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Understanding Pathways from Childhood Irritability to Psychopathology: A Scoping Study Review

Received: 31 March 2025     Accepted: 11 April 2025     Published: 29 April 2025
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Abstract

Irritability can be a prominent characteristic of various psychopathologies, including childhood psychiatric and neurodevelopmental disorders. Genetic, environmental, and prenatal factors influence the development and progression of childhood irritability. This review aims to highlight the biological and behavioral pathways associated with childhood irritability, examine the relationship between irritability and childhood psychopathology, identify the existing gap in the literature, review these connections, and provide guidance for future research. Articles published on PubMed and Google Scholar from 2000 to 2023 were reviewed using a combination of search terms such as "childhood irritability,” “maternal stress,” and “prenatal stress.” The literature search yielded roughly 2,800 articles using the predefined search terms, of which 65 were deemed relevant to this scoping review. The articles reviewed identified a link between prenatal stress, childhood irritability, and the development of adult psychopathology. Pathological irritability and its emerging connection to maternal stress pose a risk factor for developing neurodevelopmental disorders and psychopathology in the pediatric population. Much of the current literature addresses the biopathophysiologic pathway linking maternal stress to childhood irritability in offspring. However, no interventional research studies have reported on how to interrupt this pathway or mitigate its progression with predictable outcomes. Therefore, identifying a critical period during childhood or adolescence when the progression from childhood irritability to adult psychopathology can be recognized may reduce the risk of developing neurodevelopmental disorders or psychopathology in childhood and throughout life.

Published in American Journal of Pediatrics (Volume 11, Issue 2)
DOI 10.11648/j.ajp.20251102.17
Page(s) 72-80
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Childhood Irritability, Maternal Stress, Neurodevelopmental Disorders, Psychopathology

