Youth mental disorders are prevalent and show homotypic and heterotypic continuity. We followed a community sample of 609 families with 3-year-old children living within 20 contiguous miles of Stony Brook, NY, with at least one biological parent; primary caregivers were required to speak English, and children with significant medical or developmental disorders were excluded. Participants were assessed at three-year intervals from ages 3–18, tracking the prevalence and continuity of five common mental disorders (depression, anxiety, attention-deficit/hyperactivity disorder, disruptive behavior, and substance use disorders) via semi-structured diagnostic interviews. By age 18, estimated cumulative prevalence rates were: depression (34.7

The minimization of racism among White adults stifles racial progress and underscores the need to discuss racism starting in childhood. Parents are key contributors to children's racial socialization and their actions may influence the development of anti-racist behaviors through modeling. Previous work examining parenting styles and behaviors has focused on child outcomes, with little examination of characteristics of White parents themselves, such as frequency of anti-racist behavior. As parents are children's first teachers, implications of parents' own involvement in anti-racism may inform interventions disrupting the intergenerational transmission of racism. To address this, 229 White parents completed questionnaires assessing self-reported parenting, anti-racism behaviors, and White fragility. Authoritarian parenting was negatively associated with anti-racist behavior (r = -0.20, p = 0.002). This association was qualified by White fragility, such that authoritarian parenting was positively associated with anti-racist behavior at high White fragility (+1 SD) and negatively associated with anti-racist behavior at low White fragility (-1 SD). Authoritative parenting was positively associated with anti-racist behavior (r = 0.25, p < 0.001); this effect was also qualified by White fragility such that this positive association only existed at relatively low and mean levels of White fragility (but not at high levels). These results suggest that the degree to which parenting styles are associated with anti-racism depends on parents' level of White fragility. Implications of these results include potential influences of parenting style and parents' anti-racist behavior on children's racial socialization as well as considerations for research focused on anti-racist socialization efforts.

Eating disorders (ED) are dangerous psychiatric conditions that can emerge in youth. In previous work, child psychopathology increased risk for elevated body dissatisfaction and ED. Although parent psychopathology contributes to a range of psychological disorders, it has not yet been tested as a risk factor for youth body dissatisfaction and ED symptoms. The current prospective study tested whether lifetime parent anxiety and depression (measured when the child was ages 3 and 9) predicted adolescent body dissatisfaction at age 12 and 15 and symptoms of anorexia nervosa (AN) or bulimia nervosa (BN) at age 15 in a community sample of youth. We also examined whether child psychopathology at age 3 or 6 (anxiety, depression, and oppositional defiant disorder [ODD]) moderated, and body dissatisfaction mediated, these relationships. Maternal anxiety and depression predicted youth body dissatisfaction at age 12, and maternal and paternal depression predicted youth body dissatisfaction at age 15. Preregistered moderation and mediation analyses (https://osf.io/s8a6y) identified that child ODD moderated relationships between maternal anxiety and youth AN symptoms at age 15 and between paternal anxiety and youth body dissatisfaction at age 12. In addition, youth body dissatisfaction at age 12 mediated relationships between both maternal anxiety and depression and youth AN symptoms at age 15. The present study demonstrates additional vulnerability factors in early childhood that may increase risk for the development of body dissatisfaction and ED symptoms in early and middle adolescence. These data suggest that parent psychopathology should be an area of focus when evaluating early childhood risk factors for EDs.

Anxiety and eating disorders are dangerous, impairing conditions that are increasingly common in youth. Etiology of anxiety and eating disorders may overlap, as both conditions may develop from avoidance of feared situations and sensations. Awareness of feared sensations is related to interoception, the ability to sense internal signals including feared sensations. Atypical interoception in the gastrointestinal domain may be a shared risk factor for anxiety and eating disorders. Gastric sensations are implicated in both eating disorders and anxiety for some individuals. Fear learning may partially explain the relationships among interoceptive deficits and anxiety and eating disorders, such that individuals begin to fear gastric sensations and associated emotional states or situations. Fear of these experiences may generalize to other experiences or sensations associated with gastric discomfort, which may eventually lead to the development of an anxiety and/or eating disorders. Identification of interoceptive deficits in youth presents opportunities for prevention and early intervention of anxiety and eating disorders before they become impairing. This review characterizes interoceptive sensitivity and its role in the onset and maintenance of anxiety and eating disorders. Atypical interoception is defined, fear learning is discussed as it relates to interoception and psychopathology, and the existing research on interoception in children and relationships among interoceptive deficits and anxiety and eating disorders is reviewed respectively. Current gaps in the existing literature are addressed by identifying a recent series of proposed conceptual models, reviewing the evidence for such models, and proposing future research to test these models in youth.

