Irritability in autism examined through network analysis of phenotypic and physiological correlates

Symptoms of irritability are commonly reported in autism, yet correlates of this domain remain poorly understood. While prevalence estimates in the literature vary considerably, they range up to 80%. Irritability can interfere with daily functioning, social relationships, and academic performance. Despite years of research and the availability of approved medications, intervention outcomes for irritability remain highly variable. To advance understanding and inform more targeted, personalized interventions, the present study aimed to clarify the correlates of irritability in autism using network analysis, an analytical tool suited to capture complex associations across interconnected variables. We examined demographic, phenotypic, and physiological factors in a sample of autistic and neurotypical children. Our findings identified strong direct associations between irritability and externalizing behaviors, emotion dysregulation, autism features, and negative affect. Physiological responses, including heart rate reactivity and variability, were indirectly connected to irritability through links with self-regulation abilities and ADHD traits. These results highlight the importance of conceptualizing irritability in autism as part of a broader, interconnected network of influences rather than an isolated symptom. Recognizing these relationships informs potential targets for future intervention studies.