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Citation
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Finlay-Jones AL, Ang JE, Brook J, Lucas JD, MacNeill LA, Mancini VO, Kottampally K, Elliott C, Smith JD, Wakschlag LS. J. Am. Acad. Child Adolesc. Psychiatry 2023; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: Irritability is a transdiagnostic indicator of child and adolescent internalizing and externalizing problems that is measurable from early life. The objective of this systematic review was to determine the strength of the association between irritability measured from 0-5 years and later internalizing and externalizing problems, to identify mediators and moderators of these relationships, and to explore whether the strength of the association varied according to irritability operationalisation.
METHOD: Relevant studies published in peer-reviewed, English language journals between years 2000 to 2021 were sought from EMBASE, PsycINFO, MEDLINE, CINAHL, and ERIC. We synthesized studies that included a measure of irritability within the first five years of life and reported associations with later internalizing and/or externalizing problems.
METHODological quality was assessed using the JBI-SUMARI Critical Appraisal Checklist.
RESULTS: Of 29,818 identified studies, 98 met inclusion criteria with a total number of 932,229 participants. Meta-analysis was conducted on 70 studies (n = 831,913). Small, pooled associations were observed between infant irritability (0-12 months), and later internalizing (r =.14, 95% CI.09,.20) and externalizing symptoms (r =.16, 95% CI.11,.21). For toddler/preschool irritability (13-60 months), small-moderate pooled associations were observed for internalizing symptoms (r =.21, 95% CI.14,.28) and externalizing symptoms (r =.24, 95% CI.18,.29). These associations were not moderated by the lag between irritability and outcome assessment, although the strength of the associations varied according to irritability operationalization.
CONCLUSION: Early irritability is a consistent transdiagnostic predictor of internalizing and externalizing symptoms in childhood and adolescence. More work is required to understand how to accurately characterise irritability across this developmental period, and to understand mechanisms underlying the relationship between early irritability and later mental health problems. DIVERSITY & INCLUSION STATEMENT: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group.
Language: en |