The Early Childhood Irritability-Related Impairment Interview (E-CRI): A Novel Method for Assessing Young Children's Developmentally Impairing Irritability

Lauren S. Wakschlag; Sheila Krogh-Jespersen; Ryne Estabrook; Christina O. Hlutkowsky; Erica L. Anderson; James Burns; Margaret J. Briggs-Gowan; Amélie Petitclerc; Susan B. Perlman

doi:10.1016/j.beth.2019.07.008

The Early Childhood Irritability-Related Impairment Interview (E-CRI): A Novel Method for Assessing Young Children's Developmentally Impairing Irritability

Lauren S. Wakschlag^*, Sheila Krogh-Jespersen, Ryne Estabrook, Christina O. Hlutkowsky, Erica L. Anderson, James Burns, Margaret J. Briggs-Gowan, Amélie Petitclerc, Susan B. Perlman

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

Irritability is a substrate of more than one dozen clinical syndromes. Thus, identifying when it is atypical and interfering with functioning is crucial to the prevention of mental disorder in the earliest phase of the clinical sequence. Advances in developmentally based measurement of irritability have enabled differentiation of normative irritable mood and tantrums from indicators of concern, beginning in infancy. However, developmentally sensitive assessments of irritability-related impairment are lacking. We introduce the Early Childhood Irritability-Related Impairment Interview (E-CRI), which assesses impairment associated with irritable mood and tantrums across contexts. Reliability and validity are established across two independent samples varied by developmental period: the Emotional Growth preschool sample (EmoGrow; N = 151, M = 4.82 years) and the When to Worry infant/toddler sample (W2W; N = 330, M = 14 months). We generated a well-fitting two-factor E-CRI model, with tantrum- and irritable mood-related impairment factors. The E-CRI exhibited good interrater, test–retest, and longitudinal reliability. Construct and clinical validity were also demonstrated. In both samples, E-CRI factors showed association to internalizing and externalizing problems, and to caregiver-reported concern in W2W. Tantrum-related impairment demonstrated stronger and more consistent explanatory value across outcomes, while mood-related impairment added explanatory utility for internalizing problems. The E-CRI also showed incremental utility beyond variance explained by the Family Life Impairment Scale (FLIS) survey indicator of developmental impairment. The E-CRI holds promise as an indicator of impairment to inform identification of typical versus atypical patterns reflecting early emerging irritability-related syndromes in the initial phase of the clinical sequence.

Original language	English (US)
Pages (from-to)	294-309
Number of pages	16
Journal	Behavior Therapy
Volume	51
Issue number	2
DOIs	https://doi.org/10.1016/j.beth.2019.07.008
State	Published - Mar 2020

Funding

This work was supported by funding from the National Institute of Mental Health: R01MH107652 (PI: LSW) and R01 MH107540 (PI: SBP). We thank our collaborators, Megan York Roberts and Elizabeth Spencer Norton, for their ongoing contributions, as well as our devoted research teams and participating families that made this work possible. Thanks to Katie Martini, Hannah Boggs, Cindy Thompson, Hugh Adam, Ewa Gut, and Debby Zemlock for excellent editorial and data support.

Keywords

developmental psychopathology
early childhood
irritability

ASJC Scopus subject areas

Clinical Psychology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.beth.2019.07.008

Cite this

Wakschlag, L. S., Krogh-Jespersen, S., Estabrook, R., Hlutkowsky, C. O., Anderson, E. L., Burns, J., Briggs-Gowan, M. J., Petitclerc, A., & Perlman, S. B. (2020). The Early Childhood Irritability-Related Impairment Interview (E-CRI): A Novel Method for Assessing Young Children's Developmentally Impairing Irritability. Behavior Therapy, 51(2), 294-309. https://doi.org/10.1016/j.beth.2019.07.008

