Department of Psychology, Northwestern University.
Department of Communication Sciences and Disorders, Northwestern University.
J Psychopathol Clin Sci. 2022 Aug;131(6):556-566. doi: 10.1037/abn0000655.
The transdiagnostic importance of irritability in psychopathology has been demonstrated. However, the contribution of developmentally unfolding irritability patterns to specific clinical and neural outcomes remains an important and unanswered question. To address this gap in the literature, irritability patterns of 110 youth from a large, diverse cohort were assessed at preschool age and again at early school age (∼2.5 years later) with a dimensional irritability scale designed to capture the normal:abnormal spectrum. At preadolescence (∼6 years later), clinical outcomes (internalizing/externalizing symptoms) derived from a semistructured clinical interview and neural outcomes (characterized as gray-matter-volume abnormalities) were assessed. For clinical outcomes, preschool-age irritability alone was a transdiagnostic predictor of internalizing and externalizing symptoms at preadolescence. However, in a model including both preschool and early school age, irritability provided greater specificity, suggesting that higher irritability at early school age related to elevated preadolescent externalizing but not internalizing symptoms. In terms of neural outcomes, elevated preschool irritability did not predict preadolescent gray-matter-volume abnormality; however, irritability at early school age demonstrated an interactive effect among regions, with reduced volume in preadolescence emotional regions (e.g., amygdala, medial orbitofrontal cortex) and increased volume in other regions (e.g., cerebellum). These complex patterns highlight the contribution of a developmentally informed approach, the National Institute of Mental Health's Research Domain Criteria (RDoC) approach, to yield transdiagnostic phenotypes and multiple units of analysis. Capturing these individual differences and developmental heterogeneity can provide critical insight into the unfolding of mechanisms underlying emerging psychopathology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
易激惹在精神病理学中的跨诊断重要性已得到证实。然而，发展中易激惹模式对特定临床和神经结果的贡献仍然是一个重要且未解决的问题。为了解决文献中的这一空白，使用专为捕捉正常和异常范围而设计的维度易激惹量表，对来自大型、多样化队列的 110 名幼儿在学前年龄和早期学龄期（约 2.5 年后）进行易激惹模式评估。在青春期前（约 6 年后），使用半结构化临床访谈评估临床结果（内化/外化症状）和神经结果（表现为灰质体积异常）。对于临床结果，仅学前年龄的易激惹是青春期前内化和外化症状的跨诊断预测因素。然而，在包括学前和早期学龄期的模型中，易激惹提供了更高的特异性，表明早期学龄期更高的易激惹与青春期前的外化症状升高有关，而与内化症状无关。就神经结果而言，较高的学前易激惹不会预测青春期前的灰质体积异常；然而，早期学龄期的易激惹表现出与区域的相互作用，青春期前的情绪区域（例如杏仁核、内侧眶额皮层）体积减少，而其他区域（例如小脑）的体积增加。这些复杂的模式突出了一种发展知情方法的贡献，即美国国立卫生研究院的研究领域标准（RDoC）方法，以产生跨诊断表型和多个分析单元。捕捉这些个体差异和发展异质性可以为新兴精神病理学中潜在机制的发展提供关键见解。（PsycInfo 数据库记录（c）2022 APA，保留所有权利）。
