A large multinational study of irritability in adolescents

Jamilah Silver; Ellen Leibenluft; Wan‐Ling Tseng; Daniel N. Klein; Pablo Vidal‐Ribas; Reut Naim; Praveetha Patalay; Eoin McElroy; Argyris Stringaris

doi:10.1111/camh.70008

A large multinational study of irritability in adolescents

Jamilah Silver
, Ellen Leibenluft
, Wan‐Ling Tseng
, Daniel N. Klein
, Pablo Vidal‐Ribas
, Reut Naim
, Praveetha Patalay
, Eoin McElroy
, Argyris Stringaris

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

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.

Original language	English
Pages (from-to)	352-363
Number of pages	12
Journal	Child and Adolescent Mental Health
Volume	30
Issue number	4
Early online date	29 Jul 2025
DOIs	https://doi.org/10.1111/camh.70008
Publication status	Published (in print/issue) - 30 Nov 2025

Bibliographical note

Publisher Copyright:
© 2025 Association for Child and Adolescent Mental Health.

Data Availability Statement

The PISA data used in this study is publicly accessible on the OECD website. Researchers can access the data-sets through the PISA data portal, with the option to download individual country data ﬁles. Please note that access to certain detailed student-level information may require a restricted-use data access application due to conﬁdentiality requirements

Funding

Support for this research was provided through the Wellcome Trust (Stringaris). Dr. Vidal‐Ribas is supported by grant RYC2021‐033369‐I, funded by MCIN/AEI/ 10.13039/501100011033 and the European Union «NextGenerationEU/PRTR» and the CERCA program/Generalitat de Catalunya.

Funders
Wellcome Trust
European Commission

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Irritability
adolescence
developmental psychopatholgy
depression
developmental psychopathology
Humans
Male
Personal Satisfaction
Depression/epidemiology
Bullying/statistics & numerical data
Adolescent
Sex Factors
Female
Adolescent Behavior
Irritable Mood/physiology

Access to Document

10.1111/camh.70008

Cite this

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title = "A large multinational study of irritability in adolescents",

abstract = "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 \textasciitilde{}30.3\% to 44.9\% reporting {\textquoteleft}rarely or never{\textquoteright}, \textasciitilde{}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.",

keywords = "Irritability, adolescence, developmental psychopatholgy, depression, developmental psychopathology, Humans, Male, Personal Satisfaction, Depression/epidemiology, Bullying/statistics \& numerical data, Adolescent, Sex Factors, Female, Adolescent Behavior, Irritable Mood/physiology",

author = "Jamilah Silver and Ellen Leibenluft and Wan‐Ling Tseng and Klein, \{Daniel N.\} and Pablo Vidal‐Ribas and Reut Naim and Praveetha Patalay and Eoin McElroy and Argyris Stringaris",

note = "Publisher Copyright: {\textcopyright} 2025 Association for Child and Adolescent Mental Health.",

year = "2025",

month = nov,

day = "30",

doi = "10.1111/camh.70008",

language = "English",

volume = "30",

pages = "352--363",

journal = "Child and Adolescent Mental Health",

issn = "1475-357X",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "4",

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T1 - A large multinational study of irritability in adolescents

AU - Silver, Jamilah

AU - Leibenluft, Ellen

AU - Tseng, Wan‐Ling

AU - Klein, Daniel N.

AU - Vidal‐Ribas, Pablo

AU - Naim, Reut

AU - Patalay, Praveetha

AU - McElroy, Eoin

AU - Stringaris, Argyris

PY - 2025/11/30

Y1 - 2025/11/30

N2 - 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.

AB - 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.

KW - Irritability

KW - adolescence

KW - developmental psychopatholgy

KW - depression

KW - developmental psychopathology

KW - Humans

KW - Male

KW - Personal Satisfaction

KW - Depression/epidemiology

KW - Bullying/statistics & numerical data

KW - Adolescent

KW - Sex Factors

KW - Female

KW - Adolescent Behavior

KW - Irritable Mood/physiology

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UR - https://www.scopus.com/pages/publications/105012133809

U2 - 10.1111/camh.70008

DO - 10.1111/camh.70008

M3 - Article

C2 - 40729444

SN - 1475-357X

VL - 30

SP - 352

EP - 363

JO - Child and Adolescent Mental Health

JF - Child and Adolescent Mental Health

IS - 4

ER -

A large multinational study of irritability in adolescents

Abstract

Bibliographical note

Data Availability Statement

Funding

UN SDGs

Keywords

Access to Document

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Cite this