Pavlickova Hana, Turnbull Oliver, Bentall Richard P
School of Psychology, Bangor University, Bangor, UK; Unit for Social and Community Psychiatry, Queen Mary University of London, UK.
Br J Clin Psychol. 2014 Nov;53(4):386-401. doi: 10.1111/bjc.12051. Epub 2014 Apr 21.
Bipolar disorder is a highly heritable illness, with a positive family history robustly predictive of its onset. It follows that studying biological children of parents with bipolar disorder may provide information about developmental pathways to the disorder. Moreover, such studies may serve as a useful test of theories that attribute a causal role in the development of mood disorders to psychological processes.
Psychological style (including self-esteem, coping style with depression, domain-specific risk-taking, sensation-seeking, sensitivity to reward and punishment, and hypomanic personality and cognition) was assessed in 30 offspring of bipolar parents and 30 children of well parents. Parents of both child groups completed identical assessments.
Although expected differences between parents with bipolar disorder and well parents were detected (such as low self-esteem, increased rumination, high sensitivity to reward and punishment), offspring of bipolar parents were, as a group, not significantly different from well offspring, apart from a modest trend towards lower adaptive coping. When divided into affected and non-affected subgroups, both groups of index children showed lower novelty-seeking. Only affected index children showed lower self-esteem, increased rumination, sensitivity to punishment, and hypomanic cognitions. Notably, these processes were associated with symptoms of depression.
Psychological abnormalities in index offspring were associated with having met diagnostic criteria for psychiatric illnesses and the presence of mood symptoms, rather than preceding them. Implications of the present findings for our understanding of the development of bipolar disorder, as well as for informing early interventions, are discussed.
双相情感障碍是一种具有高度遗传性的疾病，家族病史呈阳性对其发病具有很强的预测性。因此，研究双相情感障碍患者的亲生孩子可能会提供有关该疾病发展途径的信息。此外，此类研究可作为一种有用的检验，验证那些认为心理过程在情绪障碍发展中起因果作用的理论。
对30名双相情感障碍患者的后代和30名健康父母的孩子进行了心理类型评估（包括自尊、应对抑郁的方式、特定领域的冒险行为、寻求刺激、对奖惩的敏感度以及轻躁狂人格和认知）。两组孩子的父母都完成了相同的评估。
尽管双相情感障碍患者父母与健康父母之间存在预期差异（如自尊较低、沉思增加、对奖惩的敏感度较高），但双相情感障碍患者的后代作为一个群体，与健康后代并无显著差异，只是在适应性应对方面有略微降低的趋势。当分为患病和未患病亚组时，两组指标儿童都表现出较低的寻求新奇性。只有患病的指标儿童表现出较低的自尊、增加的沉思、对惩罚的敏感度以及轻躁狂认知。值得注意的是，这些过程与抑郁症状相关。
指标后代的心理异常与符合精神疾病诊断标准以及情绪症状的存在相关，而非先于这些情况出现。讨论了本研究结果对我们理解双相情感障碍发展以及为早期干预提供信息的意义。
