The relationships of anxiety sensitivity and youth irritability: the mediated roles of insomnia and selective attention for threat

Background: Irritability is common in multiple psychiatric disorders and is hallmark of disruptive mood dysregulation disorder. Child irritability is associated with higher risk of suicide and adulthood mental health problems. However, the psychological mechanisms of irritability are understudied. This study examined the relationship between anxiety sensitivity and irritability among youth, and further explored three possible mediated factors: selective attention for threat, delayed reward discounting, and insomnia.
Methods: Participants were 1417 students (51.7% male; mean age 13.83 years, SD = 1.48) recruited from one high school in Hunan province, China. Self-report questionnaires were used to measure irritability, anxiety sensitivity, selective attention for threat, insomnia, and delayed reward discounting. Structural equation modal (SEM) was performed to examine mediated relations and further explore possible moderate effects of sex and age.
Results: Anxiety sensitivity was modestly related to irritability and insomnia (r from 0.25 to 0.54) and slightly correlated with selective attention for threat (r from 0.12 to 0.28). However, there is no significant relationship of delayed rewards discounting with anxiety sensitivity and irritability. The results of SEM showed that selective attention for threat (indirect effect estimate = 0.04) and insomnia (indirect effect estimate = 0.20) partially mediate the relationship between anxiety sensitivity and irritability, which explained 33% variation. Compared to females, the indirect effect of insomnia is stronger in males.
Conclusions: Anxiety sensitivity is an important susceptibility factor for irritability. Selective attention for threat and insomnia are two mediated mechanisms to understand the relationship between anxiety sensitivity and irritability.

背景：易怒在多种精神疾病中普遍存在，并被视为破坏性情绪调节障碍的标志性特征。儿童易怒与自杀风险增加及成年期心理健康问题密切相关。然而，易怒的心理机制尚未得到充分研究。本研究旨在探讨焦虑敏感性与青少年易怒之间的关系，并进一步探索三个可能的调节因素：对威胁的选择性注意、延迟奖励折价和失眠。方法：研究对象为1417名学生（男性占比51.7%，平均年龄13.83岁，标准差为1.48），均来自中国湖南省的一所高中。采用自我报告问卷测量易怒、焦虑敏感性、对威胁的选择性注意、失眠和延迟奖励折价。通过结构方程模型（SEM）分析中介关系，并进一步探讨性别和年龄的可能调节效应。结果：焦虑敏感性与易怒及失眠（相关系数范围为0.25至0.54）存在适度相关性，与对威胁的选择性注意（相关系数范围为0.12至0.28）略有相关性。然而，延迟奖励折价与焦虑敏感性和易怒之间没有显著关系。SEM的结果显示，对威胁的选择性注意（间接效应估计值为0.04）和失眠（间接效应估计值为0.20）在焦虑敏感性与易怒之间部分中介了这种关系，解释了33%的变异。与女性相比，失眠在男性中的间接效应更强。结论：焦虑敏感性是易怒的重要易感因素。对威胁的选择性注意和失眠是理解焦虑敏感性与易怒之间关系的两种中介机制。