FIGURE 1
Pearson correlation coefficients of the CLA-RI subscales and other psychopathology scores within the clinical sample
| Clinical sample, n=116 | Total CL-ARI score | Temper outbursts | Mood | Impairment |
|---|---|---|---|---|
| ARI-child form | r=0.66* | r=0.62* | r=0.55* | r=0.64* |
| ARI-parent form | r=0.65* | r=0.60* | r=0.57* | r=0.62* |
| Behavioral SDQ-child form | r=0.54* | r=0.54* | r=0.44* | r=0.51* |
| Behavioral SDQ-parent form | r=0.46* | r=0.49* | r=0.37* | r=0.44* |
| Total SDQ-child form | r=0.35* | r=0.32* | r=0.32 | r=0.32 |
| Total SDQ-parent form | r=0.42* | r=0.38* | r=0.33* | r=0.44* |
| SNAP-IV (attention deficit) | r=0.22 | r=0.24 | r=0.16 | r=0.22 |
| SNAP-IV (hyperactivity) | r=0.29 | r=0.31 | r=0.18 | r=0.35* |
| RCADS (generalized anxiety) | r= 0.05 | r= − 0.002 | r= 0.11 | r= − 0.001 |
| RCADS (panic disorder) | r= 0.12 | r= 0.01 | r= 0.18 | r= 0.10 |
| RCADS (specific phobia) | r= 0.08 | r= 0.07 | r= 0.12 | r= 0.01 |
| RCADS (social anxiety) | r= 0.20 | r= 0.22 | r= 0.22 | r= 0.12 |
| RCADS (depression) | r= 0.16 | r= 0.10 | r= 0.21 | r= 0.09 |
Construct validity scores of CLA-RI items by using principal component analysis
| Factor loading of items | Factor 1 | Factor 2 |
|---|---|---|
| Temper outbursts – severe duration (Item 6) | 0.974 | |
| Temper outbursts – mild duration (Item 2) | 0.776 | |
| Impairment-school (Item 10) | 0.757 | |
| Temper outbursts – moderate frequency (Item 3) | 0.739 | |
| Temper outbursts – severe frequency (Item 5) | 0.647 | |
| Impairment-peers (Item 11) | 0.614 | |
| Temper outbursts – moderate duration (Item 4) | 0.937 | |
| Irritable mood frequency (Item 7) | 0.705 | |
| Temper outbursts – mild frequency (Item 1) | 0.689 | |
| Impairment-family (Item 9) | 0.624 | |
| Irritable mood severity (Item 8) | 0.592 | |
| Total variance explained | 56.3% | 10.2% |
| Eigenvalue | 6.2 | 1.1 |
| Cronbach’s alpha | 0.883 | 0.875 |
Demographic, clinical, and treatment characteristics of study participants
| Total sample, n = 116 | |
|---|---|
| Age, years, M ± SD (range) | 14.1 ± 2.1 (11–17) |
| Sex, female, percent | 69 (59.5) |
| Family Status, n (%) | |
| Married | 93 (80.2) |
| Divorced or separated | 23 (19.8) |
| The number of siblings | 2.1 ± 0.8 |
| Family history of psychiatric disorder | 23 (18.9) |
| Special education, n (%) | 8 (6.9) |
| Psychiatric comorbidities, n (%) | |
| Attention-deficit hyperactivity disorder | 34 (29.3) |
| Oppositional-defiant disorder | 18 (15.5) |
| Conduct disorder | 17 (14.7) |
| Specific learning disorder | 9 (7.8) |
| Tic disorders | 12 (10.3) |
| Obsessive-compulsive disorder | 33 (28.4) |
| Panic disorder | 26 (22.4) |
| Social anxiety disorder | 8 (6.9) |
| Generalized anxiety disorder | 31 (26.7) |
| Specific phobia | 20 (17.2) |
| Major depressive disorder | 39 (33.6) |
| Eating disorders | 3 (2.6) |
| Post-traumatic stress disorder | 7 (6.0) |
