Department of Psychology, San Diego State University, San Diego, California, USA.
San Diego State University Research Foundation, San Diego, California, USA.
Int J Methods Psychiatr Res. 2023 Nov;32(S1):e1986. doi: 10.1002/mpr.1986. Epub 2023 Sep 13.
Heightened irritability in adolescence is an impairing symptom that can lead to negative outcomes in adulthood, but effective screening tools are lacking. This study aimed to derive clinically-optimized cutoff scores using the Multidimensional Assessment Profile Scales-Temper Loss (MAPS-TL) to pragmatically identify adolescents with impairing irritability.
A diverse sample of 79 adolescents and their parents completed the MAPS-TL-Youth version. Stepwise logistic regression analyses were used to determine the items associated with impairment, and receiver operator characteristic (ROC) analyses were conducted to derive optimal cutoff scores.
Three parent-report items (become frustrated easily, angry/irritable/grouchy throughout the day, difficulty calming down when angry) and two youth-report items (hit/shove/kick when lost temper, difficulty calming down when angry) were strongly associated with impairment. Optimal cutoff scores garnered very good sensitivity (91%, 73%) and specificity (77%, 75%) for the parent- and youth-report versions respectively. Scores above these cutoffs were associated with increased internalizing and externalizing problems and lower overall quality of life.
The MAPS-TL clinically optimized irritability scores show preliminary validity for implementation in practical settings to efficiently identify adolescents who need additional evaluation and/or intervention. Further research is important to validate these cutoff scores with larger population-based samples and real-world settings.
青春期的情绪易激惹是一种会导致成年后出现负面后果的损害性症状，但目前缺乏有效的筛查工具。本研究旨在通过多维评估量表-情绪丧失（MAPS-TL）得出临床优化的截断分数，以实用的方式识别出具有损害性情绪易激惹的青少年。
79 名青少年及其父母完成了多维评估量表-青少年版（MAPS-TL-Youth version）。采用逐步逻辑回归分析来确定与损害相关的项目，并进行接收者操作特征（ROC）分析以得出最佳截断分数。
三项家长报告项目（容易感到沮丧、整天生气/易怒/脾气暴躁、生气时难以平静下来）和两项青少年报告项目（发脾气时打人/推人/踢人、生气时难以平静下来）与损害高度相关。对于家长报告和青少年报告版本，最佳截断分数的敏感性分别为 91%（73%）和特异性为 77%（75%）。分数超过这些截断值与更多的内化和外化问题以及整体生活质量降低相关。
MAPS-TL 经临床优化的情绪易激惹分数显示出在实际环境中实施的初步有效性，可以有效地识别出需要进一步评估和/或干预的青少年。进一步的研究对于使用更大的基于人群的样本和现实环境来验证这些截断分数非常重要。
