title: Irritability in child and adolescent psychopathology: An integrative review for ICD-11.
abstract: In preparation for the World Health Organization's development of the Eleventh Revision of the International Classification of Diseases and Related Health Problems (ICD-11) chapter on Mental and Behavioral Disorders, this article reviews the literature pertaining to severe irritability in child and adolescent psychopathology. First, research on severe mood dysregulation suggests that youth with irritability and temper outbursts, among other features of hyperactivity and arousal, demonstrate cross-sectional correlates and developmental outcomes that distinguish them from youth with bipolar disorder. Second, other evidence points to an irritable dimension of Oppositional Defiant Disorder symptomatology, which is uniquely associated with concurrent and subsequent internalizing problems. In contrast to the Diagnostic and Statistical Manual of Mental Disorders' (5th ed.) Disruptive Mood Dysregulation Disorder, our review of the literature supports a different solution: a subtype, Oppositional Defiant Disorder with chronic irritability/anger (proposal included in Appendix). This solution is more consistent with the available evidence and is a better fit with global public health considerations such as harm/benefit potential, clinical utility, and cross-cultural applicability. Implications for assessment, treatment, and research are discussed.
authors.affiliation: Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA. Electronic address: scevans4@gmail.com.
authors.forename: Spencer C
authors.initials: SC
authors.lastname: Evans
authors.affiliation: Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Burke
authors.affiliation: Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Roberts
authors.affiliation: Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA.
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Fite
authors.affiliation: Department of Psychology, University of Alabama, Tuscaloosa, AL, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Lochman
authors.affiliation: Instituto Nacional de Psiquiatria 'Ramon de la Fuente Muñiz', Mexico City, Mexico.
authors.forename: Francisco R
authors.initials: FR
authors.lastname: de la Peña
authors.affiliation: Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Global Mental Health Program, Columbia University Medical Center, New York, NY, USA.
authors.forename: Geoffrey M
authors.initials: GM
authors.lastname: Reed
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000145:classification*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000145:classification*; D001714:Bipolar Disorder / Q000145:classification*; D002648:Child; D002653:Child Behavior Disorders / Q000145:classification*; D006801:Humans; D038801:International Classification of Diseases; D007508:Irritable Mood / Q000145:classification*
keywords: Anger; Diagnosis; ICD-11; Irritability; Mood dysregulation; Oppositional Defiant Disorder (ODD)