The Clinician Affective Reactivity Index: Validity and Reliability of a Clinician-Rated Assessment of Irritability

Behav Ther. 2020 Mar;51(2):283-293. doi: 10.1016/j.beth.2019.10.005. Epub 2019 Nov 27.


Irritability is impairing in youth and is the core feature of disruptive mood dysregulation disorder (DMDD). Currently, there are no established clinician-rated instruments to assess irritability in pediatric research and clinical settings. Clinician-rated measures ensure consistency of assessment across patients and are important specifically for treatment research. Here, we present data on the psychometric properties of the Clinician Affective Reactivity Index (CL-ARI), the first semistructured interview focused on pediatric irritability. The CL-ARI was administered to a transdiagnostic sample of 98 youth (M age = 12.66, SD = 2.47; 41% female). With respect to convergent validity, CL-ARI scores were (a) significantly higher for youth with DMDD than for any other diagnostic group, and (b) showed uniquely strong associations with other clinician-, parent-, and youth-report measures of irritability compared to measures of related constructs, such as anxiety. The three subscales of the CL-ARI (temper outbursts, irritable mood, impairment) showed excellent internal consistency. Test-retest reliability of the CL-ARI was adequate. These data support that irritability can be feasibly, validly, and reliably assessed by clinicians using the CL-ARI. A validated, gold-standard assessment of pediatric irritability is critical in advancing research and treatment efforts.

Trial registration: NCT00006177 NCT00025935 NCT00018057 NCT02531893.

Keywords: clinician; irritability; measurement; reliability; validity.

Publication types

  • Research Support, N.I.H., Intramural
  • Validation Study

MeSH terms

  • Adolescent
  • Anxiety / psychology
  • Attention Deficit and Disruptive Behavior Disorders / psychology*
  • Child
  • Child Behavior Disorders / diagnosis*
  • Female
  • Humans
  • Interview, Psychological / standards*
  • Irritable Mood*
  • Male
  • Mood Disorders / diagnosis*
  • Psychometrics
  • Reproducibility of Results

Associated data