References
[1] Copeland WE, Brotman MA, Costello EJ. Normative Irritability in Youth: Developmental Findings From the Great Smoky Mountain Study. J Am Acad Child Adolesc Psychiatry 2015; 54: 635–642.
[2] Leibenluft E, Stoddard J. The developmental psychopathology of irritability. Dev Psychopathol 2013; 25: 1473–1487.
[3] Brotman MA, Kircanski K, Leibenluft E. Irritability in Children and Adolescents. Annu Rev Clin Psychol 2017; 13: 317–341.
[4] Stringaris A, Vida-Ribas P, Brotman MA. Practitioner review: definition, recognition, and treatment challenges of irritability in young people. J Child Psychol Psychiatry 2018; 59: 721–39.
[5] Althoff RR, Crehan ET, He JP, et al. Disruptive Mood Dysregulation Disorder at Ages 13-18: Results from the National Comorbidity Survey-Adolescent Supplement. J Child Adolesc Psychopharmacol 2016; 26: 107–113.
[6] Bielas H, Barra S, Skrivanek C, et al. The associations of cumulative adverse childhood experiences and irritability with mental disorders in detained male adolescent offenders. Child Adolesc Psychiatry Ment Health 2016; 10: 34.
[7] Deveney CM, Stoddard J, Evans R, et al. On Defining Irritability and its Relationship to Affective Traits and Social Interpretations. Pers Individ Dif. 2019 Jul 1; 144: 61-67.
[8] Barker ED (ed). Epigenetics, Early Adversity and Child and Adolescent Mental Health. Psychopathology 2018; 51: 71–75.
[9] Bergh BRH, Heuvel MI, Lahti M, et al. Prenatal developmental origins of behavior and mental health: The influence of maternal stress in pregnancy. Neuroscience and biobehavioral reviews 2020; 117: 26–64.
[10] Koutra K, Chatzi L, Bagkeris M, et al. Antenatal and postnatal maternal mental health as determinants of infant neurodevelopment at 18 months of age in a mother-child cohort (Rhea Study) in Crete, Greece. Social psychiatry and psychiatric epidemiology 2013; 48: 1335–1345.
[11] Stringaris A, Zavos H, Leibenluft E, et al. Adolescent irritability: phenotypic associations and genetic links with depressed mood. Am J Psychiatry 2012; 169: 47–54.
[12] Silver J, Hawes M, Dougherty L, et al. Irritability and Temperament: Concurrent and Prospective Relationships in Childhood and Adolescence. J Clin Child Adolesc Psychol. Epub ahead of print 15 December 2023.
[13] Kessel EM, Frost A, Goldstein BL, et al. Developmental pathways from preschool irritability to multifinality in early adolescence: the role of diurnal cortisol. Psychol Med; Apr; 51(5): 761-769. Epub ahead of print 2021.
[14] Dahlerup BR, Egsmose EL, Siersma V, et al. Maternal stress and placental function, a study using questionnaires and biomarkers at birth. PLoS ONE 2018; 13: 0207184.
[15] Davis EP, Glynn LM, Schetter CD, et al. Prenatal exposure to maternal depression and cortisol influences infant temperament. J Am Acad Child Adolesc Psychiatry 2007; 46: 737–746.
[16] Dziurkowska E, Wesolowski M. Cortisol as a Biomarker of Mental Disorder Severity. J Clin Med; 8; 10(21): 5204. Epub ahead of print November 2021.
[17] Faravelli C, Lo Sauro C, Godini L, et al. Childhood stressful events, HPA axis and anxiety disorders. World journal of psychiatry 2012; 2: 13–25.
[18] Bodegom M, Homberg JR, Henckens MJAG. Modulation of the Hypothalamic-Pituitary-Adrenal Axis by Early Life Stress Exposure. Frontiers in cellular neuroscience 2017; 11: 87.
[19] Henckens MJ, Deussing JM, Chen A. Region-specific roles of the corticotropin-releasing factor-urocortin system in stress. Nature reviews Neuroscience 2016; 17: 636–651.
[20] Maras PM, Baram TZ. Sculpting the hippocampus from within: stress, spines, and CRH. Trends in neurosciences 2012; 35: 315–324.
[21] Son GH, Geum D, Chung S. Maternal stress produces learning deficits associated with impairment of NMDA receptor-mediated synaptic plasticity. The Journal of neuroscience : the official journal of the Society for Neuroscience 2006; 26: 3309–3318.
[22] Green MK, Rani CS, Joshi A, et al. Prenatal stress induces long term stress vulnerability, compromising stress response systems in the brain and impairing extinction of conditioned fear after adult stress. Neuroscience 2011; 192: 438–451.
