Laboratory-Observed Behavioral Disinhibition in the Young Offspring of Parents With Bipolar Disorder: A High-Risk Pilot Study

Harvard University, Cambridge, Massachusetts, United States
American Journal of Psychiatry (Impact Factor: 12.3). 03/2006; 163(2):265-71. DOI: 10.1176/appi.ajp.163.2.265
Source: PubMed


This study tested whether behavioral disinhibition is more prevalent among offspring of parents with bipolar disorder than among offspring of parents without bipolar disorder.
The authors conducted a secondary analysis of data from a preexisting high-risk study of offspring at risk for panic disorder and depression (N=278) that had included some children with parents who had bipolar disorder (N=34). Children (ages 2-6) had been classified as behaviorally inhibited, disinhibited, or neither in laboratory assessments.
Offspring of bipolar parents had significantly higher rates of behavioral disinhibition than offspring of parents without bipolar disorder. Behavioral inhibition did not differ between groups. Differences were not accounted for by parental panic disorder or major depression or by parental history of attention deficit hyperactivity disorder, conduct disorder, antisocial personality, or substance use disorders.
Results suggest a familial link between bipolar disorder in parents and behavioral disinhibition in their offspring. Behavioral disinhibition may be a familially transmitted predisposing factor for dysregulatory distress later in life.

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Available from: Jerrold F Rosenbaum, Sep 23, 2015
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    • "age range reported; n = 221) (Doucette et al. 2013). A single investigation has focused on temperament in very young OBD (2–6 years of age; n = 34) by examining laboratory-observed behavioral disinhibition, which represents an extreme tendency to seek out novelty, approach unfamiliar stimuli, and display disinhibition of speech and action in unfamiliar settings (Hirshfeld-Becker et al. 2006). The findings indicated significantly higher levels of behavioral disinhibition in OBD than in offspring of parents with other psychiatric illnesses; these results support the hypothesis that behavioral disinhibition might represent an early marker of risk for BD. "
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    ABSTRACT: Abstract Objective: There are no published studies examining concurrent associations between temperament and behavior during toddlerhood in offspring of parents with bipolar disorder (OBD), a population at high familial risk for psychopathology. Better understanding of early determinants contributing to well-being or mental illness in this high-risk population has the potential to aid in the identification of problem domains to be targeted clinically, and facilitate the development of early intervention and prevention initiatives for an appropriate subgroup of children at the youngest possible age. A total of 30 offspring of mothers with BD (mean age=25.4±4.9 months) participated in this study at Emory University. The mothers completed the Early Childhood Behavior Questionnaire (ECBQ) and the Child Behavior Checklist (CBCL). The results of the correlational analyses indicated that the broad temperament dimension Negative Affectivity and the individual ECBQ scales Sadness and Shyness were positively associated with the broad CBCL dimension Internalizing Problems, whereas Sociability was negatively associated with Internalizing Problems. In addition, the temperament scales Soothability and Frustration were negatively and positively associated with Internalizing Problems, respectively. All ECBQ scales included in the broad temperament dimension Effortful Control, except for Cuddliness, were significantly negatively associated with the broad CBCL dimension Externalizing Problems. A significant sex difference was found for the ECBQ scale Positive Anticipation and the CBCL scale Sleep Problems, with a higher mean rank score for girls than for boys. This is the first systematic investigation of temperament and behavior and concurrent associations between these two domains in toddlers of mothers with BD. The present findings provide a platform for future investigations of the contribution of temperament and early behavior to potential well-being or mental illness in OBD.
    Journal of Child and Adolescent Psychopharmacology 12/2014; 24(10):543-50. DOI:10.1089/cap.2013.0136 · 2.93 Impact Factor
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    • "Rates of affective disorders have been estimated at 15–56% in adolescent and young adult OBD, compared to 0–12% in control samples (Birmaher et al., 2009; Duffy et al., 2006; Henin et al., 2005; Hillegers et al., 2005; Hirschfield-Becker et al., 2006; Mesman et al., 2013; Vandeleur et al., 2012). In children, rates of disruptive behavior disorders and anxiety disorders are roughly two to nine times those observed in controls (Birmaher et al., 2009; Hirschfield-Becker et al., 2006; Vandeleur et al., 2012). Recent clinical staging models suggest that the OBD are likely to display different age-specific internalizing and Contents lists available at ScienceDirect journal homepage: "
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    ABSTRACT: Objectives It has been proposed that the offspring of parents with bipolar disorder (OBD), through genetic mechanisms and early family interactions, develop a heightened sensitivity to stress, maladaptive coping, and dysregulated behavior, which ultimately increases the risk for affective disorders. The current study tested certain predictions of this model by assessing different psychosocial and health-related outcomes in the OBD, including personality, coping style, smoking, suicidality, high-risk sexual behaviors, criminality, and mental health. Method The sample was composed of 74 OBD and 75 control offspring, who were between 14 and 27 years of age (mean: 19.38±3.56). Participants underwent a diagnostic interview and a structured interview to assess high-risk behavior and other maladaptive outcomes, and they completed the Revised NEO Personality Inventory and Coping in Stressful Situations questionnaire. Results The rates of affective (31.1%) and non-affective (56.8%) disorders were elevated in the OBD compared to controls (9.5% and 32.4%). Relative to controls, OBD endorsed fewer task-oriented and more distraction coping strategies [Wilk׳s λ=.83, F(1, 136) =6.92, p<.01], and were more likely to report engaging in high-risk sexual behavior (OR=2.37; Wald=4.13, 1 df, p<05). Importantly, OBD reported elevated high-risk sexual behavior relative to controls, irrespective of affective disorder diagnosis. Conclusion The results highlight a potential risk profile for the OBD, consisting of ineffective coping strategies and risky sexual behavior and are discussed in the context of current knowledge of stress and coping in this population. Limitations The present findings were based on cross-sectional data and relied on offspring self-report. It would be useful to corroborate these findings with biobehavioural and longitudinal measures.
    Journal of Affective Disorders 09/2014; 166:315–323. DOI:10.1016/j.jad.2014.04.047 · 3.38 Impact Factor
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    • "Those who are diagnosed with bipolar disorder obviously experience difficulties in their emotion regulation [33, 97, 98]. This is true especially for preschool children, a population that recently received much attention and debate concerning the diagnosis of bipolar disorder [33, 46, 74, 88, 98–101]. For example, despite the key differences between the subtypes of childhood-onset bipolar disorder proposed by Leibenluft and colleagues [46], the children in each of these subtypes still experience a shared impairment in emotion regulation [33, 99]. "
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    ABSTRACT: Although bipolar disorder historically was thought to only occur rarely in children and adolescents, there has been a significant increase in children and adolescents who are receiving this diagnosis more recently (Carlson, 2005). Nonetheless, the applicability of the current bipolar disorder diagnostic criteria for children, particularly preschool children, remains unclear, even though much work has been focused on this area. As a result, more work needs to be done to further the understanding of bipolar symptoms in children. It is hoped that this paper can assist psychologists and other health service providers in gleaning a snapshot of the literature in this area so that they can gain an understanding of the diagnostic criteria and other behaviors that may be relevant and be informed about potential approaches for assessment and treatment with children who meet bipolar disorder criteria. First, the history of bipolar symptoms and current diagnostic criteria will be discussed. Next, assessment strategies that may prove helpful for identifying bipolar disorder will be discussed. Then, treatments that may have relevance to children and their families will be discussed. Finally, conclusions regarding work with children who may have a bipolar disorder diagnosis will be offered.
    02/2014; 2014(4):928685. DOI:10.1155/2014/928685
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