This study aims to characterize key mechanisms underlying the development, maintenance, and treatment of severe irritability in a clinically heterogeneous sample of school-aged youth.

Severe irritability in youth is associated with significant functional impairment and occurs across diagnostic categories. This study aims to characterize key mechanisms underlying the development, maintenance, and treatment of severe irritability in a clinically heterogeneous sample of school-aged youth. Participants will complete (a) a comprehensive, multimodal assessment - including diagnostic interviews, multi-informant behavioral ratings, and neurophysiological tasks - to evaluate core cognitive, behavioral, and psychosocial factors, and (b) evidence-based treatment (e.g., cognitive behavioral therapy). Repeated assessments throughout the study period will be used to evaluate study outcomes.

Inclusion Criteria:

• Children between the ages of 4-17 years
• (a) a principal diagnosis of an anxiety or mood disorder per DSM-5 criteria, OR (b) parent report of clinically impairing irritability, emotional dysregulation, and/or disruptive behavior in youth
• Child and parent must be able to complete consent documents, assessments, and participate in treatment in English without a translator
• At least one parent must be available and willing to participant in both phases.

Exclusion Criteria:

• Gross neurological, sensory, or motor impairment
• History of seizure disorder, psychosis, or organic brain syndrome
• Conditions requiring acute intervention, e.g., active suicidality
• Non-English speaking child or parent