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FIGURE 1

Receiver Operating Characteristics (ROC) curve drawn to demonstrate the differentiation between clinically significant (CGI-S ≥ 3) irritability
Receiver Operating Characteristics (ROC) curve drawn to demonstrate the differentiation between clinically significant (CGI-S ≥ 3) irritability

Pearson correlation coefficients of the CLA-RI subscales and other psychopathology scores within the clinical sample

Clinical sample, n=116 Total CL-ARI score Temper outbursts Mood Impairment
ARI-child form r=0.66* r=0.62* r=0.55* r=0.64*
ARI-parent form r=0.65* r=0.60* r=0.57* r=0.62*
Behavioral SDQ-child form r=0.54* r=0.54* r=0.44* r=0.51*
Behavioral SDQ-parent form r=0.46* r=0.49* r=0.37* r=0.44*
Total SDQ-child form r=0.35* r=0.32* r=0.32 r=0.32
Total SDQ-parent form r=0.42* r=0.38* r=0.33* r=0.44*
SNAP-IV (attention deficit) r=0.22 r=0.24 r=0.16 r=0.22
SNAP-IV (hyperactivity) r=0.29 r=0.31 r=0.18 r=0.35*
RCADS (generalized anxiety) r= 0.05 r= − 0.002 r= 0.11 r= − 0.001
RCADS (panic disorder) r= 0.12 r= 0.01 r= 0.18 r= 0.10
RCADS (specific phobia) r= 0.08 r= 0.07 r= 0.12 r= 0.01
RCADS (social anxiety) r= 0.20 r= 0.22 r= 0.22 r= 0.12
RCADS (depression) r= 0.16 r= 0.10 r= 0.21 r= 0.09

Construct validity scores of CLA-RI items by using principal component analysis

Factor loading of items Factor 1 Factor 2
Temper outbursts – severe duration (Item 6) 0.974
Temper outbursts – mild duration (Item 2) 0.776
Impairment-school (Item 10) 0.757
Temper outbursts – moderate frequency (Item 3) 0.739
Temper outbursts – severe frequency (Item 5) 0.647
Impairment-peers (Item 11) 0.614
Temper outbursts – moderate duration (Item 4) 0.937
Irritable mood frequency (Item 7) 0.705
Temper outbursts – mild frequency (Item 1) 0.689
Impairment-family (Item 9) 0.624
Irritable mood severity (Item 8) 0.592
Total variance explained 56.3% 10.2%
Eigenvalue 6.2 1.1
Cronbach’s alpha 0.883 0.875

Demographic, clinical, and treatment characteristics of study participants

Total sample, n = 116
Age, years, M ± SD (range) 14.1 ± 2.1 (11–17)
Sex, female, percent 69 (59.5)
Family Status, n (%)
  Married 93 (80.2)
  Divorced or separated 23 (19.8)
The number of siblings 2.1 ± 0.8
Family history of psychiatric disorder 23 (18.9)
Special education, n (%) 8 (6.9)
Psychiatric comorbidities, n (%)
  Attention-deficit hyperactivity disorder 34 (29.3)
  Oppositional-defiant disorder 18 (15.5)
  Conduct disorder 17 (14.7)
  Specific learning disorder 9 (7.8)
  Tic disorders 12 (10.3)
  Obsessive-compulsive disorder 33 (28.4)
  Panic disorder 26 (22.4)
  Social anxiety disorder 8 (6.9)
  Generalized anxiety disorder 31 (26.7)
  Specific phobia 20 (17.2)
  Major depressive disorder 39 (33.6)
  Eating disorders 3 (2.6)
  Post-traumatic stress disorder 7 (6.0)
  Enuresis/encopresis 6 (5.2)
Suicide attempt, n (%) 16 (13.8)
Medications, n (%)
  Risperidone 5 (4.3)
  Aripiprazole 7 (6.0)
  Quetiapine 2 (1.7)
  Olanzapine 4 (3.4)
  Methylphenidate 10 (8.6)
  Atomoxetine 2 (1.7)
  Fluoxetine 20 (17.2)
  Sertraline 14 (12.1)
  Escitalopram 3 (2.6)
Clinical Global Impression – DMDD, n (%)
  Normal or borderline 52 (44.8)
  Mild 26 (22.4)
  Moderate 20 (17.2)
  Marked 18 (15.5)

Comparisons of study groups (according to on the CGIS scores) on the all scales using student t test

Total scale scores, M ± SD CGIS-DMDD less than 3, n=52 CGIS-DMDD ≥ 3, n=64 t-test p-value Cohen’s d
ARI-child 4.1 ± 3.6 6.2 ± 3.9 2.9 0.005 -
ARI-parent 4.1 ± 3.3 6.7 ± 3.7 3.9 < 0.001 0.74
Behavioral SDQ-child 2.4 ± 1.7 3.3 ± 2.3 2.4 0.018 -
Behavioral SDQ-parent 3.3 ± 2.3 3.3 ± 2.5 1.6 0.111 -
Total SDQ-child 19.1 ± 6.1 21.4 ± 6.1 2.0 0.045 -
Total SDQ-parent 14.5 ± 5.7 17.1 ± 5.6 2.4 0.018 -
SNAP-IV (attention deficit) 10.2 ± 6.0 11.8 ± 6.7 1.3 0.190 -
SNAP-IV (hyperactivity) 7.1 ± 5.5 9.9 ± 6.7 2.4 0.018 -
RCADS (generalized anxiety) 8.5 ± 4.8 8.6 ± 3.8 0.1 0.939 -
RCADS (panic disorder) 8.3 ± 6.8 8.8 ± 7.0 0.4 0.695 -
RCADS (specific phobia) 12.3 ± 6.9 13.6 ± 5.9 1.1 0.272 -
RCADS (social anxiety) 4.7 ± 4.2 5.2 ± 4.0 0.6 0.532 -
RCADS (depression) 4.7 ± 4.2 5.2 ± 4.0 0.2 0.854 -
CLARI-Total (%) (weighted) 13. 4 ± 16.4 34.4 ± 21.3 6.0 < 0.001 1.10
CLARI-Temper outburst score 4.4 ± 4.1 8.3 ± 5.0 4.6 < 0.001 0.85
CLARI-Mood score 1.4 ± 2.1 3.6 ± 2.4 5.4 < 0.001 0.98
CLARI-Impairment score 1.1 ± 2.0 4.1 ± 3.5 5.9 < 0.001 1.05

Item-total score correlation coefficients and Cronbach’s alpha if item deleted values of the CL-ARI

Severity Scale of the CL-ARI* Item-total score Correlation Coefficient Cronbach’s alpha if item deleted
CL-ARI temper outbursts
  Temper outbursts – mild frequency (Item 1) 0.621 0.915
  Temper outbursts – mild duration (Item 2) 0.734 0.910
  Temper outbursts – moderate frequency (Item 3) 0.586 0.917
  Temper outbursts – moderate duration (Item 4) 0.560 0.918
  Temper outbursts – severe frequency (Item 5) 0.668 0.913
  Temper outbursts – severe duration (Item 6) 0.640 0.915
CL-ARI Irritable mood
  Irritable mood frequency (Item 7) 0.704 0.911
  Irritable mood severity (Item 8) 0.829 0.904
CL-ARI Impairment
  Impairment-family (Item 9) 0.764 0.909
  Impairment-school (Item 10) 0.752 0.909
  Impairment-peers (Item 11) 0.693 0.912
eISSN:
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Language:
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Journal Subjects:
Medicine, Basic Medical Science, other