The Associations between Child Irritability, Parental Distress, Parental Irritability and Family Functioning in Children Accessing Mental Health Services

Irritability, characterised by anger, frustration, and emotional dysregulation, is a common transdiagnostic symptom associated with child and adolescent referrals to mental health services and is associated with significant negative outcomes. Despite this, little is known about the link between irritability and the broader family environment. The present study described parental and family dysfunction in families of 51 children and adolescents (aged 6 to 15 years) with severe irritability referred to Victorian public mental health services. Further, we aimed to explore the associations between children’s irritability, parent functioning (parental distress and parental irritability), and family dysfunction. Child irritability was measured on the Affective Reactivity Index (ARI) and was obtained from participating children and their primary parent/caregiver (90% mothers). Participants psychiatric diagnoses were obtained using the Development and Well-Being Assessment through an interview with parents who also provided ratings of their own distress (Kessler 6), irritability (ARI), and family dysfunction (McMaster Family Assessment Device). We found high rates of family dysfunction (80%) and 39% of parents reported moderate to high psychological distress. Higher self-reported irritability was moderately associated with lower family dysfunction. All other relationships examined were non-significant. Findings suggest a complex relationship between severe childhood irritability and parental and family functioning with implications for treatment discussed.