Using a developmental approach to investigate behavioral, neurodevelopmental, and depressive irritability types

Bekiropoulou, Aikaterini, Eyre, Olga ORCID: https://orcid.org/0000-0003-1944-9679, Heron, Jon, Langley, Kate ORCID: https://orcid.org/0000-0002-2033-2657, Thapar, Anita ORCID: https://orcid.org/0000-0002-3689-737X and Riglin, Lucy 2026. Using a developmental approach to investigate behavioral, neurodevelopmental, and depressive irritability types. JAACAP Open 10.1016/j.jaacop.2026.02.006

PDF - Accepted Post-Print Version Available under License Creative Commons Attribution. Download (1MB)

Abstract

Objective Irritability is highly heterogeneous and a common challenge in youth clinical services. Although transdiagnostic, diagnostic manuals conceptualize severe irritability differently: the ICD-11 primarily recognizes it as behavioral (oppositional defiant disorder specifier), and the DSM-5-TR, as depressive (core to disruptive mood dysregulation disorder). Irritability is also highly prevalent in, and genetically-linked to neurodevelopmental conditions. It is unclear if irritability represents a unitary construct or multiple different types. We examined whether distinct behavioral, neurodevelopmental and depressive irritability types, differentiated by their developmental course, sex-preponderance, clinical, genetic, and environmental covariates, could be observed. Method Using data from the Avon Longitudinal Study of Parents and Children (female participants: 5,085; male participants: 5,028), we explored sex-stratified irritability latent profiles across five time-points (∼ages 7-25) for irritability measured with the Development and Well-Being Assessment. We investigated associations with various clinical, genetic, and environmental covariates typifying behavioral, neurodevelopmental and depressive conditions. Results We identified five irritability profiles similar across sexes (low, child-limited, child/adolescent-limited moderate, child/adolescent-limited high, high-stable) and two sex-specific profiles: adolescent-onset (female participants), fluctuating (male participants). Although most profiles were not distinguished by condition-specific covariates, two showed some specificity with neurodevelopmental or depressive conditions: (a) the male high-stable profile was associated with ADHD diagnosis and genetic liability, and autism-like traits (b) the female adolescent-onset profile was associated with depression diagnosis and genetic liability, and adolescent/adult stressful life events. Conclusion Irritability appears developmentally-heterogeneous. While often transdiagnostic, for some irritability may align with neurodevelopmental or depressive conditions. This could have potential implications for classification and treatment.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Medicine Schools > Psychology
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by/4.0/, Start Date: 2026-02-25
Publisher:	Elsevier
ISSN:	2949-7329
Date of First Compliant Deposit:	12 March 2026
Date of Acceptance:	25 February 2026
Last Modified:	12 Mar 2026 11:00
URI:	https://orca.cardiff.ac.uk/id/eprint/185714

Actions (repository staff only)

Edit Item