Understanding Predictors of Adolescent Well-Being in a Digital Age: A Focus on Digital Skills and Mental Health Literacy.

Elevated irritability is characterized by a heightened proneness to anger and frustration relative to peers (). While irritability exists on a developmentally typical: clinically impairing spectrum, elevated childhood irritability predicts subsequent adolescent and adult psychopathology, including anxiety disorders, mood disorders, and suicidality (; ; ). Typical trajectories of irritability across development indicate peaks during both preschool and adolescence years, coinciding with critical emotional and social development periods (). Leveraging data from the large, nationwide Adolescent Brain Cognitive Development (ABCD) study, observed four trajectories of irritability symptoms across early adolescence: low-stable, low-increasing, high-decreasing, and high-chronic. These trajectories are not unique to early adolescence; similar trajectories of irritability have been observed during toddlerhood and childhood (; ). Nonetheless, increasing irritability symptom levels during early adolescence have been shown to predict greater interpersonal and mental health impairment at age 18, over and above initial irritability symptom levels (). Moreover, preadolescence represents an inflection point in irritability symptoms when trajectories can diverge and vastly vary (; ) and is thus a crucial potential intervention point to curb increases in irritability and the development of psychopathology into adolescence. Thus, examining the trajectories of irritability symptoms provides valuable insights into the progression and resolution of irritability during critical developmental periods. This understanding of symptom trajectories is crucial for developing targeted interventions that can reduce the risk of future mental health impairments associated with increased irritability. While evidence has suggested early adolescence as a pivotal point in irritability development (; ), little is known of the neural mechanisms behind these diverging pathways in irritability symptoms. One potential mechanism of differing trajectories of irritability is inhibitory control. Children with elevated irritability and related symptoms (e.g. disruptive behavior or anger) have demonstrated greater difficulty stopping or inhibiting prepotent responses (; ; ). Previous neuroimaging research has largely supported this association, as youth with elevated irritability have demonstrated increased prefrontal activation (; ) as well as decreased amygdala (), superior temporal (), and pre/post central gyri (; ) activation during inhibitory control tasks. While there have been few studies, alterations in neural network connectivity have also been observed during inhibitory control tasks in youth with elevated irritability (; ; ). Specifically, research in the ABCD study has instead observed decreased connectivity among amygdalae, striatal, and frontal regions () and decreased coactivation (an analytic proxy for connectivity) among frontal, parietal, and occipital regions (). Notably, though differences in neural connectivity during inhibitory control in youth with elevated irritability have been consistently observed, research on neural activation has not always produced significant associations (; ; ). As neural regions are deeply interconnected, disruptions in neural networks may serve as a more sensitive indicator of functional impairments than activation alone. Youths with elevated irritability may be less able to restrain exaggerated temper responses due to impaired inhibitory control, because the regions implicated in irritability and inhibitory control networks aberrations overlap with emotion regulation regions, including amygdala and prefrontal cortex. Moreover, during the transition from preadolescence to adolescence, reward and emotion processing systems mature at a faster rate than executive control systems (), making reward and emotion processing regions even more difficult to down-regulate. Thus, increased inhibitory control efficiency during preadolescence may modulate the developmentally normative increase in reward sensitivity and aid in the prevention of continuing or developing clinical levels of irritability. Research across youth psychopathology supports inhibitory control as a potential protective mechanism. For example, increased inhibitory control ability has been demonstrated to reduce the risk of the development of internalizing symptoms in youth following adverse experiences (; ) and in offspring of parents with depression (). Taken together, the evidence supports inhibitory control as a factor in irritability and suggests that, as with other forms of psychopathology, inhibitory control may serve a potential role in buffering against the escalation of irritability during early adolescence.