Affective lability in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia

Zwicker, Alyson; Drobinin, Vladislav; MacKenzie, Lynn E.; Vallis, Emily Howes; Patterson, Victoria C.; Cumby, Jill; Propper, Lukáš; Abidi, Sabina; Bagnell, Alexa; Pavlová, Barbara; Alda, Martin; Uher, Rudolf

doi:10.1007/s00787-019-01355-z

Cited by 9 publications

(7 citation statements)

References 33 publications

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“…In an attempt to clarify these issues, the construct AI has been conceptualized into three core components: the intensity of affective responsiveness [11], the ability to control affective states [12], and AL [3]. Of these components AL, the tendency to experience prominent and unpredictable changes in mood [13], is most commonly investigated and appears to have the highest impact on outcome [10] .…”

Section: Introductionmentioning

confidence: 99%

“…To what extent AL is linked to the same sociodemographic factors and clinical symptoms across these diagnostic groups is, however, not known. Also, AL is likely to exist on a continuum from normality to pathology [32], yet few studies looking into AL in severe mental illness have included at-risk populations or healthy controls (HC), with some notable exceptions [10,13,33,34]. This makes it difficult to identify the threshold where AL is so severe that it becomes pathological with need for treatment.…”

Section: Introductionmentioning

confidence: 99%

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Affective lability across psychosis spectrum disorders

et al. 2020

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Background. Despite apparent clinical remission, individuals with psychotic disorders often experience significant impairments across functional domains. Thus, there is a need to search beyond management of core symptoms to optimize treatment outcomes. Affective dysregulation is considered a risk factor for poor clinical and functional outcomes in many mental disorders, but research investigating such features in psychosis, particularly in schizophrenia, is limited. We aimed to investigate the level of affective lability (AL) in participants with schizophrenia- and bipolar spectrum disorders (n = 222) compared to healthy controls (n = 140), as well as clinical correlates of AL in the diagnostic groups. Methods. The Affective Lability Scale (ALS-SF) was used to measure total score of AL and subscores covering the domains of anxiety/depression, depression/elation, and anger. An analysis of covariance was performed to compare the ALS-SF total score between groups, correcting for potential confounders, as well as standard multiple regression analyses for diagnosis-specific investigations of the relationship between AL and demographic and clinical features. Results. Both the schizophrenia- and bipolar spectrum group had significantly higher ALS-SF total score compared to controls (p < 0.001), and no significant differences between the patient groups were found. In the schizophrenia group, current psychotic and depressive symptoms were significantly and independently associated with AL (p = 0.012 and p = 0.024, respectively). Conclusions. The findings indicate that AL is elevated in psychotic disorders and that it transcends diagnostic boundaries. Further research into the causal relationship between psychotic and affective symptoms and AL, as well as its role as a potential therapeutic target in psychosis spectrum disorders, is warranted.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Affective lability across psychosis spectrum disorders

et al. 2020

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“…The construct of affective lability refers to the propensity to experience rapid, unpredictable and excessive changes in affective states (Zwicker et al 2019 ). The main aim of the current study was to investigate differences in affective lability between different psychosis spectrum disorders.…”

Section: Discussionmentioning

confidence: 99%

“…Affective lability, the propensity to experience rapid, unpredictable and excessive changes in affective states (Zwicker et al 2019 ), is a central and common feature of affective instability that is associated with negative outcomes across psychiatric disorders (Patel et al 2015 ; Marwaha et al 2013a , 2014a , 2018 ; Broome et al 2015a , b ; McDonald et al 2020 ). As a consequence, affective lability and other elements of affective instability are gradually becoming recognized as dimensional and transdiagnostic constructs in line with the Research Domain Criteria (RDoC) project of The National Institute of Mental Health (NIMH) (Broome et al 2015b ; Insel et al 2010 ; Fernandez et al 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Characterization of affective lability across subgroups of psychosis spectrum disorders

