Severe Irritability in Youth, National 4H Conference Center, Friday, 20. September 2019

This training is only open to mental health professionals. 3 Category 1 CEUs*
Severe irritability is one of the most common reasons that children present for mental health care; however, few effective treatments are available.  Developing targeted, mechanism-based interventions is particularly essential given the new DSM-5 diagnosis of Disruptive Mood Dysregulation Disorder (DMDD).  To address this pressing public health need, this presentation will describe a translational neuroscience model of irritability that operationalizes the clinical phenotype and guides the development of novel interventions (Brotman et al., 2017).  In this model, pathological irritability is conceptualized as aberrant emotional and behavioral responding to frustrative nonreward and threat.  This conceptualization provides tractable pathophysiological treatment targets, emerging directly from imaging studies.  Specifically, the circuitry mediating frustration and threat involves perturbations in the prefrontal cortex, striatum, and amygdala.  Based on this pathophysiological work, two novel treatments have been developed:  an exposure-based cognitive behavioral therapy and a computer-based interpretation bias training.  The treatments will be described and preliminary efficacy data from both studies will be presented.


1.  Define irritability and the clinical presentation of Disruptive Mood Dysregulation Disorder (DMDD) in youth.
2.  Identify pathophysiological markers associated with irritability.
3.  Discuss novel mechanism-based treatments for irritability in children and adolescents
4.  Present ways to leverage technology (e.g., mobile based applications) to gather clinical information


Dr. Melissa A. Brotman is the Director of the Neuroscience and Novel Therapeutics Unit in the Emotion and Development Branch at the National Institute of Mental Health (NIMH). Dr. Brotman received her Ph.D. in clinical psychology from the University of Pennsylvania, where she specialized in cognitive behavioral therapy for mood and anxiety disorders.  After completing her clinical internship at the Veterans Affairs Maryland Health Care System/University of Maryland-Baltimore, she completed post-doctoral training in neuroscience at NIMH, focusing on functional magnetic resonance imaging (fMRI) and clinical phenotyping of severe irritability in youth.  Currently, she uses affective neuroscience techniques to understand the brain-based mechanisms underlying severe irritability in youth, and leverages pathophysiological knowledge to guide the development of novel targeted interventions.

Ramaris E. German, PhD, is a psychologist in the Neuroscience and Novel Therapeutics Unit under the Emotion and Development Branch at the National Institute of Mental Health (NIMH). She has a broad range of clinical, research, and training experience working with children, families, and adults through her work at the University of Pennsylvania, American University, NYU-Bellevue Hospital Center, Washington DC VA Medical Center, Greenbelt Cares, and Neuropsychological Associates of Fairfax. Her research has focused on specific processes in mood disorders and in psychotherapy process and outcome as well as in the dissemination of evidence-based practices. Before joining NIMH, Dr. German worked training community mental health therapists in CBT (in English and Spanish) to increase access to quality mental health services for underserved communities through a partnership between the Philadelphia Department of Behavioral Health and the University of Pennsylvania. Dr. German is currently a psychologist researching with Dr. Melissa Brotman brain-based mechanisms underlying severe irritability in youth to develop novel targeted interventions.

*Continuing Education Information
Rathbone & Associates is authorized by the Board of Social Work Examiners in Maryland to sponsor social work continuing education programs and maintains full responsibility for the programs and their content. These trainings qualify for Category I continuing education units. Please contact your state board for verification of reciprocity with other states and professions. In order to receive a certificate, registrants must attend the entire session.


Severe Irritability in Youth

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