Irritability: associations with real-time affect dynamics, social interactions, and daily substance use in older adolescents.

Irritability is a common and clinically significant symptom associated with a wide range of negative outcomes. Ecological Momentary Assessment (EMA) is a valuable tool for capturing experiences, such as emotions, social interactions, and substance use in real-time, and may be useful in understanding how irritability is related to everyday functioning. We investigated cross-sectional associations between a widely used self-report irritability rating scale and affect dynamics, social interactions, and substance use captured with EMA (5 surveys daily for 14 days) in 349 18-year-olds. We also examined the associations of self- and parent-reported irritability at ages 12 and 15 with the age 18 EMA variables to explore whether these relationships persist over time. Youth-reported irritability at age 18 was linked to greater intensity, variability, and inertia of irritability, sadness, and anxiety, less positive and more negative interpersonal experiences, and greater cigarette and drug use. Most effect sizes were in the medium-small range. Associations of youth- and parent-reported irritability at ages 12 and 15 with the age 18 EMA measures were generally similar, although smaller in magnitude. Findings contribute to understanding how irritability is manifested in real-time affect dynamics and interpersonal functioning, as well as daily substance use. Most effects were evident over the course of up to 6 years - that is, early adolescent irritability, reported by both youth and their parents, was associated with similar real-time affect dynamics and interpersonal experiences at age 18. This study contributes to the literature on the developmental psychopathology of irritability by extending findings to everyday functioning.

Emotion dynamics in current and remitted depression: an ecological momentary assessment study.

BACKGROUND: Individuals in a depressive episode and healthy controls exhibit robust differences on affect dynamics captured with ecological momentary assessment (EMA). However, few studies have explored affect dynamics in individuals in remission from depression, and results have been mixed. METHODS: A community sample of 18-year-olds (N = 345) completed diagnostic interviews and EMA probing emotions and low interest/motivation 5× daily for 2 weeks. Affect home base, variability, and inertia were compared across currently depressed, remitted, and never-depressed groups. RESULTS: Both depression groups had a higher negative affect (NA) and low interest/motivation home base, lower positive affect (PA) home base, greater variability of NA, PA, and low interest/motivation, and greater NA and low interest/motivation inertia than never-depressed participants. Additionally, the currently depressed group had a higher sad home base specifically, greater variability across most negative emotions and low interest/motivation, and greater low interest/motivation inertia than the remitted group. The currently depressed and remitted groups did not differ in anxious, upset, or PA home base, anxious or PA variability, and inertia of all negative emotions and PA. CONCLUSIONS: Findings suggest that a number of abnormalities in emotion and reward functioning persist after a depressive episode resolves, however, the tendency to experience higher levels of sadness, greater range of a variety of negative emotions, and more variable and persistent low interest/motivation are exacerbated during depressive episodes. Conversely, greater intensity and persistence of some negative emotions (anxiety, upset) and blunted positive emotions appear to equally characterize depression in both the symptomatic and remitted state.

Do State and Trait Affect Measures Retain Their Measurement Properties during a Disaster? An Investigation of Measurement Invariance during the COVID-19 Pandemic.

Psychologists have begun to study the impact of the COVID-19 pandemic on emotionality, though such investigations assume that the measurement properties of affect scales have not changed as a function of the pandemic. To our knowledge, no prior study has tested measurement invariance (MI) of an affect scale during a disaster, and very few studies have explored MI of scales administered through ecological momentary assessment (EMA). The current study tested invariance of trait and state affect measures across homogenous groups of 18-year-olds assessed prior to and during the first acute phase of the COVID-19 pandemic in Long Island, New York. Trait affect was measured with a single administration of the Schedule for Nonadaptive and Adaptive Personality-Youth Version. State affect was assessed with items developed for the EMA portion of this study, which were administered 5 times daily for 14 consecutive days using a smartphone application. A baseline correlated 2-factor (positive and negative affect) model was fit for both measures. Invariances tests established up to strict MI across pre-/COVID-19 groups for both affect measures. These findings suggest that valid comparisons of observed score means and variances can be made between groups assessed before and during the COVID-19 pandemic.

