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A Population-Based Twin Study of Childhood Irritability and Internalizing Syndromes.

ABSTRACT: Childhood irritability exhibits significant theoretical and empirical associations with depression and anxiety syndromes. The current study used the twin design to parse genetic and environmental contributions to these relationships. Children ages 9-14 from 374 twin pairs were assessed for irritability and symptoms of depression, generalized anxiety, panic, social phobia, and separation anxiety using dimensional self-report instruments. Multivariate structural equation modeling decomposed the correlations between these syndromes into genetic and environmental components to examine shared and specific risk domains. Irritability had significant associations with each internalizing symptom domain. Genetic contributions to irritability are moderately correlated with genetic risk for symptoms of depression, generalized anxiety, and separation anxiety with weaker overlap with the other anxiety syndromes. Familial and specific environmental risk factors explained covariation among syndromes and indicated potential syndrome-specific risk. There is substantial overlap among the genetic and environmental factors that influence individual differences in irritability and those that increase liability for depression and anxiety symptoms in children. These findings deepen the current understanding of childhood internalizing risk factors and provide important implications for syndrome prediction and susceptibility gene discovery efforts.

SUBMITTER: Rappaport LM

PROVIDER: S-EPMC6491264 | biostudies-literature | 2020 Jul-Aug

REPOSITORIES: biostudies-literature

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A Population-Based Twin Study of Childhood Irritability and Internalizing Syndromes.

Rappaport Lance M LM Carney Dever M DM Brotman Melissa A MA Leibenluft Ellen E Pine Daniel S DS Roberson-Nay Roxann R Hettema John M JM

Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 20181030 4

Childhood irritability exhibits significant theoretical and empirical associations with depression and anxiety syndromes. The current study used the twin design to parse genetic and environmental contributions to these relationships. Children ages 9-14 from 374 twin pairs were assessed for irritability and symptoms of depression, generalized anxiety, panic, social phobia, and separation anxiety using dimensional self-report instruments. Multivariate structural equation modeling decomposed the co ...[more]

PMID: 30376640

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Project description:OBJECTIVE:Advances in developmentally sensitive measurement have enabled differentiation of normative versus clinically salient irritability in early childhood. However, clinical application of these measures is still nascent. The authors developed an optimized model of clinically salient irritable behaviors at preschool age. Based on this model, the authors derived an empirically based cutoff in relation to concurrent DSM-5 irritability-related disorders (i.e., oppositional defiant disorder, disruptive mood dysregulation disorder, other depressive disorders) and used longitudinal models to test the predictive validity of the cutoff for impairment and irritability trajectories and later DSM disorders. METHOD:Preschool children oversampled for irritability were followed over 3 time points into early school age (N = 425; mean age at baseline 4.7 years, mean follow-up 2.9 years). Mothers reported on children's irritability using the developmentally validated Multidimensional Assessment of Profile of Disruptive Behavior (MAP-DB) Temper Loss scale, impairment using the Family Life Impairment Scale, and DSM categories using the Preschool Age Psychiatric Assessment and the Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. RESULTS:Of 22 MAP-DB Temper Loss behaviors, 2 behaviors-1 normative (easily frustrated) and 1 rare dysregulated (destructive tantrums)-were uniquely related to cross-domain impairment. At baseline, these 2 irritability items identified diagnostic status (oppositional defiant disorder, disruptive mood dysregulation disorder, other depressive disorders) with good sensitivity (70-73%) and specificity (74-83%). Children above the irritability cutoff at baseline also exhibited more persistent irritability and impairment and greater likelihood of DSM disorders in early school age. CONCLUSION:Clinical identification of early-onset irritability can be enhanced using brief, developmentally optimized indicators. Further research to apply these findings to tiered early intervention is important.

Project description:The nosological status of schizoaffective disorders remains controversial. Twin studies are potentially valuable for investigating relationships between schizoaffective-mania, schizoaffective-depression, and other psychotic syndromes, but no such study has yet been reported. We ascertained 224 probandwise twin pairs [106 monozygotic (MZ), 118 same-sex dizygotic (DZ)], where probands had psychotic or manic symptoms, from the Maudsley Twin Register in London (1948-1993). We investigated Research Diagnostic Criteria schizoaffective-mania, schizoaffective-depression, schizophrenia, mania and depressive psychosis primarily using a non-hierarchical classification, and additionally using hierarchical and data-derived classifications, and a classification featuring broad schizophrenic and manic syndromes without separate schizoaffective syndromes. We investigated inter-rater reliability and co-occurrence of syndromes within twin probands and twin pairs. The schizoaffective syndromes showed only moderate inter-rater reliability. There was general significant co-occurrence between syndromes within twin probands and MZ pairs, and a trend for schizoaffective-mania and mania to have the greatest co-occurrence. Schizoaffective syndromes in MZ probands were associated with relatively high risk of a psychotic syndrome occurring in their co-twins. The classification of broad schizophrenic and manic syndromes without separate schizoaffective syndromes showed improved inter-rater reliability, but high genetic and environmental correlations between the two broad syndromes. The results are consistent with regarding schizoaffective-mania as due to co-occurring elevated liability to schizophrenia, mania, and depression; and schizoaffective-depression as due to co-occurring elevated liability to schizophrenia and depression, but with less elevation of liability to mania. If in due course schizoaffective syndromes show satisfactory inter-rater reliability and some specific etiological factors they could alternatively be regarded as partly independent disorders.

Project description:BackgroundIrritability is a transdiagnostic psychiatric phenotype defined as an increased proneness to anger relative to peers. Trauma is defined as actual or threatened death, serious injury, or sexual violence while adversity more broadly describes difficult or challenging situations including abuse, neglect, and household dysfunction. Irritability [or aggression] is symptom of posttraumatic stress disorder (PTSD) and may arise in response to trauma or traumatic events. Responses to negative early life experiences may differ based on the type of exposure, for example, threat (abuse) versus deprivation (neglect), with implications for development of psychopathology. Therefore, the objective of this study was to investigate the relation between exposure to threat and deprivation, and irritability in a predominantly Hispanic/Latin sample. We hypothesized unique effects of threat versus deprivation on irritability.MethodsWe investigated relations between threat and deprivation aspects of childhood trauma (within each dimension) and later irritability in a sample of n = 48 (26F) youth ages 9-19 (M age = 14.89, SD = 2.04) recruited based on trauma exposure. Multivariate regression tested the unique effects of threat and deprivation (measurement: Childhood Trauma Questionnaire) on irritability (measurement: Affective Reactivity Index).ResultsGreater threat exposure was associated with more severe self-reported irritability, F(1,46) = 8.64, B = 0.40, R 2 = 0.14, p = 0.005. Findings remained significant after controlling for values of excessive influence and the non-significant effect of gender (B = 0.25, t = 1.88, p = 0.067). When looking at the unique effects of threat adjusted for deprivation, the relation between threat and irritability remained significant, B = 0.35, t = 2.45, p = 0.019. There was no significant association between deprivation and irritability, F(1,46) = 3.35, B = 0.26, R 2 = 0.05, p = 0.074.ConclusionsExposure to threat, but not deprivation, may increase risk for irritability in youth. Early life experiences should be considered in assessment and treatment of youth with clinically impairing irritability. Transdiagnostic treatments targeting irritability should be tested for youth with trauma exposure who do not meet criteria for post-traumatic stress disorder.

Dataset Information

A Population-Based Twin Study of Childhood Irritability and Internalizing Syndromes.

Publications

A Population-Based Twin Study of Childhood Irritability and Internalizing Syndromes.

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