[23] Bingham BC, Sheela Rani CS, Frazer A, et al. Exogenous prenatal corticosterone exposure mimics the effects of prenatal stress on adult brain stress response systems and fear extinction behavior. Psychoneuroendocrinology 2013; 38: 2746–2757.
[24] Sapolsky RM. Stress and the brain: individual variability and the inverted-U. Nat Neurosci; Oct; 18(10): 1344-6. Epub ahead of print 2015.
[25] Smith KE, Pollak SD. Early life stress and development: potential mechanisms for adverse outcomes. J Neurodev Disord; 2020; 12(1): 34. Epub ahead of print 16 December 2020.
[26] Silver J, Carlson GA, Olino TM. Differential outcomes of tonic and phasic irritability in adolescent girls. Journal of child psychology and psychiatry, and allied disciplines, 62(10), 1220–1227.
[27] Editorial V-RP. Moving From Concept to Proof in the Distinction between Phasic and Tonic Irritability. J Am Acad Child Adolesc Psychiatry 2021; 60: 1464–1466.
[28] Leibenluft E. Pediatric Irritability: A Systems Neuroscience Approach. Trends Cogn Sci (Regul Ed) 2017; 21: 277–289.
[29] Moore AA, Lapato DM, Brotman MA. Heritability, stability, and prevalence of tonic and phasic irritability as indicators of disruptive mood dysregulation disorder. J Child Psychol Psychiatry; 2019; 60.
[30] Brotman MA, Schmajuk M, Rich BA, et al. Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children. Biol Psychiatry 2006; 60: 991–997.
[31] Copeland WE, Angold A, Costello EJ, et al. Prevalence, comorbidity, and correlates of DSM-5 proposed disruptive mood dysregulation disorder. Am J Psychiatry 2013; 170: 173–179.
[32] Riglin L, Eyre O, Thapar AK, et al. Identifying Novel Types of Irritability Using a Developmental Genetic Approach. The American journal of psychiatry 2019; 176: 635–642.
[33] Wiggins JL, Briggs-Gowan MJ, Estabrook R, et al. Identifying Clinically Significant Irritability in Early Childhood. J Am Acad Child Adolesc Psychiatry 2018; 57: 191-199. e2.
[34] Eyre O, Riglin L, Leibenluft E, et al. Irritability in ADHD: association with later depression symptoms. Eur Child Adolesc Psychiatry 2019; 28: 1375–1384.
[35] Finlay-Jones AL, Ang JE, Brook J, et al. Systematic Review and Meta-Analysis: Early Irritability as a Transdiagnostic Neurodevelopmental Vulnerability to Later Mental Health Problems. Journal of the American Academy of Child and Adolescent Psychiatry, 63(2), 184–215.
[36] Edmunds SR, Jones A, Braverman Y. Irritability as a Transdiagnostic Risk Factor for Functional Impairment in Autistic and Non-autistic Toddlers and Preschoolers. Res Child Adolesc Psychopathol, 2023.
[37] Leibenluft E, Cohen P, Gorrindo T, et al. Chronic versus episodic irritability in youth: a community-based, longitudinal study of clinical and diagnostic associations. J Child Adolesc Psychopharmacol 2006; 16: 456–466.
[38] Stringaris A, Maughan B, Copeland WS, et al. Irritable mood as a symptom of depression in youth: prevalence, developmental, and clinical correlates in the Great Smoky Mountains Study. J Am Acad Child Adolesc Psychiatry 2013; 52: 831–840.
[39] Malhi GS, Byrow Y, Outhred T, et al. Irritability and internalizing symptoms: Modeling the mediating role of emotion regulation. Journal of affective disorders 2017; 211: 144–149.
[40] Stringaris A, Baroni A, Haimm C. Pediatric Bipolar Disorder versus Severe Mood Dysregulation: Risk for Manic Episodes on Follow-Up. J Am Acad Child Adolesc Psychiatry 2010; 49: 397–405.
[41] Liu Q, Nestor BA, Cole DA. Differential associations of phasic and tonic irritability to suicidality among U.S. adults. J Affect Disord 2021; 292: 391–397.
[42] Orri M, Galera C, Turecki G, et al. Association of Childhood Irritability and Depressive/Anxious Mood Profiles With Adolescent Suicidal Ideation and Attempts. JAMA Psychiatry 2018; 75: 465–473.
[43] Vidal-Ribas P, Brotman MA, Valdivieso I, et al. The Status of Irritability in Psychiatry: A Conceptual and Quantitative Review. Journal of the American Academy of Child and Adolescent Psychiatry 2016; 55: 556–570.
