Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center/Albert Einstein College of Medicine.
Department of Psychological Sciences, University of Connecticut.
J Clin Child Adolesc Psychol. 2024 Mar-Apr;53(2):199-215. doi: 10.1080/15374416.2023.2246557. Epub 2023 Sep 12.
The need to understand and treat childhood chronic irritability (CI; i.e. frequent temper loss and angry/irritable mood) is imperative. CI predicts impairment across development and complex comorbidities with both internalizing and externalizing disorders. Research has emphasized frustration reactivity as a key mechanism of CI. However, there are understudied components of frustrative non-reward, particularly regulation-oriented frustration recovery, frustration tolerance, and cognitive control, that may further explain impairments specific to CI beyond comorbid symptoms.
Sixty-three community children ( = 25 CI/38 non-CI) and a parent completed surveys and the computerized Frustration Go/No-Go (FGNG) and Mirror Tracing Persistence Task (MTPT). Analyses compared task performance and self-rated affect across youth with or without CI, with further comparison based on negative/positive screen for ADHD ( = 45-/18+).
In mixed effects models assessing change across task, the CI group did not demonstrate more intense frustration on the MTPT or rigged FGNG block but exhibited persisting frustration and inhibitory control difficulties into the FGNG recovery period; the CI+ADHD subgroup drove recovery effects. In GEE and logistic regression models including dimensional symptom clusters, only internalizing symptoms predicted child frustration intolerance and reactivity across tasks. ADHD severity was also associated with higher MTPT frustration reactivity, while oppositional behavior predicted lower frustration. Better frustration recovery was associated with lower irritability, but higher internalizing symptoms.
Co-occurring symptoms may better explain some frustration-related difficulties among youth with CI. Difficulties with postfrustration affect and inhibitory control recovery suggest the importance of characterizing CI by self-regulation impairments.
理解和治疗儿童慢性烦躁（CI；即频繁发脾气和易怒/烦躁情绪）是必要的。CI 预测整个发展过程中的损伤，并与内化和外化障碍的复杂共病有关。研究强调挫折反应性是 CI 的关键机制。然而，受挫后不奖励的成分，特别是以调节为导向的挫折恢复、挫折容忍和认知控制，在解释除了共病症状之外，CI 特定的损伤方面，可能有进一步的研究。
63 名社区儿童（ = 25 名 CI/38 名非 CI）和一名家长完成了调查和计算机化挫折 Go/No-Go（FGNG）和镜像追踪坚持任务（MTPT）。分析比较了有无 CI 的青少年在任务表现和自我报告的情绪方面的差异，并进一步根据 ADHD 的阴性/阳性筛查（ = 45-/18+）进行比较。
在混合效应模型中，评估任务的变化，CI 组在 MTPT 或 FGNG 伪块上没有表现出更强烈的挫折感，但在 FGNG 恢复期表现出持续的挫折感和抑制控制困难；CI+ADHD 亚组驱动了恢复效应。在包括维度症状群的 GEE 和逻辑回归模型中，只有内化症状预测了儿童在整个任务中的挫折不耐受和反应性。ADHD 严重程度也与 MTPT 挫折反应性相关，而对立行为预测了较低的挫折感。更好的挫折恢复与较低的易激惹有关，但与更高的内化症状有关。
共病症状可能更好地解释了一些 CI 青少年的一些与挫折相关的困难。挫折后情绪和抑制控制恢复困难表明，通过自我调节障碍来描述 CI 的重要性。
