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

Hirshfeld‐Becker, Dina R.; Biederman, Joseph; Henin, Aude; Faraone, Stephen V.; Cayton, Gabrielle A.; Rosenbaum, Jerrold F.

doi:10.1176/appi.ajp.163.2.265

Cited by 40 publications

(36 citation statements)

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“…For example, Carlson and Weintraub (1993) found that children at risk for bipolar disorder had elevated rates of mild to moderate attentional and disruptive behavioral problems at ages 7-16 compared with offspring of controls, and that these problems predicted later affective symptoms. In a test of the hypothesis linking BD to risk for bipolar disorder, we found that children from the present sample whose parents had bipolar disorder had significantly elevated rates of BD (Hirshfeld-Becker et al 2006). It is noteworthy that our present analyses revealed that BD predicted comorbid mood and disruptive behavior disorders even after presence of parental bipolar disorder was taken into account.…”

Section: Discussionsupporting

confidence: 41%

“…Recently, our group has begun to explore the nature of the risk conferred by BD (HirshfeldBecker et al 2003;Hirshfeld-Becker et al 2002;Hirshfeld-Becker et al 2006) using data from a large longitudinal sample of offspring at risk for panic disorder and major depression and comparison offspring of non-clinical parents (Rosenbaum et al 2000). Children from this sample were assessed with laboratory observations of temperament at baseline (either at age 21 months, 4, or 6 years), with diagnostic interviews at mean age 6, and, as reported here, in a subsequent follow-up wave five years after initial recruitment.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Laboratory-Observed Preschool Behavioral Disinhibition at Five-Year Follow-up

Hirshfeld‐Becker

Biederman

Henin

et al. 2007

Biological Psychiatry

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Objective-"Behavioral disinhibition" refers to a temperamental tendency to exhibit boldness, approach, and spontaneity in unfamiliar situations. We previously found it to be associated with childhood disruptive behavior and mood disorders as well as with parental bipolar disorder. In the present study, our objective was to examine the diagnostic outcome in middle childhood of behavioral disinhibition assessed at preschool-age among offspring at risk for anxiety and mood disorders.Method-The sample consisted of 284 children including offspring of parents with panic disorder or major depression and comparison offspring of parents without these disorders, who had been assessed with laboratory observations of temperament at ages 21 months-6 years. We reassessed 215 of the children (77%) at 5-year follow-up (mean age 9.6 years) with structured diagnostic interviews.Results-Compared with non-inhibited, non-disinhibited controls, behaviorally disinhibited children had higher lifetime rates of comorbid mood plus disruptive behavior disorders, and higher current rates of any disruptive behavior disorder and of oppositional defiant disorder.Conclusion-Behavioral disinhibition appears to be a temperamental antecedent of disruptive behavior disorders and their comorbidity with mood disorders in middle childhood, which may be targeted for preventive intervention.

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Section: Discussionsupporting

confidence: 41%

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes of Laboratory-Observed Preschool Behavioral Disinhibition at Five-Year Follow-up

Hirshfeld‐Becker

Biederman

Henin

et al. 2007

Biological Psychiatry

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“…Manic and hypomanic individuals also exhibit impaired inhibitory control relative to other BD states on tests such as the WCST (Ryan et al, 2012), while BD severity is associated with the degree of response inhibition (Swann et al, 2009). It is interesting to note that behavioral disinhibition in young children (age 2–6), quantified by increased approach to unfamiliar stimuli and greater vocalizations, was also elevated in the offspring of BD parents relative to healthy controls and proposed as a predictor of subsequent psychopathology (Hirshfeld-Becker et al, 2003; Hirshfeld-Becker et al, 2006). In contrast, many studies of adult BD rely on self-report measures to predict clinical outcome and determine the proximal causes of affective relapse (Proudfoot et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Inhibitory deficits in euthymic bipolar disorder patients assessed in the human behavioral pattern monitor

