How are irritability and anhedonia symptoms linked? A network approach.

BACKGROUND: Anhedonia and irritability are two prevalent symptoms of major depressive disorder (MDD) that predict greater depression severity and poor outcomes, including suicidality. Although both symptoms have been proposed to result from paradoxical reward processing dysfunctions, the interactions between these symptoms remain unclear. Anhedonia is a multifaceted symptom reflecting impairments in multiple dimensions of reward processing (e.g., pleasure, desire, motivation, and effort) across distinct reward types (e.g., food, sensory experiences, social activities, hobbies) that may differentially interact with irritability. This study investigated the complex associations between anhedonia and irritability using network analysis. METHOD: Participants (N = 448, Mage = 33.29, SD = 14.58) reported their symptoms of irritability on the Brief Irritability Test (Holtzman et al., 2015) and anhedonia (i.e., pleasure, desire, motivation, and effort dimensions across four reward types) on the Dimensional Anhedonia Rating Scale (Rizvi et al., 2015). A regularized Gaussian Graphical Model was built to estimate the network structure between items. RESULTS: Irritability was negatively related to willingness to expand effort to obtain food/drinks (estimate = -0.18), social activities (-0.13), and hobbies (-0.12) rewards. Irritability was positively associated with a desire for food/drinks (0.12). LIMITATIONS: Only a small proportion (5.8%) of our sample was clinical and the study design was cross-sectional. CONCLUSION: A specific link between irritability and the effort dimension of the hedonic response across three reward types was identified. Investigating effort expenditure deficits with experimental paradigms may help us understand the mechanisms underlying the comorbidity between irritability and anhedonia in the context of MDD.

Peer functioning difficulties may exacerbate symptoms of attention-deficit/hyperactivity disorder and irritability over time: a temporal network analysis.

BACKGROUND: Children with attention-deficit/hyperactivity disorder (ADHD) have been consistently found to experience impairments in peer functioning. Irritability is highly prevalent in children with ADHD and may worsen social impairments given the frequent temper outbursts and low frustration tolerance characterizing irritability. However, it is still unclear how ADHD and irritability symptoms interact with peer functioning difficulties over time. Assessing these temporal dynamics using a novel longitudinal approach (i.e., temporal network analysis) may reveal precise targets for intervention. METHODS: This study investigates the dynamic associations between ADHD symptoms, irritability, and peer functioning in a community sample of 739 children (ages 8-11 years, Mage = 10.06 [SD = 0.59], 47.77% females) assessed at three timepoints, 6 months apart, in a school-based study. Parents reported their child's ADHD symptoms using the Swanson, Nolan, and Pelham Rating Scale (SNAP-IV), and irritability symptoms using the Child Behavior Checklist (CBCL) irritability items. Children's peer functioning (i.e., peer acceptance, peer rejection, number of friendships, and victimization) was measured via peer nomination. To estimate the longitudinal associations between the variables, we built a graphical vector autoregression model for panel data. RESULTS: The longitudinal network highlighted that poor peer functioning contributed to increases in symptoms over time. Specifically, (1) physical victimization predicted increases in inattention, hyperactivity, and irritability; (2) peer rejection predicted increases in inattention, which in turn predicted increases in irritability; (3) peer acceptance predicted decreases in inattention and irritability; and (4) higher numbers of mutual friendships increased inattention. CONCLUSIONS: These results suggest that a negative social environment involving physical bullying and rejection may aggravate ADHD and irritability symptoms. Conversely, positive social interactions, such as being liked by peers, may improve inattention and irritability symptoms. Fostering social-emotional skills and positive social interactions and environments in children with ADHD and irritability may be a promising target for future interventions to reduce symptoms.

Associations between sleep quality and irritability: Testing the mediating role of emotion regulation.

Objectives: Irritability and sleep problems are common symptoms that span a range of internalizing and externalizing mental health disorders. While poor sleep has been associated with symptoms related to irritability (e.g., anxiety and depression), few studies have directly tested the association between sleep quality and irritability and whether the association is direct or mediated by a separate mechanism. Method: The present study used self-report measures to test whether sleep is associated with irritability in 458 adults aged 19-74 years (58 % female; 79 % White), and whether this association is mediated by emotion regulation. Confirmatory factor analyses were carried out to support the use of scores from these measures. Results: Controlling for anxiety and depression symptoms, results showed a direct association between poorer sleep quality and increased irritability (ß = 0.25, p < .001) that was not mediated by emotion regulation. Conclusions: Our findings underscore the important link between sleep and irritability, both of which are common features of mental health difficulties, prompting further inquiry into the directionality of the findings and potential mediators. This work has notable clinical implications for sleep as a possible intervention target for individuals with high irritability.

