The Clinician Affective Reactivity Index: Validity and Reliability of a Clinician-Rated Assessment of Irritability. Issue 2 (March 2020)

• Record Type: Journal Article
• Authors: Haller, Simone P.; Kircanski, Katharina; Stringaris, Argyris; Clayton, Michal; Bui, Hong; Agorsor, Courtney; Cardenas, Sofia I.; Towbin, Kenneth E.; Pine, Daniel S.; Leibenluft, Ellen; Brotman, Melissa A.
• Is Part Of: Behavior therapy. Volume 51:Issue 2(2020)
• Page Start: 283
• Page End: 293
• Publication Date: 2020-03
• Subjects: irritability -- measurement -- clinician -- validity -- reliability; Behavior therapy -- Periodicals; 616.8914205
• DOI: 10.1016/j.beth.2019.10.005
• Languages: English
• ISSNs: 0005-7894

Abstract

Highlights: The CL-ARI is a clinician-rated instrument that dimensionally assesses pediatric irritability. The instrument can be used to assess transdiagnostic irritability. The CL-ARI consists of a temper outburst, mood, and impairment subscale. Psychometric properties of the CL-ARI are examined. The CL-ARI shows good criterion validity and reliability. 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.