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and treatment of mental illnesses.

Mood Brain & Development Unit (MBDU) Mood Brain & Development Unit (MBDU)

Affective Reactivity Index (ARI)

General Information

On this page you can find the parent- and self-report ARI scales and a paper reporting on its psychometrics:

The ARI is also available in various translations: please see below.

The ARI scales have been designed with busy clinicians and large studies in mind and are, therefore, concise. The individual items are scored 0,1, 2, and only the first six items are summed to form the total score--the seventh is an impairment item and it is analysed separately. There are a number of possibilities in terms of cut off. The easiest may be to divide the sum of the first six items by 6, by which you obtain a three-point scale corresponding to a three-level gradation of irritability severity. Another way is to use the following cut offs derived from a recent publication:

ARI Parent-Report: At a cutpoint of >3 , the ARI Parent-Report correctly classified 92.6% of the sample of children with DMDD (n = 120) and healthy comparison youth (n = 110), with a sensitivity of 89.2 and a specificity of 96.4%.

ARI Child-Report: At a cutpoint of >2 , the ARI Child-Report correctly classified 80.3% of the sample of children with DMDD (n = 122) and healthy comparison youth (n = 111), with a sensitivity of 83.6 and a specificity of 76.6%.

The scale and its translations are free to use, however, they are under copyright and should not be altered in any way without our written permission (Dr Stringaris is the contact person).

Please note that this is the six-month version of the ARI. We also have a one-week version (to assess change, with treatment studies in mind). We are working on its validation, but know that it is reliable and the American Psychiatric Association are using it already. We are happy to share this with you too.

Additional Resources

Translations of the ARI

Key Publications involving the ARI

Stringaris A, Goodman R, Ferdinando S, Razdan V, Muhrer E, Leibenluft E, Brotman MA (2012). The Affective Reactivity Index: A concise irritability scale for clinical and research settings. Journal of Child Psychology and Psychiatry, 53, 1109-1117. PMCID: PMC3484687.

Wiggins JL, Brotman MA, Adleman NE, Kim P, Oakes AH, Reynolds RC, Chen G, Pine DS, Leibenluft E (2016). Neural Correlates of Irritability in Disruptive Mood Dysregulation and Bipolar Disorders. American Journal of Psychiatry [in press].

Mikita N, Hollocks MJ, Papadopoulos AS, Aslani A, Harrison S, Leibenluft E, Simonoff E, Stringaris A (2015). Irritability in boys with autism spectrum disorders: an investigation of physiological reactivity. Journal of Child Psychology and Psychiatry, 56(10):1118-1126.

Mulraney MA, Melvin GA and Tonge BJ (2014). Psychometric properties of the affective reactivity index in Australian adults and adolescents. Psychological Assessment, 26(1):148-55.

DeSousa DA, Stringaris A, Leibenluft E, Koller SH, Manfro GG & Salum GA (2013). Cross-cultural adaptation and preliminary psychometric properties of the Affective Reactivity Index in Brazilian youth : Implications for DSM-5 measured irritability. Trends in Psychiatry and Psychotherapy, 35(3):171-180.