Racism is a primary social determinant of health and chronic stressor that affects the physical and mental health of People of Color and Indigenous Individuals (POCI) and perpetuates racial and ethnic health disparities. Despite the impact of racism on POCI, the mechanisms through which experiences of racism result in negative health outcomes remain understudied, in particular among children. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is one of the possible mechanisms. Frequent and prolonged exposure to chronic stressors may result in dysregulation of the HPA axis, and in turn cause adverse physical and psychological health outcomes for POCI children. This paper argues for the importance of examining HPA axis dysregulation as a mechanism that links racism during early childhood to negative health outcomes over the lifespan. Several studies have explored the relationship between racism and HPA axis dysregulation during adulthood and adolescence and have found associations between racism and salivary and hair cortisol. Recent studies have identified racial and ethnic differences in cortisol levels during early childhood, but only one study, to our knowledge, explored whether the differences are attributed to racism. In this paper, we conduct a review of the existing literature on the links between racism and HPA axis dysregulation during adulthood and adolescence given the dearth of studies exploring this relationship during early childhood. We also highlight the importance of utilizing an intersectionality framework in the study of racism and health to provide a more comprehensive and nuanced understanding of health disparities among and within racial/ethnic groups. Using this evidence along with consideration of relevant models, we propose how HPA axis dysregulation identified early in life may foreshadow children’s increased risk for negative health outcomes from racism and other systems of oppression and signal the need for prevention and intervention.

Sleep problems in preschool-aged children are common and predict further sleep difficulties and psychopathology. Negative parenting styles and parental psychopathology can shape young children’s sleep contexts and contribute to sleep problems. We examined longitudinal associations between parenting and mothers’ and fathers’ history of psychopathology and children’s sleep problems. Participants included 541 parents of children who were age 3 at the initial assessment and age 6 at follow-up. When children were age 3, parenting style was assessed using mother- and father-reported questionnaires, and maternal and paternal history of mood and anxiety disorders were assessed with diagnostic interviews. Preschoolers’ sleep problems at age 3 were associated with more sleep problems at age 6. Mothers’ history of anxiety disorders predicted increases in children’s sleep problems from ages 3 to 6. When mothers had a history of mood disorders, more authoritarian parenting at child age 3 was associated with fewer sleep problems at age 6. When mothers had a history of anxiety disorders, more permissive parenting at child age 3 was associated with more sleep problems at age 6. Finally, parental socioeconomic status was associated with increases in children’s sleep problems from ages 3 to 6. These findings suggest parents with a history of anxiety and mood disorders or from disadvantaged socioeconomic backgrounds may have children more vulnerable to experiencing sleep problems over time, particularly in the presence of less authoritarian and more permissive parenting. Interventions to support parenting practices and manage parental mood and anxiety may improve preschool-aged children’s sleep problems.

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) often experience academic challenges such as frequent homework difficulties. A subset of children with ADHD exhibit clinically significant levels of affect variability that may contribute to ADHD-related impairment such as homework difficulties. The present study sought to examine the relations between negative and positive affect variability and the two domains of homework problems (i.e., homework management and homework completion) in children with ADHD. It was hypothesized that both negative and positive affect variability would be associated with homework completion and homework management difficulties in children with ADHD. Participants (n = 47) included parents of 7–11-year-old children (M = 8.36, SD = 1.31) with ADHD. During the baseline session, parents completed a structured diagnostic interview and questionnaire measures to assess children’s homework problems, ADHD symptoms, and related psychiatric conditions. Subsequently, parents provided ecological momentary assessments (EMA) ratings of their children’s positive and negative affect three times daily over a one-week period. Results indicate that, while controlling for ADHD symptom severity, positive affect variability was significantly associated with homework management but not completion difficulties in children with ADHD; negative affect variability was not associated with homework problems in either domain. The current study highlights the importance of positive affect regulation in children’s navigation of the homework process, and results suggest that children with ADHD who struggle with homework management difficulties might benefit from homework interventions that incorporate positive affect regulation strategies.

