Pablo Vidal-Ribas

Heart rate variability (HRV) is widely studied as a physiological marker of autonomic and emotional regulatory processes and is increasingly explored as a physiological signal for inferring affective states in digital health applications. However, it remains unclear whether HRV reliably tracks short-term mood changes and, more broadly, whether physiological signals capture moment-to-moment emotional dynamics. To address this question, we conducted a preregistered systematic review and multilevel meta-analysis of experimental studies examining HRV responses to induced positive and negative mood changes (85 studies, 165 effect sizes, n = 4,341 participants). Across studies, HRV overall decreased following negative mood induction (d = -0.179, p = 0.002), and increased following positive mood induction (d = 0.228, p = 0.009); however, substantial heterogeneity was observed across studies. Subgroup analyses indicated that the association of HRV-mood coupling depended on both physiological and experimental factors, with significant effects observed when the root mean square of successive differences (RMSSD) was used as the HRV metric, while other commonly used HRV metrics did not show HRV-mood change associations. Age and gender composition of the samples did not moderate these associations. By identifying the conditions under which HRV tracks positive and negative mood changes, this meta-analysis clarifies when HRV may reflect short-term affective dynamics and establishes its potential as a physiological correlate of mood.

BackgroundSome people experience mood changes when hungry. However, the relevance of this phenomenon to clinical conditions, such as depression and eating disorders, is understudied. Therefore, we devised a questionnaire to measure hunger-related mood dysregulation.MethodsWe developed and validated the Mood, Emotions and Appetite List (MEAL) using exploratory and confirmatory factor analysis in adults and adolescents in the community, and adults with a history of mental health disorder (N = 1,119). We examined the association of MEAL scores with happiness, frustration and boredom during the frustration-inducing mood drift task, in which participants wait for six minutes and rate their mood every 30 seconds.ResultsThe MEAL showed good psychometric properties, capturing three factors for hunger-related ‘irritability’, ‘low mood’ and ‘somatic feelings’ (RMSEA = 0.03 in community adults, 0.05 in community adolescents, 0.08 in adults with mental health disorder history). Quantitative and qualitative responses evidenced that hunger-related mood dysregulation impacts relationships, work and other activities. MEAL scores were associated with irritability, depression, anxiety and menstrual symptoms. In the mood drift task, the irritability subscale (MEAL-i) demonstrated a significant interaction with time, such that individuals with higher MEAL-i scores reported steeper decreases in happiness (B = -0.11; 95% CI: -0.16–-0.06) and steeper increases in boredom (B = 0.06; 95% CI: 0.00–0.12) and frustration (B = 0.12; 95% CI: 0.05–0.19).ConclusionsThe MEAL measures individual differences in hunger-related mood dysregulation, is associated with mental health, self-reported functioning, and predicts faster worsening of mood during experimentally induced frustration.

Background: While irritability is associated with poor psychosocial functioning and high use of mental health services, research in this area has predominantly focused on the US and the UK, leaving a significant gap in our understanding of its presentation among adolescents globally. This study explores cross‐national aspects of adolescent irritability using self‐report data, examining gender differences and associations with mental health symptoms, bullying, life satisfaction, and socioeconomic status. Method: We utilized linear mixed‐effects models to examine data from the Programme for International Student Assessment, analyzing a large sample ( n = 56,324, 50.5% females) from nine countries: Bulgaria, Georgia, China, Ireland, Mexico, Panama, Serbia, Spain, and the United Arab Emirates. Adolescents' mean age was 15.81 years ( SD : 0.29, range: 15.25–16.33). Results: Irritability showed little variation across countries, with ~30.3% to 44.9% reporting ‘rarely or never’, ~10% reported daily irritability, and over 30% reporting irritability weekly. Females reported higher irritability than males ( b = −0.46). Positive correlations were found between irritability and symptoms of depression. Associations with life satisfaction and bullying varied by country, with negative links in China and the United Arab Emirates, and stronger bullying links in China and Bulgaria. No significant associations were found with socioeconomic status. Conclusions: We find consistency of adolescent irritability in nine large samples across diverse countries. Variations in the relationships between irritability, bullying, and life satisfaction underscore the influence of country‐specific factors. These findings stress the importance of global mental health initiatives to address adolescent irritability effectively.

