Social adjustment in the offspring of parents with bipolar affective disorder

The social adjustment of the adolescent offspring of parents with bipolar affective disorder (n=41) was compared to that of the offspring of parents with nonaffective psychiatric disorders (n=22) and the offspring of normal controls (n=26). In addition, the relationship between social adjustment and cyclothymia in offspring was determined. Social adjustment was assessed using the Life Activities Inventory, a new measure developed to assess social functioning in adolescents and young adults. Cyclothymia was assessed with the General Behavior Inventory. As a group, the offspring of bipolar parents did not differ significantly from either control group on social adjustment. However, the cyclothymic offspring of bipolar parents exhibited significantly poorer social adjustment than the noncyclothymic offspring of bipolars and the offspring of psychiatric and normal controls. These findings suggest that poor social functioning in the adolescent offspring of parents with bipolar illness may be associated with the early manifestations of affective disorder. In addition, these data indicate that despite its subsyndromal intensity, cyclothymia can result in significant social impairment.This study was supported in part by National Institute of Mental Health (NIMH) Research Grant MH-39782 to Daniel N. Klein and NIMH Grants MH-33083 and MH-37195 to Richard A. Depue.     

Anxiety and selective attention in obsessive-compulsive disorder

Recently, there has been increasing evidence for information-processing deficits in individuals with obsessive-compulsive disorder (OCD). While impairments in selective attention have been identified to be central to the symptomatology of OCD, the role that situational anxiety plays in attentional processes has not been fully explored. Previous research findings were limited to tasks containing anxiety-relevant materials, only permitting for the evaluation of the impact of anxiety on simultaneous cognitive processing. Furthermore, it has not yet been determined whether the impact of anxiety is limited to selective attention or is indicative of a more general cognitive impairment. This study was designed to examine the role that situational anxiety plays in selective attention impairments. OCD participants and controls were presented with an anxiety producing statement and a neutral statement, followed by the Stroop Task. Results indicated that situational anxiety plays a significant role in the performance of tasks that require selective attention in OCD. A significant deterioration was detected in performance on selective attention tasks for the OCD participants after confronting anxiety-provoking scenarios, as compared to neutral scenarios. Anxiety did not impair performance on simple reading tasks. Possible explanations are discussed.     

The role of selective attention in perceptual and affective priming

Two kinds of perceptual priming (word identification and word fragment completion), as well as preference priming (that may rely on special affective mechanisms) were examined after participants either read or named the colors of words and nonwords at study. Participants named the colors of words more slowly than the colors of nonwords, indicating that lexical processing of the words occurred at study. Nonetheless, priming on all three tests was lower after color naming than after reading, despite evidence of lexical processing during color naming shown by slower responses to words than to nonwords. These results indicate that selective attention to (rather than the mere processing of) letter string identity at study is important for subsequent repetition priming.     

Social support and the course of bipolar disorder

The current study prospectively examined the impact of social support on symptom severity and recovery from episodes in bipolar disorder, both as a direct influence and as a buffer of life events. Fifty-nine individuals with Bipolar I disorder were followed longitudinally with monthly symptom severity interviews. Social support was measured by the Interpersonal Support Evaluation List and the Interview Schedule for Social Interaction, and life events were assessed using the Life Events and Difficulties Schedule. Individuals with low social support took longer to recover from episodes and were more symptomatic across a 6-month follow-up. Results suggest a polarity-specific effect, in that social support influences depression but not mania. Discussion focuses on theoretical implications of a series of polarity-specific findings within the field.     

Induced mood change and dysfunctional attitudes in remitted bipolar I affective disorder

This study investigated the possibility that, in remitted bipolar I affective disorder, dysfunctional attitudes are mood-state dependent. Participants were 120 individuals with remitted bipolar I disorder, remitted unipolar depression, or no history of affective disorder. The Dysfunctional Attitudes Scale (DAS; Weissman, 1979) was completed before and after positive or negative mood challenge. Following mood increase, the bipolar group changed significantly less in DAS total score than did the other 2 groups, and in goal-striving and achievement attitudes relative to the unipolar group. These findings did not provide clear support for the mood-state dependency theory in bipolar disorder, arguing instead for the presence in bipolar I disorder of dysfunctional cognitions that show characteristic resilience in the face of minor positive mood increase.     

Gaze cueing of attention: visual attention, social cognition, and individual differences

During social interactions, people's eyes convey a wealth of information about their direction of attention and their emotional and mental states. This review aims to provide a comprehensive overview of past and current research into the perception of gaze behavior and its effect on the observer. This encompasses the perception of gaze direction and its influence on perception of the other person, as well as gaze-following behavior such as joint attention, in infant, adult, and clinical populations. Particular focus is given to the gaze-cueing paradigm that has been used to investigate the mechanisms of joint attention. The contribution of this paradigm has been significant and will likely continue to advance knowledge across diverse fields within psychology and neuroscience.     

