Alloy Lauren B, Boland Elaine M, Ng Tommy H, Whitehouse Wayne G, Abramson Lyn Y
Department of Psychology, Temple University.
Corporal Michael J. Crescenz VA Medical Center.
J Abnorm Psychol. 2015 Nov;124(4):944-952. doi: 10.1037/abn0000107.
The social zeitgeber model (Ehlers, Frank, & Kupfer, 1988) suggests that irregular daily schedules or social rhythms provide vulnerability to bipolar spectrum disorders. This study tested whether social rhythm regularity prospectively predicted first lifetime onset of bipolar spectrum disorders in adolescents already at risk for bipolar disorder based on exhibiting reward hypersensitivity. Adolescents (ages 14-19 years) previously screened to have high (n = 138) or moderate (n = 95) reward sensitivity, but no lifetime history of bipolar spectrum disorder, completed measures of depressive and manic symptoms, family history of bipolar disorder, and the Social Rhythm Metric. They were followed prospectively with semistructured diagnostic interviews every 6 months for an average of 31.7 (SD = 20.1) months. Hierarchical logistic regression indicated that low social rhythm regularity at baseline predicted greater likelihood of first onset of bipolar spectrum disorder over follow-up among high-reward-sensitivity adolescents but not moderate-reward-sensitivity adolescents, controlling for follow-up time, gender, age, family history of bipolar disorder, and initial manic and depressive symptoms (β = -.150, Wald = 4.365, p = .037, odds ratio = .861, 95% confidence interval [.748, .991]). Consistent with the social zeitgeber theory, low social rhythm regularity provides vulnerability to first onset of bipolar spectrum disorder among at-risk adolescents. It may be possible to identify adolescents at risk for developing a bipolar spectrum disorder based on exhibiting both reward hypersensitivity and social rhythm irregularity before onset occurs.
社会时间线索模型（埃勒斯、弗兰克和库普弗，1988年）表明，不规律的日常作息或社会节奏会使人易患双相谱系障碍。本研究检验了社会节奏规律性是否能前瞻性地预测基于表现出奖励超敏反应而已经有双相情感障碍风险的青少年首次出现双相谱系障碍。对先前筛查出奖励敏感性高（n = 138）或中等（n = 95）但无双相谱系障碍终生病史的青少年（年龄14 - 19岁）进行了抑郁和躁狂症状、双相情感障碍家族史以及社会节奏指标的测量。每6个月对他们进行一次半结构化诊断访谈，前瞻性随访平均31.7（标准差 = 20.1）个月。分层逻辑回归表明，在控制随访时间、性别、年龄、双相情感障碍家族史以及初始躁狂和抑郁症状后，高奖励敏感性青少年基线时较低的社会节奏规律性预测其在随访期间首次出现双相谱系障碍的可能性更大，而中等奖励敏感性青少年则不然（β = -.150，Wald = 4.365，p = .037，比值比 = .861，95%置信区间[.748, .991]）。与社会时间线索理论一致，低社会节奏规律性会使有风险的青少年易患双相谱系障碍首次发作。在发病前，基于表现出奖励超敏反应和社会节奏不规律，有可能识别出有患双相谱系障碍风险的青少年。