Background: Obsessive-compulsive disorder (OCD) and autism spectrum disorder (ASD) often co-occur and have overlapping symptom profiles. Detection and diagnosis of ASD in youth with OCD can therefore be challenging but is crucial to inform care planning. Aim: The current study aimed to provide a psychometric evaluation of the Social Communication Questionnaire (SCQ), a widely used parent-report measure for assessing ASD traits, in youth with OCD. Method: In total, 484 young people with an ICD-10 diagnosis of OCD completed a battery of measures as part of a specialist clinical assessment. Results: Exploratory factor analyses (EFA) suggested a multidimensional factor solution for the SCQ, although an adequate factor solution was not identified due to cross-loading and/or weak loading items. The SCQ had good internal consistency (KR20 = 0.85), and good convergent validity with the Strengths and Difficulties Questionnaire (SDQ) Prosocial Behaviour subscale ( r = −0.52) and Peer Problems subscale ( r = 0.48). The SCQ differentiated those with versus without a clinical diagnosis of ASD with reasonable accuracy (area under the curve = .76). Discussion: The current findings support the use of the SCQ as a measure of ASD traits in youth with OCD, suggesting that this quick and easy-to-administer measure could aid detection of ASD in this population.

Background: Most research on pediatric irritability focuses on children and/or relies on parent reports. We examined how self-reported irritability in adolescents influences the prevalence, sex distribution and correlates of irritability relative to children and parent reports. Methods: Using data from Mental Health of Children and Young People Survey 2017 in England we contrasted the prevalence of irritability, encompassing irritable mood and temper outbursts, in 2,740 adolescents aged 12–17 (50.3% females), based on parent- and self-report, with that of 4,141 children aged 5–11 (49.4% females) based on parent-report. We examined associations of irritability with mental health problems and impairment. Results: Parents reported similar prevalence of irritability in adolescent males (14–23%) and females (14–22%), but higher levels of irritability in males (20–25%) than females (15–19%) during childhood. In contrast, adolescent females self-reported more irritable mood (29%, 95%CI 26–31) than males (23%, 95%CI 20–25) and parents. Self-reported irritability in adolescent females was associated with greater emotional problems (irritable mood, b = 0.27, SE = 0.10, p = 0.011; temper outbursts: b = 0.25, SE = 0.11, p = 0.022) and impairment (irritable mood, b = 0.31, SE = 0.10, p = 0.001; temper outbursts: b = 0.31, SE = 0.08, p < 0.001) compared to males. Irritable mood in adolescent females was associated with a higher increase of psychiatric disorders (b = 0.35, SE = 0.15, p = 0.020) compared to males. Conclusions: Age, sex, and informant are sources of heterogeneity in irritability reporting, and must be considered in the assessment and understanding of irritability-related psychopathology. Longitudinal design studies with comprehensive assessments of irritability across a broad age range are warranted to elucidate its developmental trajectory and causal relationships with other psychopathological symptoms.

Adolescence is a critical developmental period during which internalizing disorders, such as depression and anxiety, frequently emerge. This editorial highlights six studies from this issue that investigate the complex interplay of genetic, physiological, cognitive, social, and environmental factors contributing to these disorders. By employing robust methods, these studies inform on mechanisms and trajectories, enhancing the identification of high‐risk individuals for targeted interventions. Together, these studies emphasize the importance of nuanced, multi‐factorial approaches in advancing research and practice in adolescent internalizing psychopathology. Nevertheless, future research must prioritize diverse samples, dynamic longitudinal designs, and multi‐informant approaches to increase generalizability and impact.

Irritability, defined as proneness to anger that may reach an impairing extent, is common in youth. There has been a recent upsurge in relevant research. We combine systematic and narrative review approaches to integrate the latest clinical and translational findings and provide suggestions to address research gaps. Clinicians and researchers should assess irritability routinely; specific assessment tools are now available. Informant effects are prominent, stable, and vary by age and gender. The prevalence of irritability is particularly high in attention deficit hyperactivity disorder, autism spectrum disorder, and mood and anxiety disorders. Irritability is associated with impairment and suicidality risk independent of co-occuring diagnoses. Irritability trajectories have been identified that are differentially associated with clinical outcomes; some begin early in life. Youth irritability is associated with increased risk later in life for anxiety, depression, behavioral problems, and suicidality. Irritability is moderately heritable and genetic associations differ based on age and comorbid illnesses. Parent management training is effective for constructs related to irritability, but its efficacy in irritability should be tested rigorously, as should novel mechanism-informed interventions (e.g., those targeted to frustration exposure). Associations between irritability and suicidality and the impact of cultural context are important, under-researched topics. Large, diverse, longitudinal samples that extend into adulthood are needed. Data from both animal and human research indicate that aberrant responses to frustration and threat are central to the pathophysiology of irritability, thus affording important translational opportunities.