Specificity of facial expression labeling deficits in childhood psychopathology

Guyer, Amanda E.; McClure, Erin B.; Adler, Abby; Brotman, Melissa A.; Rich, Brendan A.; Kimes, Alane S.; Pine, Daniel S.; Ernst, Monique; Leibenluft, Ellen

doi:10.1111/j.1469-7610.2007.01758.x

Cited by 229 publications

(243 citation statements)

References 66 publications

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“…Moreover, our findings do not exclude the possibility that BD and SMD have common pathophysiologic features. Indeed, previous studies suggest that the two share behavioral deficits in emotion labeling processing 14,22 and cognitive flexibility, 23 although the neural mechanisms mediating these deficits may differ between the two patient groups. 24 In sum, to the extent that the question, "Is SMD a developmental presentation of BD?"…”

Section: Discussionmentioning

confidence: 99%

Pediatric Bipolar Disorder Versus Severe Mood Dysregulation: Risk for Manic Episodes on Follow-Up

Stringaris

Baroni

Haimm

et al. 2010

Journal of the American Academy of Child & Adolescent Psych

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Objective-An important question in pediatric bipolar research is whether marked nonepisodic irritability is a manifestation of bipolar disorder in youth. This study tests the hypothesis that youth with severe mood dysregulation (SMD), a category created for the purpose of studying children presenting with severe nonepisodic irritability, will be significantly less likely to develop (hypo-)manic or mixed episodes over time than will youth with bipolar disorder (BD). Method-Patients with SMD (N = 84) and narrowly defined BD (N = 93) at baseline were followed up in 6-monthly intervals using the relevant K-SADS modules to ascertain (hypo-)manic or mixed episodes.Results-Only one of 84 SMD subjects (1/84 [1.2%]; 95% confidence interval CI = 0.0003 to 0.064) experienced a (hypo-)manic or mixed episode during the study (median follow-up = 28.7 months). The frequency of such episodes was more than 50 times higher in those with narrowly defined BD (58/93 [62.4%]; 95% CI 0.52 to 0.72).Conclusions-These data suggest that, over an approximately 2-year follow-up period, youth with SMD are unlikely to develop (hypo-)manic or mixed episodes. Keywords bipolar disorder; pediatric; severe mood dysregulation; irritability; ADHD In American psychiatric clinics and inpatient settings, dramatic increases in the rates of diagnosis of pediatric bipolar disorder (BD) have been documented over the past decade, 1,2 with a concomitant increase in prescription rates for antipsychotic medication. 3 This rapid increase in the diagnosis of pediatric BD has coincided with the contention that the clinical presentation of BD differs between children and adults. 4,5 The debate regarding the pediatric presentation of BD is complex. One important aspect of it has been the suggestion that marked irritability, even when it does not constitute an episodic change from baseline, is a manifestation of BD in youth. 4,6,7 To provide a framework for research on whether irritable children without distinct manic episodes have a developmental presentation of BD, we operationalized 8 a clinical syndrome, severe mood dysregulation (SMD), designed to capture chronically irritable children whose diagnostic status is in doubt. This paper uses a longitudinal sample to investigate the extent to which subjects with SMD develop episodes of (hypo-)mania, compared to youth with narrowly defined BD.The criteria for SMD require a persistent, nonepisodic clinical presentation of negatively valenced mood with frequent and impairing anger outbursts, combined with at least three of the "B" criteria of mania (pressured speech, agitation, insomnia, and flight of ideas/racing thoughts) and one (distractibility) that is also common to ADHD. 8 A community-based follow-up study suggests that SMD is common, with a lifetime prevalence of 3.3% in youth 9 to 19 years of age. 9 Furthermore, in that sample SMD predicted depressive disorder at 7-year follow-up in youths who were 9 to 19 years old at baseline. 9 Consistent with this finding, another community-based study of nonepisod...

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Section: Discussionmentioning

confidence: 99%

Pediatric Bipolar Disorder Versus Severe Mood Dysregulation: Risk for Manic Episodes on Follow-Up

Stringaris

Baroni

Haimm

et al. 2010

Journal of the American Academy of Child & Adolescent Psych

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“…To that end, we tested the hypothesis that children with a family history of bipolar disorder would have facial emotion processing deficits similar to those seen in pediatric bipolar probands (5,7,9,10). Confirmation of this hypothesis would suggest that facial emotion labeling deficits may be an endophenotype for bipolar disorder.…”

mentioning

confidence: 99%

“…Recent work using standardized behavioral paradigms to assess emotional processing has identified several deficits in euthymic bipolar youths (3)(4)(5)(6)(7)(8), including difficulty identifying facial emotions (5,7,9,10). Indeed, the brain regions that mediate facial emotion processing overlap with the ventrolateral prefrontal cortex-striatumamygdala circuit implicated in the pathophysiology of both pediatric and adult bipolar disorder (9,11).…”

mentioning

confidence: 99%

Facial Emotion Labeling Deficits in Children and Adolescents at Risk for Bipolar Disorder

Brotman¹,

Guyer²,

Lawson³

et al. 2008

AJP

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“…Young people with bipolar disorder show deficits in facial emotion processing, including incorrectly identifying facial emotional expressions [19,64], negatively misinterpreting emotionally neutral facial expressions [69] and misjudging extreme emotional facial expressions as being of moderate-to-mild intensity [70][71][72]. Functional MRI studies have shown that deficits in facial emotion processing are associated with aberrant patterns of activation in the amydala, striatum and prefrontal cortex [69,[73][74][75].…”

Section: Neurobiological Characteristicsmentioning

confidence: 99%

“…In the multi-centre Course and Outcome for Bipolar Youth (CORBY) study, 263 cases were followed up at 6 month intervals for 2 years [19]. The worst outcome occurred in cases where there was an early onset of bipolar symptoms; where symptoms persisted for a long time; where there were mixed episodes with psychotic features and comorbid disorders such as ADHD, conduct disorder, substance abuse and anxiety; and where youngsters came from families of low socio-economic status, characterized by family discord and a history of psychopathology.…”

Section: Course and Outcomementioning

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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Specificity of facial expression labeling deficits in childhood psychopathology

Abstract: Background: We examined whether face-emotion labeling deficits are illness-specific or an

Cited by 229 publications

References 66 publications

Pediatric Bipolar Disorder Versus Severe Mood Dysregulation: Risk for Manic Episodes on Follow-Up

Pediatric Bipolar Disorder Versus Severe Mood Dysregulation: Risk for Manic Episodes on Follow-Up

Facial Emotion Labeling Deficits in Children and Adolescents at Risk for Bipolar Disorder

Evidence-Based Treatment

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