Dickstein Daniel P, Leibenluft Ellen
Mood and Anxiety Disorder Program, National Institute of Mental Health, Bethesda, MD 20892-2670, USA.
Dev Psychopathol. 2006 Fall;18(4):1105-31. doi: 10.1017/S0954579406060536.
Much controversy has surrounded the diagnosis of bipolar disorder (BD) in children and adolescents. However, recent work from an affective neuroscience perspective has advanced what is known about the boundaries of emotion regulation in BD compared to typically developing youth. In this article, we first briefly review the clinical issues that have contributed to this diagnostic controversy. Second, we discuss our phenotyping system, which can be used to guide neurobiological research designed to address these controversial issues. Third, we review what is known about the fundamentals of emotion regulation in human and nonhuman primate models. Fourth, we present recent data demonstrating how children and adolescents with BD differ from those without psychopathology on measures of emotion regulation. Taken as a whole, this work implicates a neural circuit encompassing the prefrontal cortex, amygdala, and striatum in the pathophysiology of pediatric BD.
儿童和青少年双相情感障碍（BD）的诊断一直存在诸多争议。然而，最近从情感神经科学角度开展的研究，相比正常发育的青少年，在BD情绪调节边界方面取得了新进展。在本文中，我们首先简要回顾导致这一诊断争议的临床问题。其次，我们讨论可用于指导旨在解决这些争议问题的神经生物学研究的表型系统。第三，我们回顾人类和非人类灵长类动物模型中情绪调节的基础知识。第四，我们展示最近的数据，这些数据表明BD儿童和青少年在情绪调节测量方面与无精神病理学问题的儿童和青少年有何不同。总体而言，这项研究表明前额叶皮质、杏仁核和纹状体组成的神经回路在儿童BD的病理生理学中发挥作用。
