• Scientific Update
The occasional meltdown is a common childhood experience, as many parents and caregivers will attest. How frequent and intense these outbursts are, and the stimuli that trigger them, vary from child to child, reflecting differences in the trait of irritability. For example, some children seem ready to explode in anger and frustration in response to the slightest challenge or request. Others struggle to calm down when upset.
Most of the time, behavioral expressions of anger and frustration are considered normal, but research has shown that high levels of irritability can be an early predictor of later mental illness. So, how can families and health care providers tell if a child’s irritability is a cause for concern?
Researchers Lauren S. Wakschlag, Ph.D. , Jillian Lee Wiggins, Ph.D. , Amy K. Roy, Ph.D. , and colleagues tackled this challenge head-on by drawing on data from the Multidimensional Assessment of Preschoolers Study (MAPS) and other NIMH-sponsored studies. Through detailed analyses, researchers capture expressions of irritability at all developmental stages through a clinically relevant measurement tool: the MAPS Temperature Loss Scale (MAPS-TL). Their findings are published in a series of papers in a special issue from International Journal of Methods in Psychiatric Research.
Establishing differentiated approaches to measurement
The special issue describes efforts to adapt and validate the MAPS-TL so that it is applicable to a range of ages, from 12 months to 17 years. These age-specific versions of the MAPS-TL are designed to indicate whether a child’s irritability differs from what is typical for their age and developmental stage. This developmental lens helps distinguish expected behaviors that are considered part of adulthood (such as the “terrible twos”) from those that warrant clinical concern.
The research presented in the issue also extends the dimensional approach of MAPS-TL. Rather than presenting irritability as a binary trait—something a child either has or doesn’t have—the MAPS-TL scale considers specific expressions of irritable behaviors and the frequency of those behaviors. The scale also takes into account the situational context, such as whether the behaviors occur with peers, parents, or other adults during times of transition or are seemingly unusual. The goal is to provide a nuanced understanding of a child’s behavior that reflects the dynamic nature of cognitive, social, and emotional development and the child’s ability to function in the world around him.
Validation of measurement tools for real-world use
Importantly, the special issue focuses on translating these advances so that they can be applied to real-world clinical practice. In several studies, researchers have demonstrated that short versions of the MAPS-TL are reliable and practical in clinical settings. These tools show promise in helping health care providers and families determine when to intervene and make use of available treatments, supports, and services. This is critical because early intervention can change a child’s developmental trajectory, benefiting their mental health and well-being in the long term.
By promoting a dimensional, diagnostic approach to measurement and charting a path to clinical application, the special issue has implications in many areas beyond irritability.
“Overall, we hope that these papers will illuminate the status of dimensional excitability methodology as exemplary, highlight its pragmatic applications and predictive utility, and catalyze interest in its scientific and real-world utility,” write Wiggins, Roy, and Wakschlag. . introduction to the subject .
The special issue includes a comment by Daniel Pine, MD, Chief of the Division of Developmental and Emotional Neuroscience at the NIMH Brain Research Program. All the special issue is available to the public online .
Report
Wiggins, JL, Roy, AK, & Wakschlag, LS (2023). MAPPING affective dimensions of behavior: Methodological development of the Multidimensional Assessment Profile Scales (MAPS) with real-world applications [Special issue]. International Journal of Methods in Psychiatry Research, 32(S1).
Grants
MH107652 , MH082830 , MH090301 , MH091140 , MH115356 , OD023319