Henry

Minassian

Patt

et al. 2013

Journal of Affective Disorders

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Background Bipolar disorder (BD) is associated with inhibitory deficits characterized by a reduced ability to control inappropriate actions or thoughts. While aspects of inhibition such as exaggerated novelty-seeking and perseveration are quantified in rodent exploration of novel environments, similar models are rarely applied in humans. The human Behavioral Pattern Monitor (hBPM), a cross-species exploratory paradigm, has identified a pattern of impaired inhibitory function in manic BD participants, but this phenotype has not been examined across different BD phases. The objective of this study was to determine if euthymic BD individuals demonstrate inhibitory deficits in the hBPM, supporting disinhibition as an endophenotype for the disorder. Methods 25 euthymic BD outpatients and 51 healthy comparison subjects were assessed in the hBPM, where activity was recorded by a concealed videocamera and an ambulatory monitoring sensor. Results Euthymic BD individuals, similar to manic subjects, demonstrated increased motor activity, greater interaction with novel objects, and more frequent perseverative behavior relative to comparison participants. The quantity of locomotion was also reduced in BD individuals treated with mood stabilizers compared to other patients. Limitations Low sample size for treatment subgroups limits the evaluation of specific medication regimens. Conclusions Our results suggest that BD is distinguished by both trait- and state-dependent inhibitory deficits optimally assessed with sophisticated multivariate measures. These data support the use of the hBPM as a tool to elucidate the effects of BD across various illness states, facilitate the development of BD animal models, and advance our understanding of the neurobiology underlying the disorder.

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“…Gotlib et al [51] found that, compared with normal controls, children of bipolar parents showed biases in attention and memory towards negative stimuli, similar to those found for bipolar and unipolar depressed adults, suggesting that children at increased risk for affective disorder are characterized by a negative cognitive style that can be activated by low mood. In a wide ranging review, Jones and Bentall [49] found that compared with normal controls, children of bipolar parents had higher levels of sensation seeking [52] and disinhibition [53], but also higher levels of creativity [54]. Thus, a genetic predisposition to mood disorders may also confer some benefits.…”

Section: Children Of Adults With Bipolar Disordermentioning

confidence: 99%

Evidence-Based Treatment

古賀¹

2017

The SAGE Encyclopedia of Abnormal and Clinical Psychology

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Objective: The literature on bipolar in children and adolescents was reviewed to provide an update for clinicians. Review process: Literature of particular relevance to evidence-based practice was selected for critical review. Outcomes: An up-to-date overview of clinical features, epidemiology, prognosis, aetiology, assessment and intervention was provided. Conclusions: Bipolar disorder in children and adolescence is a relatively common, multifactorially determined and recurring problem which persists into adulthood. Psychometrically robust screening questionnaires and structured interviews facilitate reliable assessment. Multimodal chronic care programmes involving medication (notably lithium) and familyoriented psychotherapy are currently the treatment of choice. Keywords: Paediatric bipolar disorder, bipolar disorderResumen Objetivo: Se revisó la literatura sobre el trastorno bipolar en niñ os y adolescentes para ofrecer una actualizació n al médico. Proceso de revisión: Se seleccionó para una revisió n crítica la literatura que tuviera una relevancia concreta en relació n a la práctica basada en la evidencia. Resultados: Se brinda una revisió n actualizada sobre las características clínicas, la epidemiología, el pronó stico, la evaluació n y el manejo. Conclusión: El trastorno bipolar es un problema recurrente y relativamente comú n en niñ os y adolescentes, determinado a partir de mú ltiples factores, y que persiste hasta la edad adulta. La aplicació n de cuestionarios psicométricos de tamizaje y de entrevistas estructuradas permite una evaluació n confiable. El tratamiento de elecció n son los programas multimodales de cuidado cró nico, que incluyen el uso de medicamentos (particularmente litio) y psicoterapia orientada a la familia.

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

Abstract: 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.

Cited by 40 publications

References 43 publications

Clinical Outcomes of Laboratory-Observed Preschool Behavioral Disinhibition at Five-Year Follow-up

Clinical Outcomes of Laboratory-Observed Preschool Behavioral Disinhibition at Five-Year Follow-up

Inhibitory deficits in euthymic bipolar disorder patients assessed in the human behavioral pattern monitor

Evidence-Based Treatment

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