Contents lists available at ScienceDirect Journal of Adolescence journal homepage: www.elsevier.com/locate/adolescence Focus on methodology The Cranky Thermometers: Visual analogue scales measuring irritability in youth Glenn A. Melvin a,* , Bruce J. Tonge a , Melissa Mulraney c , Michael Gordon a,b , John Taffe a , Ester Klimkeit a a Centre for Developmental Psychiatry & Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Building #1, Ferntree Gully Rd, Notting Hill, Victoria, 3168, Australia b Early in Life Mental Health Service, Southern Health, Monash Medical Centre, 246 Clayton Rd, Clayton, Victoria, 3168, Australia c Centre for Community Child Health, Murdoch Childrens Research Institute, 50 Flemington Rd, Parkville, Victoria, 3052, Australia ARTICLE INFO Keywords: Irritability Adolescents Depression ABSTRACT This study assessed the psychometric properties of two visual analogue scales of irritability, known as the Cranky Thermometers (CT), in both an Australian community secondary-school sample (N = 164) and a sample of adolescents with a depressive disorder (N = 127). The first scale Cranky Now measures current irritability, and the second, Cranky Two Weeks, measures peak irritability within the last two weeks. CT scores were significantly higher in adolescents with major depressive disorder than in the school sample and showed improvement following treatment for depression. Positive associations were found between CT and irritability scores as determined by Kiddie Schedule for Affective Disorders and Schizophrenia (not irritable, sub- threshold, threshold irritability) and Affective Reactivity Index scores. Results suggest that the CTs are rapidly administered, have promising psychometric properties and demonstrate utility in measuring irritability in clinical and community settings. Irritable mood is defined in the DSM-5 as “easily annoyed and provoked to anger” (p 825; American Psychiatric Association, 2013), and while it is under-researched, epidemiological studies suggest that irritability is commonly reported in adolescence. Sund, Larsson, and Wichstrøm (2001) found that 44% of 13–14 year olds (N = 2560) reported feeling irritable for some of the past two weeks (as measured by a Moods and Feelings Questionnaire item about grumpiness and being cross with parents), with a further 12% reporting feeling irritable for most of the past two weeks. Mixed findings exist about the relationship between irritability and age and gender, with some longitudinal findings suggesting higher levels of both chronic and episodic irritability in females than males (Leibenluft, Cohen, Gorrindo, Brook, & Pine, 2006) and others finding no gender differences in chronic irritability (Holtzman, O'Connor, Barata, & Stewart, 2015; Stringaris et al., 2012). Reductions in adolescent irritability with age, that could be interpreted to reflect changes in social competence and self-regulation development, have not been found consistently in the literature (e.g., no change with age, Stringaris et al., 2012; reductions with age for males but not females, Caprara, Paciello, Gerbino, & Cugini, 2007). Reduction in severe mood dysregulation, a syndrome characterised by chronic elevated irritability, has been found with age (Deveney et al., 2015). Irritable mood is present in the diagnostic criteria of a number of psychiatric disorders, both internalising and externalising, including pediatric depressive disorder, generalized anxiety disorder, post-traumatic stress disorder, oppositional defiant disorder https://doi.org/10.1016/j.adolescence.2018.02.008 Received 5 April 2017; Received in revised form 1 February 2018; Accepted 7 February 2018 * Corresponding author. Monash University Centre for Developmental Psychiatry & Psychology, Building #1, 270 Ferntree Gully Rd, Notting Hill, Victoria, 3168, Australia. E-mail address: glenn.melvin@monash.edu (G.A. Melvin). Journal of Adolescence 64 (2018) 146–154 0140-1971/ © 2018 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved. T