@article{ref1,
title="Phasic versus tonic irritability: differential associations with attention-deficit/hyperactivity disorder symptoms",
journal="Journal of the American Academy of Child and Adolescent Psychiatry",
year="2021",
author="Cardinale, Elise M. and Freitag, Gabrielle F. and Kircanski, Katharina and Leibenluft, Ellen and Pine, Daniel S. and Brotman, Melissa A.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: Irritability is a multifaceted construct in pediatric psychopathology. It has been conceptualized as having a 'phasic' dimension and a 'tonic' dimension. Disruptive mood dysregulation disorder (DMDD) is defined by the presence of both  dimensions. Severe irritability, or DMDD, is highly comorbid with  attention-deficit/hyperactivity disorder (ADHD). However, it is unknown whether the  presence of ADHD modulates the expression of phasic and tonic irritability. <br><br>METHOD:  A data-driven, latent variable approach was used to examine irritability and ADHD  symptoms in a transdiagnostic pediatric sample (N=489) with primary DMDD, ADHD,  subclinical irritability symptoms, or no diagnosis. Using latent profile analyses  (LPA), we identified four classes: high levels of both irritability and ADHD  symptoms, high levels of irritability and moderate levels of ADHD symptoms, moderate  levels of irritability and high levels of ADHD symptoms, and low levels of both  irritability and ADHD symptoms. Confirmatory factor analysis operationalized phasic  irritability and tonic irritability. <br><br>RESULTS: As expected, the two latent classes  characterized by high overall irritability exhibited the highest levels of both  phasic and tonic irritability. However, between these two high irritability classes,  highly comorbid ADHD symptoms were associated with significantly greater phasic  irritability than were moderately comorbid ADHD symptoms. In contrast, the two high  irritability groups did not differ on levels of tonic irritability. <br><br>CONCLUSION:  These findings suggest that phasic, but not tonic, irritability has a significant  association with ADHD symptoms, and that phasic and tonic might be distinct, though  highly related, irritability dimensions. Future research should investigate  potential mechanisms underlying this differential association.<p /> <p>Language: en</p>",
language="en",
issn="0890-8567",
doi="10.1016/j.jaac.2020.11.022",
url="http://dx.doi.org/10.1016/j.jaac.2020.11.022"
}