[44] Riglin L, Eyre O, Cooper M, et al. Investigating the genetic underpinnings of early-life irritability. Transl Psychiatry 2017; 7: e1241.
[45] Akingbuwa OA. (2022). Polygenic analyses of childhood and adult psychopathology, and their overlap [Doctoral dissertation, Vrije Universiteit Amsterdam]. VU Research Portal.
[46] Akingbuwa WA, Hammerschlag AR, Jami ES, et al.... Bipolar Disorder and Major Depressive Disorder Working Groups of the Psychiatric Genomics Consortium. JAMA psychiatry 2020; 77: 715–728.
[47] Rettew DC, McKee L. Temperament and its role in developmental psychopathology. Harv Rev Psychiatry; Jan-Feb; 13(1): 14-27. Epub ahead of print 2005.
[48] Gartstein MA, Skinner MK. Prenatal influences on temperament development: The role of environmental epigenetics. Dev Psychopathol; Oct; 30(4): 1269-1303. Epub ahead of print 2018.
[49] Chess S, Thomas A, Rutter M, et al. Interaction of temperament and environment in the production of behavioral disturbances in children. Am J Psychiatry 1963; 120: 142–8.
[50] McGrath JM, Records K, Rice M. Maternal depression and infant temperament characteristics. Infant Behav Dev 2008; 31: 71–80.
[51] Hamilton JP. Epigenetics: principles and practice. Dig Dis; 2011; 29(2): 130–5. Epub ahead of print 5 July 2011.
[52] Seckl J. Prenatal glucocorticoids and long-term programming. Eur J Endocrinol; 151.
[53] Huizink AC. Stress during pregnancy is associated with developmental outcome in infancy. J Child Psychol Psychiatry 2003; 44: 810–818.
[54] Davis EP, Sandman CA. The timing of prenatal exposure to maternal cortisol and psychosocial stress is associated with human infant cognitive development. Child Dev; Jan-Feb; 81(1): 131-48.
[55] Ellman LM. Timing of fetal exposure to stress hormones: effects on newborn physical and neuromuscular maturation. Dev Psychobiol 2008; 50: 232–241.
[56] Duthie L, Reynolds RM. Changes in the maternal hypothalamic-pituitary-adrenal axis in pregnancy and postpartum: influences on maternal and fetal outcomes. Neuroendocrinology; 2013; 98(2): 106–15. Epub ahead of print 19 September 2013.
[57] Bruijn ATCE, Bakel HJA, Wijnen H, et al. Prenatal maternal emotional complaints are associated with cortisol responses in toddler and preschool aged girls. Dev Psychobiol 2009; 51: 553–563.
[58] Deave T, Heron J, Evans J, et al. The impact of maternal depression in pregnancy on early child development. BJOG 2008; 115: 1043–1051.
[59] Luoma I, Tamminen T, Kaukonen P, et al. Longitudinal study of maternal depressive symptoms and child well-being. J Am Acad Child Adolesc Psychiatry 2001; 40: 1367–1374.
[60] Luoma I, Kaukonen P, Mäntymaa M, et al. A longitudinal study of maternal depressive symptoms, negative expectations and perceptions of child problems. Child Psychiatry Hum Dev 2004; 35: 37–53.
[61] Wiggins JL, Mitchell C, Stringaris A, et al. Developmental trajectories of irritability and bidirectional associations with maternal depression. J Am Acad Child Adolesc Psychiatry 2014; 53: 1191–1205, 1205. e1–4.
[62] Whelan YM, Leibenluft E, Stringaris A, et al. Pathways from maternal depressive symptoms to adolescent depressive symptoms: the unique contribution of irritability symptoms. J Child Psychol Psychiatry 2015; 56: 1092–1100.
[63] Fraser A, Macdonald-Wallis C, Tilling K. Cohort Profile: The Avon Longitudinal Study of Parents and Children: ALSPAC mothers cohort. Int J Epidemiol 2013; 42: 97–110.
[64] Sukhodolsky DG, Smith SD, McCauley SA, et al. Behavioral Interventions for Anger, Irritability, and Aggression in Children and Adolescents. Journal of child and adolescent psychopharmacology 2016; 26: 58–64.
[65] Zentner M. Identifying child temperament risk factors from 2 to 8 years of age: validation of a brief temperament screening tool in the US, Europe, and China. Eur Child Adolesc Psychiatry; May; 29(5): 665-678.
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  • APA Style