Predicting adolescent depression and anxiety from multi-wave longitudinal data using machine learning.

BACKGROUND: This study leveraged machine learning to evaluate the contribution of information from multiple developmental stages to prospective prediction of depression and anxiety in mid-adolescence. METHODS: A community sample (N = 374; 53.5% male) of children and their families completed tri-annual assessments across ages 3-15. The feature set included several important risk factors spanning psychopathology, temperament/personality, family environment, life stress, interpersonal relationships, neurocognitive, hormonal, and neural functioning, and parental psychopathology and personality. We used canonical correlation analysis (CCA) to reduce the large feature set to a lower dimensional space while preserving the longitudinal structure of the data. Ablation analysis was conducted to evaluate the relative contributions to prediction of information gathered at different developmental periods and relative to previous disorder status (i.e. age 12 depression or anxiety) and demographics (sex, race, ethnicity). RESULTS: CCA components from individual waves predicted age 15 disorder status better than chance across ages 3, 6, 9, and 12 for anxiety and 9 and 12 for depression. Only the components from age 12 for depression, and ages 9 and 12 for anxiety, improved prediction over prior disorder status and demographics. CONCLUSIONS: These findings suggest that screening for risk of adolescent depression can be successful as early as age 9, while screening for risk of adolescent anxiety can be successful as early as age 3. Assessing additional risk factors at age 12 for depression, and going back to age 9 for anxiety, can improve screening for risk at age 15 beyond knowing standard demographics and disorder history.

Increases in depression and anxiety symptoms in adolescents and young adults during the COVID-19 pandemic.

BACKGROUND: The coronavirus [coronavirus disease 2019 (COVID-19)] pandemic has introduced extraordinary life changes and stress, particularly in adolescents and young adults. Initial reports suggest that depression and anxiety are elevated during COVID-19, but no prior study has explored changes at the within-person level. The current study explored changes in depression and anxiety symptoms from before the pandemic to soon after it first peaked in Spring 2020 in a sample of adolescents and young adults (N = 451) living in Long Island, New York, an early epicenter of COVID-19 in the U.S. METHODS: Depression (Children's Depression Inventory) and anxiety symptoms (Screen for Child Anxiety Related Symptoms) were assessed between December 2014 and July 2019, and, along with COVID-19 experiences, symptoms were re-assessed between March 27th and May 15th, 2020. RESULTS: Across participants and independent of age, there were increased generalized anxiety and social anxiety symptoms. In females, there were also increased depression and panic/somatic symptoms. Multivariable linear regression indicated that greater COVID-19 school concerns were uniquely associated with increased depression symptoms. Greater COVID-19 home confinement concerns were uniquely associated with increased generalized anxiety symptoms, and decreased social anxiety symptoms, respectively. CONCLUSIONS: Adolescents and young adults at an early epicenter of the COVID-19 pandemic in the U.S. experienced increased depression and anxiety symptoms, particularly amongst females. School and home confinement concerns related to the pandemic were independently associated with changes in symptoms. Overall, this report suggests that the COVID-19 pandemic is having multifarious adverse effects on the mental health of youth.

Testing Invariance of Measures of Internalizing Symptoms Before and After a Major Life Stressor: The Impact of COVID-19 in an Adolescent and Young Adult Sample.

There are reports of increases in levels of internalizing psychopathology during the COVID-19 pandemic. However, these studies presume that measurement properties of these constructs remained unchanged from before the pandemic. In this study, we examined longitudinal measurement invariance of assessments of depression, anxiety, and intolerance of uncertainty (IU) in adolescents and young adults from ongoing longitudinal studies. We found consistent support for configural and metric invariance across all constructs, but scalar invariance was unsupported for depression and IU. Thus, it is necessary to interpret pandemic-associated mean-level changes in depression and IU cautiously. In contrast, mean-level comparisons of panic, generalized, and social anxiety symptoms were not compromised. These findings are limited to the specific measures examined and the developmental period of the sample. We acknowledge that there is tremendous distress accompanying disruptions due to the COVID-19 outbreak. However, for some instruments, comparisons of symptom levels before and during the pandemic may be limited.

