Longitudinal Patterns of Irritability During the Transition to Adolescence: Examining Caregiver and Youth perspectives and Sex Differences

Anger-related irritability is a leading reason for referral to child and adolescent mental health services. However, studies on longitudinal patterns of irritability typically rely on caregiver reports, yielding limited insights into youths’ own experiences. Furthermore, there has been little focus on potential sex differences during the transition to adolescence. Using data from the Adolescent Brain Cognitive Development (ABCD) Study® (n = 9,411, 48% females), this study compared caregiver and youth reports of anger-related irritability from ages 9 to 13, focusing on a high-persistent irritability classification (defined as ≥2 ‘very true’ and ≥1 ‘somewhat true’ ratings of “hot temper” across time points) and examined sex differences. High-persistent irritability was reported by 5.1% of youths, whereas caregiver reports indicated 1.6%. Among four irritability classifications (low, low-to-moderate, moderate, and high-persistent) there was limited agreement between informants (Cohen’s κ = 0.22, SE=0.01), particularly among females. This discrepancy was primarily driven by poor concordance on the latter three classifications, while agreement on the low class was comparatively greater. When females reported high-persistent irritability, 3.9% of their caregivers reported the same, compared to 9.5% among males. During the transition to adolescence, most youths experience low irritability levels, whereas a small minority display persistently high, anger-related irritability. Agreement between caregivers and youths on which individuals belong to this high‑persistent classification was low. These findings highlight the importance of incorporating youth self‑reports—particularly for females—because reliance on caregiver reports alone may miss critical aspects of the informant-specific longitudinal patterns of irritability.