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abstract = "Irritability is a substrate of more than one dozen clinical syndromes. Thus, identifying when it is atypical and interfering with functioning is crucial to the prevention of mental disorder in the earliest phase of the clinical sequence. Advances in developmentally based measurement of irritability have enabled differentiation of normative irritable mood and tantrums from indicators of concern, beginning in infancy. However, developmentally sensitive assessments of irritability-related impairment are lacking. We introduce the Early Childhood Irritability-Related Impairment Interview (E-CRI), which assesses impairment associated with irritable mood and tantrums across contexts. Reliability and validity are established across two independent samples varied by developmental period: the Emotional Growth preschool sample (EmoGrow; N = 151, M = 4.82 years) and the When to Worry infant/toddler sample (W2W; N = 330, M = 14 months). We generated a well-fitting two-factor E-CRI model, with tantrum- and irritable mood-related impairment factors. The E-CRI exhibited good interrater, test–retest, and longitudinal reliability. Construct and clinical validity were also demonstrated. In both samples, E-CRI factors showed association to internalizing and externalizing problems, and to caregiver-reported concern in W2W. Tantrum-related impairment demonstrated stronger and more consistent explanatory value across outcomes, while mood-related impairment added explanatory utility for internalizing problems. The E-CRI also showed incremental utility beyond variance explained by the Family Life Impairment Scale (FLIS) survey indicator of developmental impairment. The E-CRI holds promise as an indicator of impairment to inform identification of typical versus atypical patterns reflecting early emerging irritability-related syndromes in the initial phase of the clinical sequence.",

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Wakschlag, LS, Krogh-Jespersen, S, Estabrook, R, Hlutkowsky, CO, Anderson, EL, Burns, J, Briggs-Gowan, MJ, Petitclerc, A & Perlman, SB 2020, 'The Early Childhood Irritability-Related Impairment Interview (E-CRI): A Novel Method for Assessing Young Children's Developmentally Impairing Irritability', Behavior Therapy, vol. 51, no. 2, pp. 294-309. https://doi.org/10.1016/j.beth.2019.07.008

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AU - Wakschlag, Lauren S.

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AU - Estabrook, Ryne

AU - Hlutkowsky, Christina O.

AU - Anderson, Erica L.

AU - Burns, James

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AB - Irritability is a substrate of more than one dozen clinical syndromes. Thus, identifying when it is atypical and interfering with functioning is crucial to the prevention of mental disorder in the earliest phase of the clinical sequence. Advances in developmentally based measurement of irritability have enabled differentiation of normative irritable mood and tantrums from indicators of concern, beginning in infancy. However, developmentally sensitive assessments of irritability-related impairment are lacking. We introduce the Early Childhood Irritability-Related Impairment Interview (E-CRI), which assesses impairment associated with irritable mood and tantrums across contexts. Reliability and validity are established across two independent samples varied by developmental period: the Emotional Growth preschool sample (EmoGrow; N = 151, M = 4.82 years) and the When to Worry infant/toddler sample (W2W; N = 330, M = 14 months). We generated a well-fitting two-factor E-CRI model, with tantrum- and irritable mood-related impairment factors. The E-CRI exhibited good interrater, test–retest, and longitudinal reliability. Construct and clinical validity were also demonstrated. In both samples, E-CRI factors showed association to internalizing and externalizing problems, and to caregiver-reported concern in W2W. Tantrum-related impairment demonstrated stronger and more consistent explanatory value across outcomes, while mood-related impairment added explanatory utility for internalizing problems. The E-CRI also showed incremental utility beyond variance explained by the Family Life Impairment Scale (FLIS) survey indicator of developmental impairment. The E-CRI holds promise as an indicator of impairment to inform identification of typical versus atypical patterns reflecting early emerging irritability-related syndromes in the initial phase of the clinical sequence.

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The Early Childhood Irritability-Related Impairment Interview (E-CRI): A Novel Method for Assessing Young Children's Developmentally Impairing Irritability

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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