Early childhood temperament predicts intolerance of uncertainty in adolescence.

Intolerance of uncertainty (IU) is the trait propensity to react negatively to uncertainty. To date, very few studies have explored early childhood predictors of IU. The current study identifies relations between child temperament assessed at age 3 (N = 559) and IU assessed at ages 12 (N = 432) and 15 (N = 415). Temperament was assessed through both laboratory observation (Laboratory Temperament Assessment Battery) and maternal report (Children's Behavior Questionnaire). IU was assessed through both maternal rating and child self-report using the 12-item Intolerance of Uncertainty Scale for Children. Higher levels of temperamental negative emotionality/neuroticism and lower levels of temperamental positive emotionality/extraversion assessed at age 3 predicted higher levels of IU in early-mid adolescence. Unique relationships were found at the trait facet level, and differences were observed between informants. These findings suggest that certain early child temperament traits can serve as markers of risk for difficulty dealing with uncertainty later in life. Future research should explore whether this relationship translates to increased risk for psychopathology.

Trajectories of depression, anxiety and pandemic experiences; A longitudinal study of youth in New York during the Spring-Summer of 2020.

Initial reports suggest that mental health problems were elevated early in the COVID-19 pandemic. However, few studies have followed-up participants as the pandemic evolved and examined both between and within person predictors of symptom trajectories. In the current study, adolescents and young adults (N=532) in New York were surveyed monthly between March 27th and July 14th, 2020, a period spanning the first peak and subsequent decline in COVID-19 infection rates in the region. Surveys assessed symptoms of depression and anxiety using the Child Depression Inventory and the Screen for Child Anxiety Related Disorders, as well as experiences related to the pandemic. Multilevel growth modeling indicated that symptoms of depression and anxiety peaked around late April/early May and then decreased through May-July. Some pandemic experiences followed a similar quadratic trajectory, while others decreased linearly across the study. Specific relationships emerged between some types of pandemic experiences and depression and anxiety symptoms. While symptoms of depression and anxiety in youth may have been elevated early in the pandemic, these findings suggest they subsided across Spring-Summer of 2020, with higher levels of both corresponding to a period of peak infection rates and decreases paralleling the decline in pandemic experiences and COVID-19 infection rates.

Dimensions of irritability in adolescents: longitudinal associations with psychopathology in adulthood.

BACKGROUND: There is an emerging consensus in developmental psychopathology that irritable youth are at risk for developing internalizing problems later in life. The current study explored if irritability in youth is multifactorial and the impact of irritability dimensions on psychopathology outcomes in adulthood. METHODS: We conducted exploratory factor analysis on irritability symptom items from a semi-structured diagnostic interview administered to a community sample of adolescents (ages 14-19; 42.7% male; 89.1% white). The analysis identified two factors corresponding to items from the mood disorders v. the oppositional defiant disorder (ODD) (Leibenluft and Stoddard) sections of the interview. These factors were then entered together into regression models predicting psychopathology assessed at age 24 (N = 941) and again at age 30 (N = 816). All models controlled for concurrent psychopathology in youth. RESULTS: The two irritability dimensions demonstrated different patterns of prospective relationships, with items from the ODD section primarily predicting externalizing psychopathology, items from the mood disorder sections predicting depression at age 24 but not 30, and both dimensions predicting borderline personality disorder symptoms. CONCLUSIONS: These results suggest that the current standard of extracting and compositing irritability symptom items from diagnostic interviews masks distinct dimensions of irritability with different psychopathological outcomes. Additionally, these findings add nuance to the prevailing notion that irritability in youth is specifically linked to later internalizing problems. Further investigation using more sensitive and multifaceted measures of irritability are needed to parse the meaning and clinical implications of these dimensions.