Cognitive flexibility and attentional patterns among trauma survivors: preliminary evidence from an eye-tracking study.

Background: Executive functioning has been linked to both the development of post-traumatic symptoms and the efficiency of therapy. Specifically, flexibility processes seem to play a major role in the use of efficient coping strategies after a traumatic event. However, only a few studies have focused on the links between flexibility, resilience, and concrete behaviours displayed by individuals. Objective: The aim of this study was to investigate the influence of emotional content on the efficiency of cognitive flexibility among trauma-exposed individuals. Method: Twenty-eight trauma-exposed (TE) and 27 non-trauma-exposed (NTE) individuals performed an overlap task in which neutral, positive, and negative pictures appeared in the centre of the screen. Participants were required to disengage their attentional focus from this picture to identify a peripheral target. Analyses included eye movements during the presentation of the scenes and the response times associated with target localization. Results: TE individuals initially presented a rapid overt disengagement from both neutral and negative emotional information. In other words, TE participants moved their gaze away from the central picture towards the target more rapidly than NTE participants. However, TE participants then displayed longer reaction times to identify the target in comparison with NTE participants. Discussion: This study presents preliminary evidence that cognitive flexibility may be relevant when considering the impact of trauma. The developed task could provide a novel way to assess this flexibility within an emotional context. HIGHLIGHTS: • This study developed an original assessment of cognitive flexibility processes in an emotional context.• Cognitive flexibility was assessed using an overlap task and eye-tracking technology.• Cognitive flexibility may be relevant when considering the impact of a trauma.

Antecedentes: El funcionamiento ejecutivo se ha relacionado tanto con el desarrollo de síntomas postraumáticos como con la eficiencia de la terapia. Específicamente, los procesos de flexibilidad parecen jugar un papel importante en el uso de estrategias de afrontamiento después de un evento traumático. Sin embargo, solo unos pocos estudios se han centrado en los vínculos entre la flexibilidad, la resiliencia y los comportamientos concretos que muestran los individuos.Objetivo: El objetivo de este estudio fue investigar la influencia del contenido emocional en la eficiencia de la flexibilidad cognitiva entre individuos expuestos a traumas.Método: 28 personas expuestas a trauma (ET) y 27 no expuestas a trauma (NET) realizaron una tarea superpuesta en la que aparecían imágenes neutras, positivas y negativas en el centro de la pantalla. Se pidió a los participantes que desvincularan su foco de atención de esta imagen para identificar un objetivo periférico. Los análisis incluyeron movimientos oculares durante la presentación de las escenas y los tiempos de respuesta asociados con la localización del objetivo.Resultados: Los individuos con ET inicialmente presentaron una desconexión abierta y rápida de la información emocional tanto neutral como negativa. En otras palabras, los participantes con ET alejaron su mirada de la imagen central hacia el objetivo más rápido que los participantes NET. Sin embargo, los participantes con ET mostraron tiempos de reacción más largos para identificar el objetivo en comparación con los participantes NET.Discusión: Los individuos con ET inicialmente presentaron una desconexión abierta y rápida de la información emocional tanto neutral como negativa. En otras palabras, los participantes con ET alejaron su mirada de la imagen central hacia el objetivo más rápido que los participantes NET. Sin embargo, los participantes con ET mostraron tiempos de reacción más largos para identificar el objetivo en comparación con los participantes NET.

French Adaptation of the Brief Irritability Test: Factor Structure, Psychometric Properties, and Relationship with Depressive Symptoms.

The Brief Irritability Test (BITe, Holtzman et al., 2014) is a brief, reliable, and valid self-report measure of irritability. Despite the growing interest to understand the underlying causes and consequences of irritability, this questionnaire has not been developed and validated for a French-speaking population yet. In the present study, 413 participants completed our French adaptation of the BITe (i.e., TCI; Test Court d'Irritabilité) and measures of associated constructs (depression, anger, hostility, and aggression) and well-being (life satisfaction and social support). Descriptive, psychometric (i.e., Cronbach alpha and Spearman correlation coefficients), and factor analyses were conducted. An exploratory factor analysis in sample 1 (n = 209), yielded one single factor. The confirmatory factor analysis in sample 2 (n = 204) showed a reasonable fit of this single factor model explaining 55.5% of the variance and presenting a strong internal consistency (α = .80). Compared to the original English questionnaire, the TCI shares similar unidimensional factor organization and correlations with other constructs, although a gender bias was identified, with women scoring higher than men. Irritability was higher among respondents in the age range 17-25, compared to older adults. A hierarchical regression analysis showed that TCI scores significantly predict depressive symptoms when demographics were controlled for. In summary, the TCI presents good psychometric properties and could constitute a valuable tool to evaluate irritability in clinical and research contexts.