Preschool irritability predicts child psychopathology, functional impairment, and service use at age nine
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Background: Little is known about the predictive validity and clinical significance of chronic irritability during early childhood. This prospective, longitudinal study examined associations of preschool chronic irritability with psychiatric disorders, functional impairment, and service use at age nine in a large community sample. Methods: Four hundred and forty‐six children were assessed at age three and again at age nine. Child psychopathology and functional impairment were assessed at age three with the Preschool Age Psychiatric Assessment ( PAPA ) with parents and at age nine with the Kiddie‐Schedule of Affective Disorders and Schizophrenia (K‐ SADS ) with parents and children. Items from the PAPA were used to create a dimensional measure of chronic irritability at age three. At age nine, mothers, fathers, and youth completed the Child Depression Inventory ( CDI ) and the Screen for Anxiety Related Disorders ( SCARED ). Results: Chronic irritability at age three predicted any current and lifetime anxiety disorders at age nine, current and lifetime generalized anxiety disorder, and current separation anxiety, after controlling for baseline anxiety disorders. In addition, preschool irritability predicted increases in anxiety and disruptive behavior disorder symptoms on the K‐ SADS , and maternal and paternal reports of depressive and anxiety symptoms on the CDI and SCARED . Lastly, preschool irritability predicted greater functional impairment and outpatient treatment use, even after controlling for all psychiatric disorders at baseline. Conclusions: Findings underscore the central role of irritability in developmental psychopathology and support the importance of early detection and interventions targeting preschool irritability.
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“Furthermore, depressive symptoms in middle childhood are moderately stable and hold clinical significance in predicting later onset of depressive disorders and functional impairment (Keenan et al., 2008).”
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- Authors
- Dougherty, L. R., Smith, V. C., Bufferd, S. J., Kessel, E., Carlson, G. A., & Klein, D. N.
- Affiliations
- University of Maryland, College Park (US)
- California State University, San Marcos (US)
- Stony Brook University (US)
- Corresponding author
- Dougherty, Lea R.
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2015-02-27
- Volume
- 56
- Issue
- 9
- Pages
- 999-1007
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- PMC
- PMC4531384
- OpenAlex
- W2055341991
- Cited by
- 160
- References
- 28
- Citations by year
- 2026: 12 · 2025: 6 · 2024: 17 · 2023: 16 · 2022: 17 · 2021: 16 · 2020: 14 · 2019: 34 · 2018: 9 · 2017: 12 · 2016: 7
- FWCI
- 11.57
- Type
- journal article
- Language
- en
- Update notices
- erratum (2020-10-25)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Bristol Myers Squibb
- Otsuka
- Pfizer (R01MH069942)
- General Clinical Research Center (M01RR10710)
- Stony Brook University, National Center for Research Resources
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- chronic irritability, child psychopathology, anxiety disorders, generalized anxiety disorder, separation anxiety, functional disability, early childhood development, developmental psychopathology, early detection, disruptive behavior disorders, depressive symptoms
- MeSH terms
- Anxiety Disorders, Anxiety, Separation, Child, Child, Preschool, Depression, Female, Humans, Irritable Mood, Longitudinal Studies, Male, Mental Health Services, Prognosis, Attention Deficit and Disruptive Behavior Disorders
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