TY - JOUR
T1 - Predictive Utility of Irritability “In Context”
T2 - Proof-of-Principle for an Early Childhood Mental Health Risk Calculator
AU - Wakschlag, Lauren S.
AU - MacNeill, Leigha A.
AU - Pool, Lindsay R.
AU - Smith, Justin D.
AU - Adam, Hubert
AU - Barch, Deanna M.
AU - Norton, Elizabeth S.
AU - Rogers, Cynthia E.
AU - Ahuvia, Isaac
AU - Smyser, Christopher D.
AU - Luby, Joan L.
AU - Allen, Norrina B.
N1 - Publisher Copyright:
© 2023 Society of Clinical Child and Adolescent Psychology, Division 53, American Psychological Association. All Rights Reserved.
PY - 2024
Y1 - 2024
N2 - Objective: We provide proof-of-principle for a mental health risk calculator advancing clinical utility of the irritability construct for identification of young children at high risk for common, early onsetting syndromes. Method: Data were harmonized from two longitudinal early childhood subsamples (total N = 403; 50.1% Male; 66.7% Nonwhite; Mage = 4.3 years). The independent subsamples were clinically enriched via disruptive behavior and violence (Subsample 1) and depression (Subsample 2). In longitudinal models, epidemiologic risk prediction methods for risk calculators were applied to test the utility of the transdiagnostic indicator, early childhood irritability, in the context of other developmental and social-ecological indicators to predict risk of internalizing/externalizing disorders at preadolescence (Mage = 9.9 years). Predictors were retained when they improved model discrimination (area under the receiver operating characteristic curve [AUC] and integrated discrimination index [IDI]) beyond the base demographic model. Results: Compared to the base model, the addition of early childhood irritability and adverse childhood experiences significantly improved the AUC (0.765) and IDI slope (0.192). Overall, 23% of preschoolers went on to develop a preadolescent internalizing/externalizing disorder. For preschoolers with both elevated irritability and adverse childhood experiences, the likelihood of an internalizing/externalizing disorder was 39–66%. Conclusions: Predictive analytic tools enable personalized prediction of psychopathological risk for irritable young children, holding transformative potential for clinical translation.
AB - Objective: We provide proof-of-principle for a mental health risk calculator advancing clinical utility of the irritability construct for identification of young children at high risk for common, early onsetting syndromes. Method: Data were harmonized from two longitudinal early childhood subsamples (total N = 403; 50.1% Male; 66.7% Nonwhite; Mage = 4.3 years). The independent subsamples were clinically enriched via disruptive behavior and violence (Subsample 1) and depression (Subsample 2). In longitudinal models, epidemiologic risk prediction methods for risk calculators were applied to test the utility of the transdiagnostic indicator, early childhood irritability, in the context of other developmental and social-ecological indicators to predict risk of internalizing/externalizing disorders at preadolescence (Mage = 9.9 years). Predictors were retained when they improved model discrimination (area under the receiver operating characteristic curve [AUC] and integrated discrimination index [IDI]) beyond the base demographic model. Results: Compared to the base model, the addition of early childhood irritability and adverse childhood experiences significantly improved the AUC (0.765) and IDI slope (0.192). Overall, 23% of preschoolers went on to develop a preadolescent internalizing/externalizing disorder. For preschoolers with both elevated irritability and adverse childhood experiences, the likelihood of an internalizing/externalizing disorder was 39–66%. Conclusions: Predictive analytic tools enable personalized prediction of psychopathological risk for irritable young children, holding transformative potential for clinical translation.
UR - http://www.scopus.com/inward/record.url?scp=85151926183&partnerID=8YFLogxK
U2 - 10.1080/15374416.2023.2188553
DO - 10.1080/15374416.2023.2188553
M3 - Article
C2 - 36975800
AN - SCOPUS:85151926183
SN - 1537-4416
VL - 53
SP - 231
EP - 245
JO - Journal of Clinical Child and Adolescent Psychology
JF - Journal of Clinical Child and Adolescent Psychology
IS - 2
ER -