TY - JOUR
T1 - A symptom-level perspective on irritability, PTSD, and depression in children and adults
AU - Zhan, Nalan
AU - Li, Fan
AU - Fung, Hong Wang
AU - Zhang, Kailiang
AU - Wang, Jian
AU - Geng, Fulei
N1 - Funding Information:
The present study was funded by the National Natural Science Foundation of China (grant number: 32260210 for Fulei Geng) and Graduate Innovation Foundation of Jiangxi Province (grant number: YC2023-S278 for Nalan Zhan).
Publisher Copyright:
© 2024 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
PY - 2024/12/15
Y1 - 2024/12/15
N2 - Background: Although irritability is a prominent clinical manifestation among traumatized populations, its relationships with other psychopathologies are rarely studied. Adopting a symptom-level perspective, this study aimed to explore how symptoms of irritability, posttraumatic stress disorder (PTSD), and depression are associated. Method: The Brief Irritability Test, the PTSD Checklist for DSM-5, and the Patient Health Questionnaire-9 were used to measure irritability, PTSD, and depression, respectively, in a large sample of trauma-exposed children and adolescents (n = 5454), trauma-exposed adults (n = 4718), and children and adolescents with probable PTSD (n = 556). Exploratory graph analysis (EGA) and network analysis were conducted to examine potential communities and significant relations. Results: Although irritability, PTSD, and depression were highly correlated at the disorder level, EGA results indicated that, at the symptom level, they formed highly stable and dense communities, respectively. Relations across disorders mainly emerged at symptoms related to negative cognition, dysphoria, and suicidal thoughts. Especially, strong transdiagnostic relations across all samples were “negative beliefs” and “suicidal thoughts”, “numbing” and “suicidal thoughts”, “startle” and “moving slowly or restless”, “bothering” and “moving slowly or restless”. Furthermore, irritability symptoms seem more central than PTSD and depression symptoms, with “snap” being the most central node across all networks, especially in the child and adolescent sample. Conclusion: Irritability, PTSD, and depression are relatively independent constructs when analyzed at the symptom level. Irritability symptoms emerged as core symptoms in trauma-exposed populations. Our findings highlight the importance of independent assessment of irritability in the diagnosis and treatment of PTSD.
AB - Background: Although irritability is a prominent clinical manifestation among traumatized populations, its relationships with other psychopathologies are rarely studied. Adopting a symptom-level perspective, this study aimed to explore how symptoms of irritability, posttraumatic stress disorder (PTSD), and depression are associated. Method: The Brief Irritability Test, the PTSD Checklist for DSM-5, and the Patient Health Questionnaire-9 were used to measure irritability, PTSD, and depression, respectively, in a large sample of trauma-exposed children and adolescents (n = 5454), trauma-exposed adults (n = 4718), and children and adolescents with probable PTSD (n = 556). Exploratory graph analysis (EGA) and network analysis were conducted to examine potential communities and significant relations. Results: Although irritability, PTSD, and depression were highly correlated at the disorder level, EGA results indicated that, at the symptom level, they formed highly stable and dense communities, respectively. Relations across disorders mainly emerged at symptoms related to negative cognition, dysphoria, and suicidal thoughts. Especially, strong transdiagnostic relations across all samples were “negative beliefs” and “suicidal thoughts”, “numbing” and “suicidal thoughts”, “startle” and “moving slowly or restless”, “bothering” and “moving slowly or restless”. Furthermore, irritability symptoms seem more central than PTSD and depression symptoms, with “snap” being the most central node across all networks, especially in the child and adolescent sample. Conclusion: Irritability, PTSD, and depression are relatively independent constructs when analyzed at the symptom level. Irritability symptoms emerged as core symptoms in trauma-exposed populations. Our findings highlight the importance of independent assessment of irritability in the diagnosis and treatment of PTSD.
KW - Children
KW - Depression
KW - Irritability
KW - Network analysis
KW - Posttraumatic stress disorder
UR - http://www.scopus.com/inward/record.url?scp=85203457375&partnerID=8YFLogxK
UR - https://www.sciencedirect.com/science/article/pii/S0165032724014460?via%3Dihub
U2 - 10.1016/j.jad.2024.08.213
DO - 10.1016/j.jad.2024.08.213
M3 - Journal article
C2 - 39236894
AN - SCOPUS:85203457375
SN - 0165-0327
VL - 367
SP - 606
EP - 616
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -