Editorial: Neuropsychological Correlates of Irritability Accompanying Symptoms of Attention-Deficit/Hyperactivity Disorder: Clues and Pitfalls

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders and is characterized by developmentally inappropriate, pervasive, and impairing symptoms of inattention and/or hyperactivity/impulsivity.1 Although not listed among the core symptoms, irritability, reduced tolerance to frustration, and labile mood are considered features associated with ADHD.1,2 Irritability refers to a tendency to get angry quickly and/or easily at a lower threshold of frustration and respond disproportionately to triggers.3 Almost two-thirds of youth with ADHD may display impairing irritability, while rates of ADHD may be elevated among youth with clinically significant irritability.2 Irritability and impulsivity are thought to share neurobiological mechanisms that may overlap with executive and self-regulatory functions such as inhibitory control.3-5 The nature and developmental stability of these associations are still debated. Areas of controversy include the role of emotion regulation problems in positive vs negative emotions for impairment6; relations between those problems and risk-taking behavior, hyperactive-impulsive symptoms, and disruptive behavior problems2-5; and the nature of emotion regulation problems (ie, as core symptoms, as a feature of a variant of ADHD, or as a characteristic of specific comorbidities such as depression).2.