Depressive moods and behaviors are developmentally normative, yet potentially impairing, in preschool-aged children. In addition to frequency, duration of behavior is an important parameter to consider when characterizing risk for worsening mood dysregulation. The goal of this study was to identify the duration and severity of depressive moods and behaviors and associations with impairment in a large community sample of preschool-aged children using an online parent-report daily diary. Primary caregivers ( N  = 900) of 3–5-year-old children reported the daily duration of each instance of seven depressive moods and behaviors for 14 days. We used item response theory analyses to examine duration item characteristics. Moods and behaviors occurred at specific durations to be considered psychometrically severe/rare; for example, instances of sadness had to last an average total of 32 min per day or more, irritability at least 38 min, tantrums at least 30 min, and tearfulness/sensitivity at least 35 min. Longer durations of mood and behavior were associated with daily impairment, as well as older child age and less parental education. To our knowledge, this is the first study to delineate specific duration ranges for depressive moods and behaviors in preschool-aged children. These data, coupled with information about the frequency of mood-related behaviors, can assist child practitioners in differentiating normative patterns from less normative mood problems to evaluate which children may be at risk. Future work should identify the duration of depressive moods and behaviors in early childhood that predict clinically significant psychopathology over time.

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) often experience significant emotion dysregulation. However, there is limited longitudinal data on associations between multiple aspects of emotion dysregulation and ADHD symptoms. Additionally, given substantial evidence that increased levels and variability of negative affect (NA) are identified in children with ADHD, it is important to examine the role of NA in this relationship. The present study used momentary and longitudinal data to examine the relation between two aspects of emotion dysregulation (emotional lability and emotional reactivity), the two ADHD symptom clusters separately (inattentive and hyperactive/impulsive), total ADHD symptom severity, and NA variability over a period of six months. Participants (N = 68) were parents of children aged 7–12 years old (M = 9.80, SD = 1.34) who completed baseline and 6-month follow-up reports of children’s ADHD symptoms and emotion dysregulation as well as ecological momentary assessments (EMA) of their children’s NA for one week. Results were threefold: (1) children’s emotional reactivity predicted inattentive, hyperactive/impulsive, and total ADHD symptom severity above and beyond initial ADHD symptom severity, but emotional lability did not significantly predict severity of any ADHD symptom cluster; (2) NA variability predicted hyperactive/impulsive and total ADHD symptom severity, but not inattentive severity; and (3) initial ADHD symptom severity did not predict emotion dysregulation at follow-up. The current study provides novel insight regarding the longitudinal influence of specific aspects of emotion dysregulation and NA on ADHD symptom severity in children and suggests that targeting emotional reactivity could minimize ADHD symptom severity.

Background Depressive moods and behaviors are developmentally normative, yet potentially impairing, in preschool‐aged children. In addition to frequency, duration of behavior is an important parameter to consider when characterizing risk for worsening mood dysregulation. The goal of this study was to identify the duration and severity of depressive moods and behaviors and associations with impairment in a large community sample of preschool‐aged children using an online parent‐report daily diary. Methods Primary caregivers ( N = 900) of 3–5‐year‐old children reported the daily duration of each instance of seven depressive moods and behaviors for 14 days. We used item response theory analyses to examine duration item characteristics. Results Moods and behaviors occurred at specific durations to be considered psychometrically severe/rare; for example, instances of sadness had to last an average total of 32 min per day or more, irritability at least 38 min, tantrums at least 30 min, and tearfulness/sensitivity at least 35 min. Longer durations of mood and behavior were associated with daily impairment, as well as older child age and less parental education. Conclusions To our knowledge, this is the first study to delineate specific duration ranges for depressive moods and behaviors in preschool‐aged children. These data, coupled with information about the frequency of mood‐related behaviors, can assist child practitioners in differentiating normative patterns from less normative mood problems to evaluate which children may be at risk. Future work should identify the duration of depressive moods and behaviors in early childhood that predict clinically significant psychopathology over time.

