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Excitability and irritability in preschoolers predicts later psychopathology: The importance of positive and negative emotion dysregulation

Published online by Cambridge University Press:  21 May 2019

Alecia C. Vogel*
Affiliation:
Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
Joshua J. Jackson
Affiliation:
Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
Deanna M. Barch
Affiliation:
Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
Rebecca Tillman
Affiliation:
Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
Joan L. Luby
Affiliation:
Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
*
Author for Correspondence: Alecia C. Vogel, Early Emotional Development Program, Washington University School of Medicine, 4444 Forest Park Parkway, Campus Box 8511, St. Louis, MO 63108; E-mail: [email protected].

Abstract

Emotion dysregulation is a risk factor for the development of a variety of psychopathologic outcomes. In children, irritability, or dysregulated negative affect, has been the primary focus, as it predicts later negative outcomes even in very young children. However, dysregulation of positive emotion is increasingly recognized as a contributor to psychopathology. Here we used an exploratory factor analysis and defined four factors of emotion dysregulation: irritability, excitability, sadness, and anhedonia, in the preschool-age psychiatric assessment collected in a sample of 302 children ages 3–5 years enriched for early onset depression. The irritability and excitability factor scores defined in preschoolers predicted later diagnosis of mood and externalizing disorders when controlling for other factor scores, social adversity, maternal history of mood disorders, and externalizing diagnoses at baseline. The preschool excitability factor score predicted emotion lability in late childhood and early adolescence when controlling for other factor scores, social adversity, and maternal history. Both excitability and irritability factor scores in preschoolers predicted global functioning into the teen years and early adolescence, respectively. These findings underscore the importance of positive, as well as negative, affect dysregulation as early as the preschool years in predicting later psychopathology, which deserves both further study and clinical consideration.

Type
Special Issue Articles
Copyright
Copyright © Cambridge University Press 2019 

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