Frustration Response and Regulation Among Irritable Children: Contributions of Chronic Irritability, Internalizing, and Externalizing Symptoms

ABSTRACTObjective The need to understand and treat childhood chronic irritability (CI; i.e. frequent temper loss and angry/irritable mood) is imperative. CI predicts impairment across development and complex comorbidities with both internalizing and externalizing disorders. Research has emphasized frustration reactivity as a key mechanism of CI. However, there are understudied components of frustrative non-reward, particularly regulation-oriented frustration recovery, frustration tolerance, and cognitive control, that may further explain impairments specific to CI beyond comorbid symptoms.Method Sixty-three community children (N = 25 CI/38 non-CI) and a parent completed surveys and the computerized Frustration Go/No-Go (FGNG) and Mirror Tracing Persistence Task (MTPT). Analyses compared task performance and self-rated affect across youth with or without CI, with further comparison based on negative/positive screen for ADHD (N = 45-/18+).Results In mixed effects models assessing change across task, the CI group did not demonstrate more intense frustration on the MTPT or rigged FGNG block but exhibited persisting frustration and inhibitory control difficulties into the FGNG recovery period; the CI+ADHD subgroup drove recovery effects. In GEE and logistic regression models including dimensional symptom clusters, only internalizing symptoms predicted child frustration intolerance and reactivity across tasks. ADHD severity was also associated with higher MTPT frustration reactivity, while oppositional behavior predicted lower frustration. Better frustration recovery was associated with lower irritability, but higher internalizing symptoms.Conclusions Co-occurring symptoms may better explain some frustration-related difficulties among youth with CI. Difficulties with postfrustration affect and inhibitory control recovery suggest the importance of characterizing CI by self-regulation impairments. AcknowledgmentsWe wish to thank the participating families and our research assistants who helped facilitate this study: Kaitlin Girardini, Hannah Lavoie, Amanda Morach, Hazel Simpson, Sabrina Yum-Chan, and Claudia Paszek. We appreciate feedback from Margaret Briggs-Gowan, Ph.D., Stephanie Milan, Ph.D., and Carolyn Greene, Ph.D., across stages of this project.Disclosure StatementThis work was prepared while Karen Seymour was employed at Johns Hopkins University/the Kennedy Krieger Institute. The opinions expressed in this article are the author's own and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government.Supplementary MaterialSupplemental material for this article can be accessed online at https://doi.org/10.1080/15374416.2023.2246557Additional informationFundingThe work was supported by the Association for Psychological Science [APSSC Student Research Grant]; College of Liberal Arts and Sciences, University of Connecticut; University of Connecticut Department of Psychological Sciences.