Severe temper outbursts (STO) represent extreme, dysregulated reactions to frustration that can be the source of significant impairment. Despite this, little is known about the adolescent outcomes of children who exhibit STO. The primary aim of the proposed work is to examine psychopathology, and frustration reactivity and regulation in a unique sample of adolescents who exhibited STO in childhood.
The second aim i s to test the putative contribution of dorsal anterior cingulate cortex (dACC) structure and functional connectivity assessed in childhood to these adolescent outcomes. To accomplish these aims, the proposed investigation will recruit 169 adolescents, ages 12-17.9, who participated in a previous study conducted by the PI when they were between the ages of 5 and 9.9 years. We expect to obtain data from ~90% (n=152). Functional and structural MRI data are available for 118 children (70% of the sample). Consistent with the RDoC framework, adolescents will be assessed across multiple domains. First, clinical diagnoses will be determined through semi-structured interview. Second, symptom severity will be further assessed through self-report questionnaires. Third, the impact of frustration on cognitive processing will be examined using the Affective Posner task, which has been used in previous studies to demonstrate altered frustration responding in clinically irritable youth. Finally, cortisol reactivity to frustration will be assessed using a novel social frustration paradigm. Fulfillment of study aims has the potential to advance our understanding of STO in childhood as a risk factor for adolescent pathology. Further, this investigation lays the foundation for a subsequent study to evaluate the associations between brain measures and psychopathological outcomes when these children are young adults.
Severe temper outbursts (STO) in young children are a significant source of concern in child psychiatry as they are functionally impairing and frequently the primary reason for treatment referral. Many such children, particularly boys, are treated with medications with worrisome side effect profiles. Given the concerning adverse effects of these agents and the unknown consequences of their long-term use, there continues to be an urgent clinical and public health need for improved characterization of the developmental trajectories of child emotion dysregulation, as evidenced by STO, into key developmental periods such as adolescence.