| Enuresis/encopresis | 6 (5.2) |
| Suicide attempt, n (%) | 16 (13.8) |
| Medications, n (%) | |
| Risperidone | 5 (4.3) |
| Aripiprazole | 7 (6.0) |
| Quetiapine | 2 (1.7) |
| Olanzapine | 4 (3.4) |
| Methylphenidate | 10 (8.6) |
| Atomoxetine | 2 (1.7) |
| Fluoxetine | 20 (17.2) |
| Sertraline | 14 (12.1) |
| Escitalopram | 3 (2.6) |
| Clinical Global Impression – DMDD, n (%) | |
| Normal or borderline | 52 (44.8) |
| Mild | 26 (22.4) |
| Moderate | 20 (17.2) |
| Marked | 18 (15.5) |
Comparisons of study groups (according to on the CGIS scores) on the all scales using student t test
| Total scale scores, M ± SD | CGIS-DMDD less than 3, n=52 | CGIS-DMDD ≥ 3, n=64 | t-test | p-value | Cohen’s d |
|---|---|---|---|---|---|
| ARI-child | 4.1 ± 3.6 | 6.2 ± 3.9 | 2.9 | 0.005 | - |
| ARI-parent | 4.1 ± 3.3 | 6.7 ± 3.7 | 3.9 | < 0.001 | 0.74 |
| Behavioral SDQ-child | 2.4 ± 1.7 | 3.3 ± 2.3 | 2.4 | 0.018 | - |
| Behavioral SDQ-parent | 3.3 ± 2.3 | 3.3 ± 2.5 | 1.6 | 0.111 | - |
| Total SDQ-child | 19.1 ± 6.1 | 21.4 ± 6.1 | 2.0 | 0.045 | - |
| Total SDQ-parent | 14.5 ± 5.7 | 17.1 ± 5.6 | 2.4 | 0.018 | - |
| SNAP-IV (attention deficit) | 10.2 ± 6.0 | 11.8 ± 6.7 | 1.3 | 0.190 | - |
| SNAP-IV (hyperactivity) | 7.1 ± 5.5 | 9.9 ± 6.7 | 2.4 | 0.018 | - |
| RCADS (generalized anxiety) | 8.5 ± 4.8 | 8.6 ± 3.8 | 0.1 | 0.939 | - |
| RCADS (panic disorder) | 8.3 ± 6.8 | 8.8 ± 7.0 | 0.4 | 0.695 | - |
| RCADS (specific phobia) | 12.3 ± 6.9 | 13.6 ± 5.9 | 1.1 | 0.272 | - |
| RCADS (social anxiety) | 4.7 ± 4.2 | 5.2 ± 4.0 | 0.6 | 0.532 | - |
| RCADS (depression) | 4.7 ± 4.2 | 5.2 ± 4.0 | 0.2 | 0.854 | - |
| CLARI-Total (%) (weighted) | 13. 4 ± 16.4 | 34.4 ± 21.3 | 6.0 | < 0.001 | 1.10 |
| CLARI-Temper outburst score | 4.4 ± 4.1 | 8.3 ± 5.0 | 4.6 | < 0.001 | 0.85 |
| CLARI-Mood score | 1.4 ± 2.1 | 3.6 ± 2.4 | 5.4 | < 0.001 | 0.98 |
| CLARI-Impairment score | 1.1 ± 2.0 | 4.1 ± 3.5 | 5.9 | < 0.001 | 1.05 |
Item-total score correlation coefficients and Cronbach’s alpha if item deleted values of the CL-ARI
| Severity Scale of the CL-ARI* | Item-total score Correlation Coefficient | Cronbach’s alpha if item deleted |
|---|---|---|
| CL-ARI temper outbursts | ||
| Temper outbursts – mild frequency (Item 1) | 0.621 | 0.915 |
| Temper outbursts – mild duration (Item 2) | 0.734 | 0.910 |
| Temper outbursts – moderate frequency (Item 3) | 0.586 | 0.917 |
| Temper outbursts – moderate duration (Item 4) | 0.560 | 0.918 |
| Temper outbursts – severe frequency (Item 5) | 0.668 | 0.913 |
| Temper outbursts – severe duration (Item 6) | 0.640 | 0.915 |
| CL-ARI Irritable mood | ||
| Irritable mood frequency (Item 7) | 0.704 | 0.911 |
| Irritable mood severity (Item 8) | 0.829 | 0.904 |
| CL-ARI Impairment | ||
| Impairment-family (Item 9) | 0.764 | 0.909 |
| Impairment-school (Item 10) | 0.752 | 0.909 |
| Impairment-peers (Item 11) | 0.693 | 0.912 |