OBJECTIVE:Irritability symptoms are closely associated with, and may reflect, temperament traits, particularly negative affectivity (NA). However, there are few empirical data on the relationships between child temperament and irritability symptoms.METHOD:We investigated cross-sectional and longitudinal relationships between irritability symptoms and temperament traits from age 3-15 in a community sample of 609 children and their parents. Irritability symptoms were assessed through structured interviews with parents at ages 3/6, and inventories completed by parents and youth at ages 12/15. Temperament traits were assessed using parent reports at ages 3/6, and parent and child reports at ages 12/15. Path analysis and structural equation modeling were used to explore longitudinal associations from ages 3-6 and 12-15, respectively.RESULTS:Higher levels of irritability symptoms at ages 3/6 were concurrently associated with higher levels of NA and lower levels of effortful control (EC). In adolescence, higher irritability symptoms were concurrently associated with higher negative temperament and disinhibition. In longitudinal analyses from age 3-6 and 12-15, irritability symptoms showed modest but significant stability after adjusting for the stability of temperament traits. However, there were significant differences in the stability paths at age 3-6, reflecting lower stability of irritability symptoms. Finally, EC at age 3 predicted increased irritability symptoms at age 6, while irritability symptoms at age 3 predicted increased NA at age 6.CONCLUSION:Irritability symptoms are robustly associated with both temperamental NA and difficulty regulating attention and behavior. These findings help situate irritability symptoms within widely accepted temperament/personality taxonomies.

Over a quarter of children with Attention-deficit/hyperactivity disorder (ADHD) meet diagnostic criteria for an anxiety disorder as well. The goals of this paper are (a) to examine what is currently known about co-occurring ADHD and anxiety in children, (b) propose and outline underlying factors relevant to the development of anxiety in children with ADHD, and (c) discuss future directions and clinical implications for the prevention and identification of anxiety development in children with ADHD. It is proposed that certain associated features of ADHD (i.e., low effortful control and emotion dysregulation) as well as various interpersonal factors related to ADHD (i.e., poor parent, teacher, and peer relationships) form a negative feedback loop that increases susceptibility to anxiety in a subset of children with ADHD. The literature supports interrelations between and across the associated features and interpersonal factors. Additional research is needed to test the validity of the proposed process. Obtaining further insight into the interplay between these different factors can help identify a subset of children with ADHD who are at risk for developing anxiety, which can enhance the precision of prevention, assessment, and treatment efforts for these children.

Anxiety and depressive difficulties can emerge during early childhood and cause impairment in functioning. Anxiety and depressive behaviors and impairment are typically assessed with global questionnaires that require recall of children’s behavior over an extended period which could reduce the accuracy of parent report of children’s behavior and functioning. The current study compared parents’ report of children’s anxiety and depressive behaviors and impairment when evaluated with global measures versus a daily diary measure. Participants (N = 901 parents of 3-5-year-old children) completed global and daily measures of children’s behavior and impairment during enrollment to the study. Global measures were completed at baseline and the 14 daily diary measures were completed consecutively for two weeks. Across most measures, daily associations between parent-reported anxiety and depressive behaviors and impairment were stronger compared to associations with global measures. These results suggest that daily measures may better capture links between young children’s typical behavior and functioning compared to global measures. In addition, daily assessment might be more effective for measuring mild to moderate yet still impairing behaviors that may be missed on global reports that require longer periods of recall.

OBJECTIVE:Irritability is a common and clinically important problem in children and adolescents and a risk factor for later psychopathology and impairment. Irritability can manifest in both tonic (e.g., irritable, touchy mood) and phasic (e.g., temper outburst) forms, and recent studies of adolescents suggest that they predict different outcomes. However, no studies have examined whether tonic and phasic irritability are empirically distinguishable in 6-year-old children and whether they have distinct correlates and outcomes.METHOD:We utilized data from a longitudinal study of an unselected community sample of four hundred fifty-two 6-year-olds followed at 3-year intervals to age 15. We conducted confirmatory factor analysis (CFA) using relevant items from a diagnostic interview and several parent-report inventories.RESULTS:The CFA identified dimensions that were consistent with tonic and phasic irritability. Tonic irritability was independently associated with concurrent parent-reported temperamental negative affectivity and internalizing and externalizing disorders at age 6 and predicted higher rates of internalizing psychopathology, and suicidal ideation, in adolescence. Phasic irritability was independently associated with concurrent parent-reported temperamental negative affectivity, surgency, and low effortful control, maladaptive parenting styles and practices, and externalizing disorders at age 6, and predicted higher rates of externalizing psychopathology in adolescence.CONCLUSIONS:Tonic and phasic irritability in 6-year-old children appear to be distinguishable constructs with different temperament and parenting correlates and psychopathological outcomes. Distinguishing these components has implications for research on the etiology and pathophysiology of irritability and developing effective treatments.

