Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.
Res Child Adolesc Psychopathol. 2024 Jan;52(1):125-139. doi: 10.1007/s10802-023-01098-1. Epub 2023 Jul 6.
Preschool-age irritability is a transdiagnostic marker of internalizing and externalizing problems. However, researchers have generally been reluctant to examine irritability within a clinically salient framework at younger ages due to some instability during the "terrible twos" period. Developmentally sensitive and dense measurements to capture intra- and inter-individual variability, as well as exploration of developmental processes that predict change, are needed. This study aimed to examine (1) the trajectories of irritability at the transition to toddlerhood (12-24 months of age) using repeated measures, (2) whether effortful control was associated with individual differences in level and growth rate of irritability, and (3) whether individual differences in the irritability trajectories were associated with later psychopathology. Families were recruited when the child was 12-18 months old (N = 333, 45.65% female). Mothers reported on their toddler's irritability at baseline and every two months until a follow-up laboratory assessment approximately one year later. Effortful control was measured at baseline. Clinical internalizing/externalizing symptoms were measured at the follow-up assessment. Hierarchical linear models revealed an increase in irritability over time, yet there was relatively little within-person variability. Effortful control was only associated with the level of irritability and not growth rate. Level of irritability was associated with internalizing, externalizing, and combined symptoms, but growth rate was not. Findings suggest intraindividual stability in irritability at the transition to toddlerhood and the possibility that screening for elevated irritability at toddler age is meaningful.
幼儿期烦躁是内在和外在问题的跨诊断标志物。然而,由于“可怕的两岁”期间存在一些不稳定性,研究人员通常不愿意在较年轻的年龄段内根据临床显著框架检查烦躁。需要发展敏感和密集的测量方法来捕捉个体内和个体间的可变性,以及探索预测变化的发展过程。本研究旨在检验:(1) 使用重复测量法,在向幼儿期(12-24 个月)过渡时,烦躁的轨迹;(2) 努力控制是否与烦躁水平和增长速度的个体差异有关;(3) 烦躁轨迹的个体差异是否与以后的心理病理学有关。当孩子 12-18 个月大时(N=333,45.65%为女性),招募家庭。母亲在基线和每两个月报告一次他们的幼儿的烦躁情况,直到大约一年后的后续实验室评估。努力控制在基线时进行测量。临床内在/外在症状在随访评估时进行测量。分层线性模型显示,随着时间的推移,烦躁感会增加,但个体内的变化相对较小。努力控制仅与烦躁水平有关,而与增长率无关。烦躁水平与内在、外在和综合症状有关,但增长率无关。研究结果表明,在向幼儿期过渡期间,个体内的烦躁情绪具有稳定性,并且在幼儿时期筛查烦躁情绪升高可能具有意义。