Høegh

Melle

Aminoff

et al. 2021

Int J Bipolar Disord

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Background Affective lability is elevated and associated with increased clinical burden in psychosis spectrum disorders. The extent to which the level, structure and dispersion of affective lability varies between the specific disorders included in the psychosis spectrum is however unclear. To have potential value as a treatment target, further characterization of affective lability in these populations is necessary. The main aim of our study was to investigate differences in the architecture of affective lability in different psychosis spectrum disorders, and if putative differences remained when we controlled for current symptom status. Methods Affective lability was measured with The Affective Lability Scale Short Form (ALS-SF) in participants with schizophrenia (SZ, n = 76), bipolar I disorder (BD-I, n = 105), bipolar II disorder (BD-II, n = 68) and a mixed psychosis-affective group (MP, n = 48). Multiple analyses of covariance were conducted to compare the ALS-SF total and subdimension scores of the diagnostic groups, correcting for current psychotic, affective and anxiety symptoms, substance use and sex. Double generalized linear models were performed to compare the dispersion of affective lability in the different groups. Results Overall group differences in affective lability remained significant after adjusting for covariates (p = .001). BD-II had higher affective lability compared to SZ and BD-I (p = .004), with no significant differences between SZ and BD-I. There were no significant differences in the contributions of ALS-SF dimensions to the total affective lability or in dispersion of affective lability between the groups. Conclusions This study provides the construct of affective lability in psychosis spectrum disorders with more granular details that may have implications for research and clinical care. It demonstrates that despite overlap in core symptom profiles, BD-I is more similar to SZ than it is to BD-II concerning affective lability and the BD groups should consequently be studied apart. Further, affective lability appears to be characterized by fluctuations between depressive- and other affective states across different psychosis spectrum disorders, indicating that affective lability may be related to internalizing problems in these disorders. Finally, although the level varies between groups, affective lability is evenly spread and not driven by extremes across psychosis spectrum disorders and should be assessed irrespective of diagnosis.

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“…Still, there is a paucity of studies investigating the role of specific facets of affective dysregulation for social functioning in severe mental disorders [ 17 , 18 ]. Affective lability refers to the propensity to experience rapid, excessive and unpredictable changes in affective states and is associated with poor clinical and functional outcome in many psychiatric disorders [ 19 , 20 ]. In a sample partially overlapping with that of the current study, we have previously found that affective lability is elevated in schizophrenia- and bipolar spectrum disorders compared to healthy controls [ 21 ]; with the highest level in bipolar II disorder (BDII) and equally high levels in schizophrenia and bipolar I disorder (BDI) [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Affective lability and social functioning in severe mental disorders

Høegh

Melle

Aminoff

et al. 2022

Eur Arch Psychiatry Clin Neurosci

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Social functioning is impaired in severe mental disorders despite clinical remission, illustrating the need to identify other mechanisms that hinder psychosocial recovery. Affective lability is elevated and associated with an increased clinical burden in psychosis spectrum disorders. We aimed to investigate putative associations between affective lability and social functioning in 293 participants with severe mental disorders (schizophrenia- and bipolar spectrum), and if such an association was independent of well-established predictors of social impairments. The Affective Lability Scale (ALS-SF) was used to measure affective lability covering the dimensions of anxiety-depression, depression-elation and anger. The interpersonal domain of the Social Functioning Scale (SFS) was used to measure social functioning. Correlation analyses were conducted to investigate associations between affective lability and social functioning, followed by a hierarchical multiple regression and follow-up analyses in diagnostic subgroups. Features related to premorbid and clinical characteristics were entered as independent variables together with the ALS-SF scores. We found that higher scores on all ALS-SF subdimensions were significantly associated with lower social functioning (p < 0.005) in the total sample. For the anxiety-depression dimension of the ALS-SF, this association persisted after controlling for potential confounders such as premorbid social functioning, duration of untreated illness and current symptoms (p = 0.019). Our results indicate that elevated affective lability may have a negative impact on social functioning in severe mental disorders, which warrants further investigation. Clinically, it might be fruitful to target affective lability in severe mental disorders to improve psychosocial outcomes.

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Affective lability in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia

Cited by 9 publications

References 33 publications

Affective lability across psychosis spectrum disorders

Affective lability across psychosis spectrum disorders

Characterization of affective lability across subgroups of psychosis spectrum disorders

Affective lability and social functioning in severe mental disorders

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