Categorical and dimensional approaches to the developmental relationship between ADHD and irritability

Author:

Johns‐Mead Rania1,Vijayakumar Nandita1,Mulraney Melissa2ORCID,Melvin Glenn1,Youssef George1,Sciberras Emma13ORCID,Anderson Vicki A.345,Nicholson Jan M.6,Efron Daryl345,Hazel Philip7,Silk Tim J.13

Affiliation:

1. Centre for Social and Early Emotional Development (SEED) and School of Psychology Deakin University Geelong Vic. Australia

2. Institute for Social Neuroscience ISN Psychology Ivanhoe Vic. Australia

3. Murdoch Children's Research Institute Melbourne Vic. Australia

4. The Royal Children's Hospital Melbourne Vic. Australia

5. Department of Paediatrics University of Melbourne Melbourne Vic. Australia

6. Judith Lumley Centre La Trobe University Melbourne Vic. Australia

7. Sydney Medical School, Faculty of Medicine and Health The University of Sydney Sydney NSW Australia

Abstract

BackgroundAttention deficit hyperactivity disorder (ADHD) and irritability commonly co‐occur, and follow similar developmental trajectories from childhood to adolescence. Understanding of the developmental relationship between these co‐occurrences is limited. This study provides a longitudinal assessment of how ADHD diagnostic status and symptom patterns predict change in irritability.MethodsA community sample of 337 participants (45.2% ADHD), recruited for the Childhood Attention Project, completed the Affective Reactivity Index (ARI) to measure irritability at baseline (mean age 10.5 years) and follow‐up after 18‐months. Latent change score models were used to assess how (a) baseline ADHD vs. control group status, (b) baseline symptom domain (inattention, hyperactivity–impulsivity) and (c) longitudinal change in ADHD symptom severity predicted change in irritability.ResultsIrritability was significantly higher among the ADHD group than controls; however, change in irritability over time did not differ between groups. When assessed across the entire cohort, change in irritability was predicted by higher symptom count in the hyperactive–impulsive domain, but not the inattentive domain. Greater declines in ADHD symptoms over time significantly predicted greater declines in irritability. Baseline ADHD symptom severity was found to significantly predict change in irritability; however, baseline irritability did not significantly predict change in ADHD symptoms.ConclusionsADHD symptoms—particularly hyperactive–impulsive symptoms—predict the degree and trajectory of irritability during childhood and adolescence, even when symptoms are below diagnostic thresholds. The use of longitudinal, dimensional and symptom domain‐specific measures provides additional insight into this relationship.

Funder

Collier Charitable Fund

National Health and Medical Research Council

Publisher

Wiley

Subject

Psychiatry and Mental health,Developmental and Educational Psychology,Pediatrics, Perinatology and Child Health

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