youth

Published online by Cambridge University Press:  07 December 2021

Reut Naim*
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Ashley Smith
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Amanda Chue
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Hannah Grassie
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Julia Linke
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Kelly Dombek
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Shannon Shaughnessy
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Cheri McNeil
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Elise Cardinale
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Courtney Agorsor
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Sofia Cardenas
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Julia Brooks
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Anni R. Subar
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Emily L. Jones
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Quyen B. Do
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Daniel S. Pine
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Ellen Leibenluft
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Melissa A. Brotman
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
Katharina Kircanski
Affiliation:
Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
*
Author for Correspondence: Reut Naim, National Institute of Mental Health, Bldg. 15K, MSC 2670, Bethesda, MD20892-2670, USA; E-mail: reut.naim@nih.gov

Abstract

Irritability is a transdiagnostic symptom dimension in developmental psychopathology, closely related to the Research Domain Criteria (RDoC) construct of frustrative nonreward. Consistent with the RDoC framework and calls for transdiagnostic, developmentally-sensitive assessment methods, we report data from a smartphone-based, naturalistic ecological momentary assessment (EMA) study of irritability. We assessed 109 children and adolescents (Mage = 12.55 years; 75.20% male) encompassing several diagnostic groups – disruptive mood dysregulation disorder (DMDD), attention-deficit/hyperactivity disorder (ADHD), anxiety disorders (ANX), healthy volunteers (HV). The participants rated symptoms three times per day for 1 week. Compliance with the EMA protocol was high. As tested using multilevel modeling, EMA ratings of irritability were strongly and consistently associated with in-clinic, gold-standard measures of irritability. Further, EMA ratings of irritability were significantly related to subjective frustration during a laboratory task eliciting frustrative nonreward. Irritability levels exhibited an expected graduated pattern across diagnostic groups, and the different EMA items measuring irritability were significantly associated with one another within all groups, supporting the transdiagnostic phenomenology of irritability. Additional analyses utilized EMA ratings of anxiety as a comparison with respect to convergent validity and transdiagnostic phenomenology. The results support new measurement tools that can be used in future studies of irritability and frustrative nonreward.

Type
Special Issue Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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