Category: Translational

Clinical Grand Rounds

Clinical Grand Round - Mechanism-Based Treatments of Irritability: Exposure-Based CBT and Interpretation Bias Modification

Keywords: Anger/Irritability | Translational Research | Treatment Development
Presentation Type: Clinical Grand Rounds

Presenter(s)

• 

  Ellen Leibenluft, M. D.

  Emotion and Development Branch, NIMH
• 

  Melissa Brotman, Ph.D.

  Emotion and Development Branch, NIMH
• 

  Katharina Kircanski, Ph.D.

  Emotion and Development Branch, NIMH

  Nothing to disclose

Irritability is one of the most common reasons that youth present for psychological evaluation and treatment. As a transdiagnostic, dimensional construct, irritability transects traditional boundaries of internalizing and externalizing psychopathology and is prominent in the NIMH RDoC initiative. The past decade has witnessed an upsurge in research on irritability and related constructs (e.g., anger, frustration, emotional lability), attesting to its significant public health impact and need for conceptual and clinical advances.

In this Clinical Grand Rounds, we will present recent insights into the behavioral and brain mechanisms of irritability and discuss novel, mechanism-based treatments. Specifically, we will address: (a) clinical presentations of irritability in children and adolescents, including new assessment methods for irritability (clinician interview, ecological momentary assessment); (b) translational research on reward and threat processing, and how these findings map onto the clinical phenomenology of irritability; (c) development of a new, exposure-based CBT for irritability and anger; and (d) testing of a computerized interpretation bias modification program for irritable youth.

Learning Objectives:

• Describe clinical presentations of irritability in youth, including new assessment instruments for irritability.
• Translate basic science research on reward and threat processing to the clinical context of irritability.
• Apply mechanisms of irritability to new, cognitive-behavioral and computer-based interventions.

Recommended Reading: Brotman, M. A., Kircanski, K., & Leibenluft, E. (2017). Irritability in youth. Annual Review of Clinical Psychology, 13, 317-341.
Brotman, M. A., Kircanski, K., Stringaris, A., Pine, D. S., & Leibenluft, E. (2017). Irritability in youths: A translational model. American Journal of Psychiatry, 174, 520-532.
Leibenluft, E. (2011). Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youths. American Journal of Psychiatry, 168, 129-142.