Irritability is a common and clinically important problem in children and adolescents and a risk factor for later psychopathology and impairment. Irritability can manifest in both tonic (e.g., irritable, touchy mood) and phasic (e.g., temper outburst) forms, and recent studies of adolescents suggest that they predict different outcomes. However, no studies have examined whether tonic and phasic irritability are empirically distinguishable in 6-year-old children and whether they have distinct correlates and outcomes. We utilized data from a longitudinal study of an unselected community sample of four hundred fifty-two 6-year-olds followed at 3-year intervals to age 15. We conducted confirmatory factor analysis (CFA) using relevant items from a diagnostic interview and several parent-report inventories. The CFA identified dimensions that were consistent with tonic and phasic irritability. Tonic irritability was independently associated with concurrent parent-reported temperamental negative affectivity and internalizing and externalizing disorders at age 6 and predicted higher rates of internalizing psychopathology, and suicidal ideation, in adolescence. Phasic irritability was independently associated with concurrent parent-reported temperamental negative affectivity, surgency, and low effortful control, maladaptive parenting styles and practices, and externalizing disorders at age 6, and predicted higher rates of externalizing psychopathology in adolescence. Tonic and phasic irritability in 6-year-old children appear to be distinguishable constructs with different temperament and parenting correlates and psychopathological outcomes. Distinguishing these components has implications for research on the etiology and pathophysiology of irritability and developing effective treatments.

Anxiety disorders are among the most common disorders in early childhood. Although many older children and adolescents with anxiety disorders recover and remain well, little is known about the continuity of early childhood anxiety and the factors that predict persistence/recurrence in later childhood and adolescence. We followed 129 children who met anxiety disorder criteria at age 3 and/or 6 and determined how many continued to experience an anxiety disorder between age 7 and 15, as well as the continuity of specific anxiety disorders. We explored whether biological sex, number of anxiety disorders, early childhood persistence (i.e., anxiety diagnosis at both age 3 and 6), childhood comorbidities, temperamental behavioral inhibition, a maternal history of anxiety, and authoritarian and overprotective parenting predicted persistence/recurrence of an anxiety disorder from age 7 to 15. Sixty-five (50.4%) of the adolescents with an early childhood anxiety disorder met anxiety disorder criteria during the age 7-15 interval. Homotypic continuity from early childhood to school-age/mid-adolescence was observed for social anxiety disorder, separation anxiety disorder, and generalized anxiety disorder (GAD). Early childhood agoraphobia predicted school-age/mid-adolescent GAD and early childhood GAD predicted school-age/mid-adolescent specific phobia. In bivariate analyses, number of anxiety disorders, persistence of anxiety from age 3 to 6, and having a mother with a history of anxiety predicted the persistence/recurrence of anxiety disorders from age 7 to 15. Only early childhood persistence of anxiety uniquely predicted the persistence/recurrence of an anxiety disorder over and above the other predictors. Early intervention efforts should focus on identifying and intervening with young children who demonstrate a protracted course of anxiety.

Parental factors, including parenting behavior, parent mental health, and parent stress, are associated with child stress. More recently, studies have shown that these parental factors may also be associated with children's hair cortisol concentration (HCC). HCC is a novel biomarker for chronic stress. HCC indexes cumulative cortisol exposure thereby reflecting longer-term stress reactivity. Although HCC is associated with a range of problems in adults such as depression, anxiety, appraisal of stressful events, and diabetes, studies investigating HCC in children have been inconsistent, with particularly little information about parental factors and HCC. As chronic stress may have long-term physiological and emotional effects on children, and parent-based interventions can reduce these effects, it is important to identify parental factors that relate to children's HCC. The aim of this study was to examine associations between preschool-aged children's physiological stress measured via HCC and mother-and father-reported parenting behavior, psychopathology, and stress. Participants included N = 140 children ages 3-5-years-old and their mothers (n = 140) and fathers (n = 98). Mothers and fathers completed questionnaire measures on their parenting behavior, depressive and anxiety symptoms, and perceived stress. Children's HCC was assessed by processing small hair samples. HCC levels were higher in boys compared to girls, and higher in children of color compared to white children. There was a significant association between chil-dren's HCC and fathers' authoritarian parenting. Children's HCC was positively associated with physical coer-cion, a specific facet of fathers' authoritarian parenting, even after accounting for sex of the child, race/ethnicity of the child, stressful life events, fathers' depression, fathers' anxiety, and fathers' perceived stress. In addition, there was a significant interaction between higher levels of both mothers' and fathers' authoritarian parenting and children's HCC. Children's HCC was not significantly related to mothers' and fathers' anxiety and depression or mothers' and fathers' perceived stress. These findings contribute to the large literature that links harsh and physical parenting practices with problematic outcomes in children.

