Differentiating irritable mood and disruptive behavior in adults.
Differentiating irritable mood and disruptive behavior in adults.
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DOI：
10.1590/2237-6089-2019-0078
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发表时间：
2020-10
影响因子：
2.6
通讯作者：
Salum GA
中科院分区：
文献类型：
--
作者：
Knackfuss ACU;Leibenluft E;Brotman MA;de Moura Silveira Júnior É;Simioni A;Teixeira LS;Gerchmann L;Fijtman A;Trasel AR;Sperotto D;Manfro AG;Kapczinski F;Sant'Anna MK;Salum GA
易怒既有情绪表现，也有行为表现。这些经常同时发生，并且不清楚它们在多大程度上是可分离的域。我们使用验证性因子分析和外部验证器来调查情绪和行为因素对易怒的独立性。样本包括246名患者（平均年龄45岁，63%为女性），来自一家三级医院的四个门诊项目（抑郁症、焦虑症、双相情感障碍和精神分裂症）。一种由训练有素的临床医生评定的临床工具被专门设计用于从维度上捕捉易怒情绪和破坏性行为，以及当前的分类诊断，即间歇性爆炸障碍（IED）；对立违抗性障碍；以及诊断成人破坏性情绪失调障碍（DMDD）的适应性。验证性因子分析（CFA）用于检验烦躁模型的最佳拟合，回归分析用于调查与外部验证者的关联。易怒情绪和破坏性行为都是常见的，但诊断为破坏性综合征的少见（IED, 8%； ODD, 2%； DMDD, 2%）。包含两个维度的相关模型和包含一个一般维度和两个特定维度（情绪和行为）的双因素模型均具有较好的拟合指数。相关模型的近似均方根误差(RMSEA) = 0.077, 90%置信区间(90% ci) = 0.071 ~ 0.083；比较拟合指数(CFI) = 0.99；塔克-刘易斯指数(TLI) = 0.99，双因子模型RMSEA = 0.041；Cfi = 0.99；TLI = 0.99)。在双因素模型中，易怒情绪和损害与抑郁和躁狂的临床测量之间的关联也支持了易怒情绪和行为成分区分的外部有效性，而抑郁和躁狂与破坏性行为无关。心理测量和外部效度数据表明易怒的情绪与破坏性行为维度有重叠和特定的特征。
Irritability has both mood and behavioral manifestations. These frequently co-occur, and it is unclear to what extent they are dissociable domains. We used confirmatory factor analysis and external validators to investigate the independence of mood and behavioral components of irritability. The sample comprised 246 patients (mean age 45 years; 63% female) from four outpatient programs (depression, anxiety, bipolar, and schizophrenia) at a tertiary hospital. A clinical instrument rated by trained clinicians was specifically designed to capture irritable mood and disruptive behavior dimensionally, as well as current categorical diagnoses i.e., intermittent explosive disorder (IED); oppositional defiant disorder (ODD); and an adaptation to diagnose disruptive mood dysregulation disorder (DMDD) in adults. Confirmatory factor analysis (CFA) was used to test the best fitting irritability models and regression analyses were used to investigate associations with external validators. Irritable mood and disruptive behavior were both frequent, but diagnoses of disruptive syndromes were rare (IED, 8%; ODD, 2%; DMDD, 2%). A correlated model with two dimensions, and a bifactor model with one general dimension and two specific dimensions (mood and behavior) both had good fit indices. The correlated model had root mean square error of approximation (RMSEA) = 0.077, with 90% confidence interval (90%CI) = 0.071-0.083; comparative fit index (CFI) = 0.99; and Tucker-Lewis index (TLI) = 0.99, while the bifactor model had RMSEA = 0.041; CFI = 0.99; and TLI = 0.99 respectively). In the bifactor model, external validity for differentiation of the mood and behavioral components of irritability was also supported by associations between irritable mood and impairment and clinical measures of depression and mania, which were not associated with disruptive behavior. Psychometric and external validity data suggest both overlapping and specific features of the mood vs. disruptive behavior dimensions of irritability.
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影响因子：
4.6
作者：
Burke, Jeffrey D.;Boylan, Khrista;Rowe, Richard;Duku, Eric;Stepp, Stephanie D.;Hipwell, Alison E.;Waldman, Irwin D.
通讯作者：
Waldman, Irwin D.
DOI：
10.1348/000711001159582
发表时间：
2001-11-01
影响因子：
2.6
作者：
Raykov, T
通讯作者：
Raykov, T
DOI：
10.1146/annurev-clinpsy-032816-044941
发表时间：
2017-01-01
期刊：
ANNUAL REVIEW OF CLINICAL PSYCHOLOGY, VOL 13
影响因子：
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作者：
Brotman, Melissa A.;Kircanski, Katharina;Leibenluft, Ellen
通讯作者：
Leibenluft, Ellen
影响因子：
4
作者：
O'Connor, TG;Deater-Deckard, K;Plomin, R
通讯作者：
Plomin, R
影响因子：
3.5
作者：
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通讯作者：
Amtmann, Dagmar