title: Loss of Temper and Irritability: The Relationship to Tantrums in a Community and Clinical Sample.
abstract: BACKGROUND
  This study explores the relationship of irritability to tantrums and loss of temper in a community and clinical sample.
  
  
  METHODS
  The community sample, recruited via commercial mailing lists, consisted of 462 6-year-olds whose parents completed the Child Behavior Checklist (CBCL), and Preschool Age Psychiatric Assessment (PAPA). Tantrums were assessed in the oppositional defiant disorder (ODD) section of the PAPA. Irritability was assessed in the depression section to identify persistently irritable and/or angry mood. The clinic sample, drawn from a child psychiatry clinic, included 229 consecutively referred 6-year-olds from 2005 through 2014 whose parents completed the CBCL and Child and Adolescent Symptom Inventory (CASI). Temper loss and irritability items came from the ODD and depression sections of the CASI, and tantrum description was taken from an irritability inventory. Children's Global Assessment Scale (CGAS) and the CBCL Dysregulation Profile were examined in both samples. Logistic and multiple regression were used to compare rates of diagnosis, CBCL subscales, CGAS, and tantrum quality between children with tantrums only and tantrums with irritability.
  
  
  RESULTS
  Almost half (45.9%) of clinic children had severe tantrums; only 23.8% of those were said to be irritable. In the community, 11% of children had tantrums, but 78.4% of those were called irritable. However, irritability in the clinic, although less common, was associated with aggressive tantrums and substantial impairment. In contrast, irritability was associated with only a relatively small increase in impairment in the community sample.
  
  
  CONCLUSIONS
  Irritability may have different implications in community versus clinic samples, and tantrums assessed in the community may be qualitatively different from those seen in clinics.
authors.affiliation: 1 Division of Child and Adolescent Psychiatry, Stony Brook University School of Medicine , Stony Brook, New York.
authors.forename: Gabrielle A
authors.initials: GA
authors.lastname: Carlson
authors.affiliation: 2 Department of Psychology, Stony Brook University , Stony Brook, New York.
authors.forename: Allison P
authors.initials: AP
authors.lastname: Danzig
authors.affiliation: 3 Department of Psychology, University of Maryland , College Park, Maryland.
authors.forename: Lea R
authors.initials: LR
authors.lastname: Dougherty
authors.affiliation: 4 Department of Psychology, California State University , San Marcos, California.
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Bufferd
authors.affiliation: 2 Department of Psychology, Stony Brook University , Stony Brook, New York.
authors.forename: Daniel N
authors.initials: DN
authors.lastname: Klein
mesh_terms: D000374:Aggression; D057189:Checklist; D002648:Child; D002652:Child Behavior; D005260:Female; D006801:Humans; D007508:Irritable Mood; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D010290:Parents; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires