Association between irritability and suicide-related outcomes across the life-course. Systematic review of both community and clinical studies

Orri, Massimiliano; Perret, Léa C.; Turecki, Gustavo; Geoffroy, Marie‐Claude

doi:10.1016/j.jad.2018.07.010

Cited by 58 publications

(38 citation statements)

References 88 publications

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“…Similarly, longitudinal studies have also reported an association between the presence of anger at index visit and subsequent suicidal ideation (SI), suicide attempt, or completed suicide (Ducasse et al, 2017; Hogstedt et al, 2018; Start et al, 2019). These findings of association between anger and suicidality are consistent with the previously reported association of constructs related to anger such as irritability (Conner et al, 2004; Jha et al, 2020; Orri, Galera, et al, 2018; Orri, Perret, et al, 2018; Orri et al, 2019; Pickles et al, 2009) and aggression (Fanning et al, 2016; McCloskey & Ammerman, 2018) with suicidality. However, these previous reports have not considered the association between overt behaviors of anger attacks and suicidality.…”

Section: Introductionsupporting

confidence: 88%

Association of anger attacks with suicidal ideation in adults with major depressive disorder: Findings from the EMBARC study

Jha

Fava

Minhajuddin

et al. 2020

Depression and Anxiety

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Background: This report evaluates whether anger attacks (sudden uncharacteristic bouts of anger that are associated with autonomic arousal and/or aggression) in patients with major depressive disorder (MDD) are associated with elevated suicidal ideation (SI; active suicidal thoughts and plans). Methods: Participants of Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study who completed Massachusetts General Hospital Anger Attack Questionnaire (AAQ) at baseline were included (n = 293). Levels of SI (suicidal thoughts factor of Concise Health Risk Tracking) were compared at baseline with generalized linear models, and during Stage 1 (baseline-to-week-8) and Stage 2 (week-8-to-week-16) with repeated-measures mixed model analyses. Covariates included age, sex, race, ethnicity, site, and treatment arm. Results: At baseline, participants with (n = 109) versus without anger attacks (n = 184) had higher levels of SI (Cohen's d effect size [d] = 1.20). Those with ≥9 anger attacks in the past month had significantly higher SI than those with 1-2 (d = 1.21), 3-4 (d = 1.48), and 5-8 (d = 0.94) anger attacks in the past month. Furthermore, participants with anger attacks at baseline reported higher SI at each post-baseline visit (both Stages 1 and 2) of EMBARC study (d = 0.39-0.77; all p < .05). Associations between anger attacks and SI were significant even after controlling for irritability, hostility, anxious arousal, depression, suicide propensity, and self-reported pain at baseline and lifetime suicidal tendencies. Similar results were found in participants with aggressive behaviors. Conclusion: Anger attacks in outpatients with MDD may be associated with chronically elevated SI.

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Section: Introductionsupporting

confidence: 88%

Association of anger attacks with suicidal ideation in adults with major depressive disorder: Findings from the EMBARC study

Jha

Fava

Minhajuddin

et al. 2020

Depression and Anxiety

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“…From a theoretical perspective, the "big build" model characterises escalating behaviours of avoidance, numbing, risk-taking, and anger or aggression as potential transdiagnostic markers of psychological distress (Brownhill, Wilhelm, Barclay, & Schmied, 2005). In the "big build" model, psychological distress is associated with difficulties in self-regulation including irritability and anger (Möller-Leimkühler & Yücel, 2010), which is especially true among younger adult populations (Fava et al, 2010;Massimiliano, Perret, Turecki, & Geoffroy, 2018), as well as problems with goal directed behaviour and motivation (Gillan, Kosinski, Whelan, Phelps, & Daw, 2016), and coping through use of substances (Lai, Cleary, Sitharthan, & Hunt, 2015).…”

Section: Introductionmentioning

confidence: 99%

Preliminary psychometric validation of a brief screening tool for athlete mental health among male elite athletes: the Athlete Psychological Strain Questionnaire

Rice

Parker

Mawren

et al. 2019

International Journal of Sport and Exercise Psychology

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There is growing interest in the area of elite athlete mental health, however brief, valid and reliable screening instruments designed to identify early indictors of athlete-specific distress and potential mental health symptoms are lacking. This study sought to develop a brief screening instrument for athlete populationsthe Athlete Psychological Strain Questionnaire (APSQ)and examine convergent, divergent and construct validity. A twostage psychometric validation study was undertaken. Self-report data was collected from 1,007 currently competing Australian elite male athletes (M = 23.67, SD = 4.16). The sample was randomly partitioned into calibration (n = 497) and validation (n = 510) samples. Exploratory and confirmatory factor analysis, and tests of differential item functioning were conducted. Exploratory factor analysis, with parallel analysis, conducted on the calibration sample supported a three-factor solution, with subscales assessing Self-Regulation, Performance and External Coping accounting for 50.44% of total scale variance. Confirmatory factor analysis supported this three-factor model, yielding excellent model fit indices (CFI = 0.976, TLI = 0.966, RMSEA = 0.055, SRMR = 0.032), with the Bayesian Information Criterion supporting the superordinate structure. Differential item functioning analysis indicated item-equivalence relative to athletes' level of education and ethnicity. As predicted, a multivariate effect indicated higher APSQ scores for currently injured athletes (p = .040) with a univariate effect on the Performance subscale. The APSQ may help identify early symptoms of athlete psychological strain facilitating timely management. Replication and validation studies in broader samples, including female athletes and comparison with other athlete-specific, coping and stress measures are needed.

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“…Impairments in adaptive, daily living, and social skills, propensity to fight, rejection from peers and adults, academic failure, lowered quality of life, and self‐esteem (Anastopoulos et al, 2011; Bunford et al, 2018; Lee et al, 2018; Surman et al, 2013) are risk factors for psychiatric problems. Beyond internalizing/externalizing problems, emotional distress combined with the tendency to act impulsively makes individuals more prone to suicidal ideation and attempted suicide (Benarous et al, 2018; Orri, Perret, Turecki, & Geoffroy, 2018). The multifinality of environmental/biological commonalities may also underlie the associations between ADHD, irritability, internalizing, and externalizing problems.…”

Section: Discussionmentioning

confidence: 99%

Developmental profiles of childhood attention‐deficit/hyperactivity disorder and irritability: association with adolescent mental health, functional impairment, and suicidal outcomes

Galèra

Orri

Vergunst

et al. 2020

Child Psychology Psychiatry

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Background Irritability is frequently comorbid with ADHD. Although irritability alone has been linked to deleterious mental health and adaptive issues, the joint developmental course of ADHD and irritability symptoms during childhood as well as its association with later mental health and suicidal outcomes is not fully understood. We aimed to describe the developmental trajectories of childhood ADHD and irritability symptoms and to quantify their association with adolescent mental health and suicidal outcomes. Methods The Quebec Longitudinal Study of Child Development (QLSCD) included 1407 participants from the general population followed up from age 5 months to 17 years. We used a multitrajectory approach to identify developmental trajectories of childhood (6–12 years) ADHD and irritability symptoms. Outcome measures were adolescent (13–17 years) mental health (psychiatric symptoms/functional impairment) and suicidal outcomes. Results We identified distinct developmental profiles: combined absent or very low ADHD and absent or very low irritability (940 [66.8%]; reference group), moderately high irritability and low ADHD (158 [11.2%]), moderately high ADHD and low irritability (198 [14.1%]), and combined high ADHD and high irritability (111 [7.9%]). Multivariate modeling showed that, compared to children in the reference group, those in the combined high ADHD and high irritability profile showed higher levels of ADHD continuity (d ranges = 0.40–0.50), externalizing (d ranges = 0.25–0.59), internalizing (d ranges = 0.20–0.29), and functional impairments (d ranges = 0.17–0.48) and suicidal behaviors (odds ratio (OR) = 2.12, confidence interval (CI) = 1.47–3.06) in adolescence. Conclusions The presence of persistently high levels of irritability along with ADHD symptoms during childhood significantly predicts adolescent ADHD continuity, externalizing, internalizing, and suicidal outcomes. Systematic consideration of irritability when assessing and treating ADHD may improve long‐term mental health outcomes.

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Association between irritability and suicide-related outcomes across the life-course. Systematic review of both community and clinical studies

Cited by 58 publications

References 88 publications

Association of anger attacks with suicidal ideation in adults with major depressive disorder: Findings from the EMBARC study

Association of anger attacks with suicidal ideation in adults with major depressive disorder: Findings from the EMBARC study

Preliminary psychometric validation of a brief screening tool for athlete mental health among male elite athletes: the Athlete Psychological Strain Questionnaire

Developmental profiles of childhood attention‐deficit/hyperactivity disorder and irritability: association with adolescent mental health, functional impairment, and suicidal outcomes

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