The role of depressive symptoms in the aberrant processing of emotional stimuli in youth with severe irritability

Authors

• LK Meffert
• P Vidal-Ribas
• MA Brotman
• E Leibenluft
• A Stringaris

Abstract

Severe irritability is a predictor of future depression according to recent meta-analytic evidence. However, the mechanisms for this developmental transition remain unclear. We test whether aberrant emotional processing may be a plausible candidate mechanism. Participants aged 8–20 years old (Mean=13.3, SD=2.8) included youth with severe irritability, defined as Disruptive Mood Dysregulation Disorder (DMDD), split by low (DMDD/LD; n = 56) and high (DMDD/HD; n = 25) depressive symptoms, and healthy controls (HC; n = 45). The DANVA was used to assess emotional processing of faces and voices of adults and children expressing happiness, fear, sadness and anger. A Group (3) × Emotion (4) × Actor (2) × Modality (2) repeated measures ANCOVA, covaried with age and sex, examined the number of errors and misidentification of emotions. These were then used to predict depressive symptoms in a subsample at the 1 year follow-up employing linear regression. DMDD/HD youth were more likely to interpret happy stimuli as angry and fearful compared to DMDD/LD (happy as angry: p=0.011; happy as fearful: p=0.004) and HC (happy as angry: p=0.004; happy as fearful: p=0.010). In youth with DMDD, the misidentification of happy stimuli as fearful was associated with higher depressive symptoms at follow up (ß=0.42, p=0.022, n=23), even when adjusting for baseline depressive and irritability symptoms. To our knowledge, this is the first study to specifically examine depressive symptoms in youth with severe irritability. Our findings suggest that aberrant emotional processing may partially explain the specific association between irritability and depression.

Scientific Focus Area: Social and Behavioral Sciences

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