ADHD with Comorbid Irritability and Recurrent Temper Outbursts

Attention deficit hyperactivity disorder (ADHD), is one of the most prevalent childhood disorders and is associated with significant academic and social impairment. Irritability, defined as proneness to anger, is commonly associated with ADHD, as up to half of youth with ADHD have prominent symptoms of irritability. Similarly, recurrent temper outbursts that are developmentally inappropriate for the age, occur in up to 1/3 of youth with ADHD. Children with ADHD who also have persistent irritability and recurrent temper outbursts experience greater functional impairment and are more likely to seek treatment. These children are also more likely to be treated with multiple medications, which is associated with increased morbidity. These unique challenges and worse outcomes among youth with ADHD and persistent irritability highlight the need for improved clinical care for this population.

Irritability predicts mood and anxiety disorders in adulthood; similarly, recurrent temper outbursts in elementary school are a significant predictor of sustained, adverse outcomes into adulthood, including the diseases of despair of substance abuse and suicide. Furthermore, these symptoms significantly impact functioning, and impairment often persists even after treatment of ADHD leading to increased rates of psychiatric hospitalization and polypharmacy. In order to improve outcomes for this population of youth, the development and dissemination of psychometrically-sound assessments and evidence-based treatments specifically targeting irritability and temper outbursts are critically needed.

The goal of this Research Topic is to understand the underlying neuronal basis, assessment, impairment, long-term outcome and pharmacological and psychosocial interventions for comorbid irritability and recurrent temper outburst in children and adolescents with ADHD. 

We welcome articles on the following topics:

•      Neural basis of irritability and recurrent temper outbursts in pediatric ADHD;

•      Assessment of irritability and recurrent temper outbursts in Children with ADHD;

•      Assessment of impairment related irritability and recurrent temper outbursts;

•      Role of psychosocial factors in presentation of irritability and recurrent temper outbursts in Children with ADHD;

•      Long-term outcome of children with ADHD and comorbid irritability and recurrent temper outbursts; 

•      Pharmacological interventions for comorbid irritability and recurrent temper outburst in children and adolescents with ADHD;

•      Psychosocial interventions for comorbid irritability and recurrent temper outburst in children and adolescents with ADHD.