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双相障碍高危青少年的社会功能损害与临床症状的关系。

Social impairment in relation to clinical symptoms in youth at high risk for bipolar disorder.

机构信息

Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA.

Department of Psychology, University of California, Los Angeles, California, USA.

出版信息

Early Interv Psychiatry. 2022 Jan;16(1):17-25. doi: 10.1111/eip.13124. Epub 2021 Feb 8.

Abstract

AIM

Social impairment is common in individuals with bipolar disorder (BD), although its role in youths at high-risk for BD (i.e., mood symptoms in the context of a family history of BD) is not well understood. Social impairment takes many forms including social withdrawal, relational aggression, physical aggression, and victimization. The aim of this study was to explore the links between social impairment and clinical symptoms in youth at high-risk for BD.

METHODS

The sample included 127 youths with elevations in mood symptoms (depression or hypomania) and at least one first and/or second degree relative with BD. Measures of youths' current psychopathology (i.e., depressive and manic severity, suicidality, anxiety, and attention-deficit/hyperactivity disorder [ADHD]) were regressed onto youths' self-reports of social impairment (i.e., social withdrawal, relational aggression, physical aggression, and victimization).

RESULTS

Depressive symptoms, suicidal ideation, and anxiety symptoms were related to social withdrawal. Suicidal ideation was also related to reactive aggression. ADHD symptoms related to reactive and proactive aggression as well as relational victimization. Manic symptoms were not associated with social impairment in this sample.

CONCLUSIONS

Although cross-sectional, study findings point to potential treatment targets related to social functioning. Specifically, social withdrawal should be a target for treatment of childhood depressive and anxiety symptoms. Treatments that focus on social skills and cognitive functioning deficits associated with BD may also have clinical utility.

摘要

目的

双相情感障碍(BD)患者常存在社交障碍,但具有 BD 家族史的高危青少年(即心境症状)的社交障碍的作用尚不清楚。社交障碍有多种表现形式,包括社交退缩、关系攻击、身体攻击和受害。本研究旨在探讨具有 BD 家族史的高危青少年的社交障碍与临床症状之间的关系。

方法

该样本包括 127 名情绪症状(抑郁或轻躁狂)升高且至少有一位一级或二级 BD 亲属的青少年。青少年当前精神病理学(即抑郁和躁狂严重程度、自杀意念、焦虑和注意缺陷多动障碍[ADHD])的衡量标准被回归到青少年自我报告的社交障碍(即社交退缩、关系攻击、身体攻击和受害)上。

结果

抑郁症状、自杀意念和焦虑症状与社交退缩有关。自杀意念也与反应性攻击有关。ADHD 症状与反应性和主动性攻击以及关系受害有关。在该样本中,躁狂症状与社交障碍无关。

结论

尽管本研究为横断面研究,但研究结果指向与社交功能相关的潜在治疗目标。具体来说,治疗儿童抑郁和焦虑症状时,应将社交退缩作为治疗目标。针对与 BD 相关的社交技能和认知功能缺陷的治疗方法也可能具有临床效用。

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