    Oyetunji, A., Genovese, A., Moore, T. (2025). Understanding Pathways from Childhood Irritability to Psychopathology: A Scoping Study Review. American Journal of Pediatrics, 11(2), 72-80. https://doi.org/10.11648/j.ajp.20251102.17

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    ACS Style

    Oyetunji, A.; Genovese, A.; Moore, T. Understanding Pathways from Childhood Irritability to Psychopathology: A Scoping Study Review. Am. J. Pediatr. 2025, 11(2), 72-80. doi: 10.11648/j.ajp.20251102.17

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    AMA Style

    Oyetunji A, Genovese A, Moore T. Understanding Pathways from Childhood Irritability to Psychopathology: A Scoping Study Review. Am J Pediatr. 2025;11(2):72-80. doi: 10.11648/j.ajp.20251102.17

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  • @article{10.11648/j.ajp.20251102.17,
      author = {Aderonke Oyetunji and Ann Genovese and Trevena Moore},
      title = {Understanding Pathways from Childhood Irritability to Psychopathology: A Scoping Study Review
    },
      journal = {American Journal of Pediatrics},
      volume = {11},
      number = {2},
      pages = {72-80},
      doi = {10.11648/j.ajp.20251102.17},
      url = {https://doi.org/10.11648/j.ajp.20251102.17},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20251102.17},
      abstract = {Irritability can be a prominent characteristic of various psychopathologies, including childhood psychiatric and neurodevelopmental disorders. Genetic, environmental, and prenatal factors influence the development and progression of childhood irritability. This review aims to highlight the biological and behavioral pathways associated with childhood irritability, examine the relationship between irritability and childhood psychopathology, identify the existing gap in the literature, review these connections, and provide guidance for future research. Articles published on PubMed and Google Scholar from 2000 to 2023 were reviewed using a combination of search terms such as "childhood irritability,” “maternal stress,” and “prenatal stress.” The literature search yielded roughly 2,800 articles using the predefined search terms, of which 65 were deemed relevant to this scoping review. The articles reviewed identified a link between prenatal stress, childhood irritability, and the development of adult psychopathology. Pathological irritability and its emerging connection to maternal stress pose a risk factor for developing neurodevelopmental disorders and psychopathology in the pediatric population. Much of the current literature addresses the biopathophysiologic pathway linking maternal stress to childhood irritability in offspring. However, no interventional research studies have reported on how to interrupt this pathway or mitigate its progression with predictable outcomes. Therefore, identifying a critical period during childhood or adolescence when the progression from childhood irritability to adult psychopathology can be recognized may reduce the risk of developing neurodevelopmental disorders or psychopathology in childhood and throughout life.
    },
     year = {2025}
    }
    

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    T1  - Understanding Pathways from Childhood Irritability to Psychopathology: A Scoping Study Review
    
    AU  - Aderonke Oyetunji
    AU  - Ann Genovese
    AU  - Trevena Moore
    Y1  - 2025/04/29
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    N1  - https://doi.org/10.11648/j.ajp.20251102.17
    DO  - 10.11648/j.ajp.20251102.17
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
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    UR  - https://doi.org/10.11648/j.ajp.20251102.17
    AB  - Irritability can be a prominent characteristic of various psychopathologies, including childhood psychiatric and neurodevelopmental disorders. Genetic, environmental, and prenatal factors influence the development and progression of childhood irritability. This review aims to highlight the biological and behavioral pathways associated with childhood irritability, examine the relationship between irritability and childhood psychopathology, identify the existing gap in the literature, review these connections, and provide guidance for future research. Articles published on PubMed and Google Scholar from 2000 to 2023 were reviewed using a combination of search terms such as "childhood irritability,” “maternal stress,” and “prenatal stress.” The literature search yielded roughly 2,800 articles using the predefined search terms, of which 65 were deemed relevant to this scoping review. The articles reviewed identified a link between prenatal stress, childhood irritability, and the development of adult psychopathology. Pathological irritability and its emerging connection to maternal stress pose a risk factor for developing neurodevelopmental disorders and psychopathology in the pediatric population. Much of the current literature addresses the biopathophysiologic pathway linking maternal stress to childhood irritability in offspring. However, no interventional research studies have reported on how to interrupt this pathway or mitigate its progression with predictable outcomes. Therefore, identifying a critical period during childhood or adolescence when the progression from childhood irritability to adult psychopathology can be recognized may reduce the risk of developing neurodevelopmental disorders or psychopathology in childhood and throughout life.
    
    VL  - 11
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