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Understanding Irritability in Relation to Anger, Aggression, and Informant in a Pediatric Clinical Population
Journal of the American Academy of Child and Adolescent Psychiatry ( IF 9.2 ) Pub Date : 2021-08-23 , DOI: 10.1016/j.jaac.2021.08.012
Jodi Zik 1 , Christen M Deveney 2 , Jarrod M Ellingson 3 , Simone P Haller 4 , Katharina Kircanski 4 , Elise M Cardinale 4 , Melissa A Brotman 4 , Joel Stoddard 1
Affiliation  

Objective

Despite its clinical relevance to pediatric mental health, the relationship of irritability with anger and aggression remains unclear. We aimed to quantify the relationships between well-validated, commonly used measurements of these constructs and informant effects in a clinically relevant population.

Method

A total of 195 children with primary diagnoses of attention-deficit/hyperactivity disorder, disruptive mood dysregulation disorder, or no major disorder and their parents rate irritability, anger, and aggression on measures of each construct. Construct and informant relationships were mapped via multi-trait, multi-method factor analysis.

Results

Parent- and child-reported irritability and child-reported anger are highly associated (r = 0.89) but have some significant differences. Irritability overlaps with outward expression of anger but diverges from anger in anger suppression and control. Aggression has weaker associations with both irritability (r = 0.56) and anger (r = 0.49). Across measures, informant source explains a substantial portion of response variance.

Conclusion

Irritability, albeit distinct from aggression, is highly associated with anger, with notable overlap in child-reported outward expression of anger, providing empirical support for formulations of clinical irritability as a proneness to express anger outwardly. Diagnostic and clinical intervention work on this facet of anger can likely translate to irritability. Further research on external validation of divergence of these constructs in anger suppression and control may guide future scale revisions. The proportion of response variance attributable to informant may be an under-recognized confound in clinical research and construct measurement.



中文翻译:

了解儿科临床人群中易激惹与愤怒、攻击性和告密者的关系

客观的

尽管它与儿科心理健康具有临床相关性,但易怒与愤怒和攻击性之间的关系仍不清楚。我们的目的是量化临床相关人群中这些结构的经过充分验证的常用测量与线人效应之间的关系。

方法

共有 195 名初步诊断为注意力缺陷/多动障碍、破坏性情绪失调障碍或无重大障碍的儿童及其父母对每个结构的指标的易怒、愤怒和攻击性进行评分。通过多特征、多方法因素分析绘制构造和线人关系。

结果

父母和孩子报告的易怒和孩子报告的愤怒高度相关 ( r  = 0.89),但有一些显着差异。易怒与愤怒的外在表达重叠,但在愤怒抑制和控制方面与愤怒不同。攻击性与烦躁 ( r  = 0.56) 和愤怒 ( r  = 0.49)的关联较弱。在所有措施中,线人来源解释了响应方差的很大一部分。

结论

易怒虽然不同于攻击性,但与愤怒高度相关,儿童报告的愤怒外在表达有显着重叠,为临床易怒作为一种向外表达愤怒的倾向的表述提供了实证支持。针对愤怒这一方面的诊断和临床干预工作可能会转化为易怒。进一步研究这些结构在愤怒抑制和控制方面的差异的外部验证可能会指导未来量表的修订。归因于信息提供者的响应方差比例可能是临床研究和构建测量中未被充分认识的混杂因素。

更新日期:2021-08-23
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