Project Details

Affective Profiles in Irritable Youth: Identifying Early Substance Use Risk Pathways

Emily Kemp, PhD

Summary

BACKGROUND: Pediatric irritability (proneness to anger) affects roughly half of youth, is a leading reason for mental health referral, and predicts serious downstream consequences including earlier and more problematic substance use. However, no two irritable youth present the same — pediatric clinicians routinely see highly irritable youth with a range of emotional problems: some highly distressed and emotionally dysregulated, while others appear callous, antagonistic, and aside from anger, emotionally flat. These different presentations may carry meaningfully different implications for substance use risk, yet no validated framework exists for characterizing them or translating them into prevention-relevant clinical guidance. GAP: No study has examined whether distinct affective profiles among irritable youth reflect different underlying substance use risk pathways, leaving clinicians without guidance on which irritable children are at greatest risk or what type of early intervention is most appropriate. HYPOTHESIS: We hypothesize that distinct affective profiles will emerge among irritable youth — defined primarily by co-occurring depressive-internalizing features versus callous-unemotional-antagonistic features — and that each profile will predict substance use risk through different pathways: distress-driven use motivated by coping among depressive profiles, and reward-seeking use among callous profiles. METHODS: This study recruits 400 youth ages 11-14 through an online community panel, oversampled for irritability and behavioral difficulties, who will complete a validated self-report battery assessing irritability, depressive affect, and callous-unemotional traits, along with substance use outcomes including initiation, use frequency, motives, and expectancies. Latent profile analysis will identify affective subgroups and test whether profiles differ in substance use risk in theoretically predicted ways. RESULTS: Pending. IMPACT: Findings will give pediatric clinicians an evidence-based framework for identifying which irritable children are at greatest substance use risk, and what kind of support is most likely to help, directly informing early identification and prevention for a population seen frequently in primary care and mental health settings but rarely studied with this level of specificity. Website Link: GoogleScholar: https://scholar.google.com/citations?user=ZdgELJ4AAAAJ&hl=enORCiD: https://orcid.org/0000-0002-2008-7938LinkedIn: www.linkedin.com/in/emilykemp1Twitter/X: @emily_kemp7 (https://x.com/emily_kemp7) Optional/Additional Comments: This project is conducted in collaboration with Dr. William Pelham III, Ph.D., with the UC San Diego Department of Psychiatry.