The Clinician Affective Reactivity Index: Validity and Reliability of a Clinician-Rated Assessment of Irritability.

Published on Mar 1, 2020in Behavior Therapy
· DOI :10.1016/J.BETH.2019.10.005
Simone P.W. Haller4
Estimated H-index: 4
(NIH: National Institutes of Health),
Simone P. Haller1
Estimated H-index: 1
(NIH: National Institutes of Health)
+ 8 AuthorsMelissa A. Brotman26
Estimated H-index: 26
(NIH: National Institutes of Health)
Abstract Irritability is impairing in youth and is the core feature of disruptive mood dysregulation disorder (DMDD). Currently, there are no established clinician-rated instruments to assess irritability in pediatric research and clinical settings. Clinician-rated measures ensure consistency of assessment across patients and are important specifically for treatment research. Here, we present data on the psychometric properties of the Clinician Affective Reactivity Index (CL-ARI), the first semistructured interview focused on pediatric irritability. The CL-ARI was administered to a transdiagnostic sample of 98 youth (M age = 12.66, SD = 2.47; 41% female). With respect to convergent validity, CL-ARI scores were (a) significantly higher for youth with DMDD than for any other diagnostic group, and (b) showed uniquely strong associations with other clinician-, parent-, and youth-report measures of irritability compared to measures of related constructs, such as anxiety. The three subscales of the CL-ARI (temper outbursts, irritable mood, impairment) showed excellent internal consistency. Test-retest reliability of the CL-ARI was adequate. These data support that irritability can be feasibly, validly, and reliably assessed by clinicians using the CL-ARI. A validated, gold-standard assessment of pediatric irritability is critical in advancing research and treatment efforts.
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