In recent years, epidemiological and clinical studies have revealed that depressive disorders can present in early childhood. To clarify the validity and prognostic significance of early childhood-onset depression, we investigated diagnostic and functional outcomes in later childhood and adolescence. A community sample ( N  = 516) was assessed for psychopathology at ages 3 and 6 using the Preschool Age Psychiatric Assessment. When participants were 9, 12, and 15 years old, children and parents completed the Kiddie Schedule for Affective Disorders and Schizophrenia and measures of symptoms and functioning. In models adjusting for covariates, depressed 3/6-year-old children were more likely to experience subsequent episodes of depressive disorders and exhibited significantly higher rates of later anxiety disorder, attention deficit hyperactivity disorder, and suicidality compared to children without depressive disorders at age 3/6. Early childhood depression was also associated with higher levels of mother, but not child, reported depressive symptoms at age 15 compared to children without depressive disorders at age 3/6. Finally, depression at age 3/6 predicted lower levels of global and interpersonal functioning and higher rates of treatment at age 15 compared to children without depressive disorders at age 3/6. Results support the clinical significance of depression in 3/6-year-old children, although further studies with larger samples are needed.

Eating disorders (ED) are highly impairing and dangerous conditions that typically onset in adolescence. However, very few prospective studies have examined early childhood risk factors for ED pathology. Given well established links between temperament and psychopathology, examination of these factors could inform prevention efforts. The current multi-method, multi-informant prospective longitudinal study tested whether laboratory-observed and parent-reported temperament and psychiatric disorders at ages 3 and 6 (N = 609) predict body dissatisfaction at ages 12 and 15 and dimensional symptoms of EDs (anorexia nervosa [AN] and bulimia nervosa [BN]) at age 15 (n = 458) in a community sample. Results indicated that early childhood temperament (positive and negative emotionality, perceptual sensitivity, impulsivity, less shyness) and childhood psychopathology (anxiety, oppositional defiant, attention deficit/hyperactivity, and depressive disorders), predicted body dissatisfaction in adolescence. In addition, childhood perceptual sensitivity and oppositional defiant and depressive disorders predicted AN symptoms. Demographic characteristics (female sex, lower levels of fathers' education, and parental marital status) in childhood predicted body dissatisfaction and AN symptoms. No temperament or psychopathology variables predicted BN symptoms. This study is an important first step toward continuing to identify areas of focus for future research on early childhood risk factors for ED symptoms and body dissatisfaction.

Irritability encompasses both normative misbehavior in early childhood and clinically significant problems across development. Recent studies have distinguished between tonic (i.e., persistently angry or grumpy mood) and phasic (i.e., temper tantrums or outbursts) forms of irritability and shown that they have different implications for psychopathology and functioning. However, data on this distinction in young (i.e., preschool aged) children are nonexistent. We utilized data from a longitudinal study of a community sample of 462 3-year-olds followed to age 15. We conducted confirmatory factor analysis (CFA) using items from a diagnostic interview and several parent-report inventories and examined concurrent and prospective associations with clinically relevant variables. The CFA identified dimensions consistent with tonic and phasic irritability. Tonic irritability was independently associated with concurrent parent-reported temperamental negative affectivity and surgency, and depressive and oppositional defiant (ODD) disorders, and predicted higher rates of disruptive behavior disorders (DBD) and suicidal behavior in later childhood and adolescence. Phasic irritability was independently associated with concurrent laboratory observations of child impulsivity, parent-reported temperamental negative affectivity, surgency, and low effortful control, maladaptive parenting, and generalized anxiety disorder (GAD), attention-deficit hyperactivity disorder (ADHD), and ODD, but it did not predict later psychopathology. Tonic and phasic irritability are separable in 3-year-old children, but their correlates and outcomes are not as distinct as in older youth. This may reflect the greater difficulty characterizing normative and pathological irritability in the preschool period.