Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb;64(2):234-243.
doi: 10.1111/jcpp.13688. Epub 2022 Aug 27.

Tonic and phasic irritability in 6-year-old children: differential correlates and outcomes

Jamilah Silver  1 , Daniel M Mackin  1 , Sara J Bufferd  2 , Lea R Dougherty  3 , Brandon L Goldstein  4 , Gabrielle A Carlson  5 , Daniel N Klein  1
Affiliations

Tonic and phasic irritability in 6-year-old children: differential correlates and outcomes

Jamilah Silver et al. J Child Psychol Psychiatry. 2023 Feb.

Abstract

Objective: Irritability is a common and clinically important problem in children and adolescents and a risk factor for later psychopathology and impairment. Irritability can manifest in both tonic (e.g., irritable, touchy mood) and phasic (e.g., temper outburst) forms, and recent studies of adolescents suggest that they predict different outcomes. However, no studies have examined whether tonic and phasic irritability are empirically distinguishable in 6-year-old children and whether they have distinct correlates and outcomes.

Method: We utilized data from a longitudinal study of an unselected community sample of four hundred fifty-two 6-year-olds followed at 3-year intervals to age 15. We conducted confirmatory factor analysis (CFA) using relevant items from a diagnostic interview and several parent-report inventories.

Results: The CFA identified dimensions that were consistent with tonic and phasic irritability. Tonic irritability was independently associated with concurrent parent-reported temperamental negative affectivity and internalizing and externalizing disorders at age 6 and predicted higher rates of internalizing psychopathology, and suicidal ideation, in adolescence. Phasic irritability was independently associated with concurrent parent-reported temperamental negative affectivity, surgency, and low effortful control, maladaptive parenting styles and practices, and externalizing disorders at age 6, and predicted higher rates of externalizing psychopathology in adolescence.

Conclusions: Tonic and phasic irritability in 6-year-old children appear to be distinguishable constructs with different temperament and parenting correlates and psychopathological outcomes. Distinguishing these components has implications for research on the etiology and pathophysiology of irritability and developing effective treatments.

Keywords: Early childhood; irritability; outcomes; phasic; tonic.

PubMed Disclaimer

References

    1. Achenbach, T.M., Dumenci, L., & Rescorla, L.A. (2001). Ratings of relations between DSM-IV diagnostic categories and items of the CBCL/6-18, TRF, and YSR (pp. 1-9). Burlington, VT: University of Vermont.
    1. Beauchaine, T.P., & Tackett, J.L. (2020). Irritability as a transdiagnostic vulnerability trait: Current issues and future directions. Behavior Therapy, 51, 350-364.
    1. Brotman, M.A., Kircanski, K., Stringaris, A., Pine, D.S., & Leibenluft, E. (2017). Irritability in youths: A translational model. American Journal of Psychiatry, 174, 520-532.
    1. Burke, J.D., Hipwell, A.E., & Loeber, R. (2010). Dimensions of oppositional defiant disorder as predictors of depression and conduct disorder in preadolescent girls. Journal of the American Academy of Child & Adolescent Psychiatry, 49, 484-492.
    1. Byrne, G., & Connon, G. (2021). The use of standard parenting management training in addressing disruptive mood dysregulation disorder: A pilot study. Journal of Contemporary Psychotherapy, 51, 1-5.

Publication types

LinkOut - more resources