Group therapy as an adjunct to medication in the management of bipolar affective disorder

This paper asserts that, contrary to the beliefs of many clinicians, patients with bipolar affective disorder often experience a deteriorating course characterized by pervasive social dysfunction. It reviews the literature, identifying a rationale for group psychotherapy as an adjunct to medication in the management of these chronic patients. It outlines a theoretical approach to bipolar group therapy, and presents a retrospective study comparing the course of 43 lithium-treated bipolar patients before and after entering bipolar groups. During the year in group therapy, bipolar patients displayed significant improvements in symptom relief as well as social functioning. It is proposed that group process enhances treatment with medication, providing benefits not evident with medication alone.     

Social functioning and emotional regulation in the attention deficit hyperactivity disorder subtypes

Compared 16 children with attention deficit hyperactivity disorder (ADHD) combined type (ADHD-C), 14 children with ADHD predominantly inattentive type (ADHD-I), and 17 controls on parent and teacher ratings of social status and performance, self-report of social knowledge and performance, and observations of behavior on an emotional regulation task. Analyses revealed distinct patterns of social dysfunction between ADHD subgroups. Children with ADHD-C were rated as showing more aggressive behavior; furthermore, they displayed emotional dysregulation characterized by high intensity and high levels of both positive and negative behavior. In contrast, children with ADHD-I were perceived as displaying social passivity and showed deficits in social knowledge on the self-report measure but did not evidence problems in emotional regulation. Regression analyses revealed that social performance, emotional regulation, and, to a lesser degree, social knowledge, were predictive of social status. The application of these findings to understanding the nature of the social deficits in the ADHD subtypes and directions for future research are discussed.     

Aging, selective attention, and inhibitory processes: a psychophysiological approach.

The present study investigated the efficiency with which younger and older adults allocate attention to relevant and irrelevant stimuli. The model of attention guiding this research links the orienting response with the allocation of attention and habituation with the inhibition of the allocation of attention. We adapted a paradigm developed by Iacono and Lykken (1983) in which subjects are instructed unambiguously either to attend to or to ignore a series of innocuous tones, and the skin conductance orienting response elicited by each tone is measured. Results revealed that young subjects instructed to ignore the tones habituated more quickly than did those instructed to attend to the tones. However, older adults exhibited nondifferential orienting across the 2 instruction conditions. These results suggest an age-related deficit in the ability to inhibit attention to irrelevant stimuli.     

Aging and motivated cognition: the positivity effect in attention and memory

As people get older, they experience fewer negative emotions. Strategic processes in older adults' emotional attention and memory might play a role in this variation with age. Older adults show more emotionally gratifying memory distortion for past choices and autobiographical information than younger adults do. In addition, when shown stimuli that vary in affective valence, positive items account for a larger proportion of older adults' subsequent memories than those of younger adults. This positivity effect in older adults' memories seems to be due to their greater focus on emotion regulation and to be implemented by cognitive control mechanisms that enhance positive and diminish negative information. These findings suggest that both cognitive abilities and motivation contribute to older adults' improved emotion regulation.     

Beyond cognition: predicting health risk behaviors from instrumental and affective beliefs.

OBJECTIVE: Two studies assessed the relative contribution of affective and instrumental beliefs to the prediction of 2 risk behaviors: driving above the speed limit and smoking. DESIGN: Both studies took the form of large-scale questionnaire surveys (Study 1, N=292; Study 2, N=500) measuring instrumental and affective beliefs and self-reported behavior. In both cases, behavior was also measured objectively. OUTCOME MEASURES: In Study 1, speeding behavior was measured via infrared camera along sections of road with 30 mph, 40 mph, and 60 mph speed limits. Self-reports of speeding in these same contexts represented a 2nd dependent variable. In Study 2, level of smoking was measured via a carbon monoxide monitor, and participants were asked to indicate the number of cigarettes they smoked in a week. RESULTS: In Study 1, positive and negative instrumental and affective beliefs were significant predictors of self-reported speed. The most powerful predictor was negative affective beliefs. Observed speed was predicted by negative affective beliefs only. In Study 2, the significant predictors of self-reported smoking and objective measures of smoking were positive and negative affective beliefs. CONCLUSION: The findings indicate the importance of affective beliefs across 2 health risk behaviors. Implications for social cognition models and interventions are discussed.     

Time perception,attention, and memory: A selective review

This article provides a selective review of time perception research, mainly focusing on the authors' research. Aspects of psychological time include simultaneity, successiveness, temporal order, and duration judgments. In contrast to findings at interstimulus intervals or durations less than 3.0–5.0 s, there is little evidence for an “across-senses” effect of perceptual modality (visual vs. auditory) at longer intervals or durations. In addition, the flow of time (events) is a pervasive perceptual illusion, and we review evidence on that. Some temporal information is encoded All rights reserved. relatively automatically into memory: People can judge time-related attributes such as recency, frequency, temporal order, and duration of events. Duration judgments in prospective and retrospective paradigms reveal differences between them, as well as variables that moderate the processes involved. An attentional-gate model is needed to account for prospective judgments, and a contextual-change model is needed to account for retrospective judgments.     

Suicide in bipolar disorder: Risks and management

Bipolar disorders are prevalent, often severe, and disabling illnesses with elevated lethality largely due to suicide. Suicide rates average approximately 1% annually, or perhaps 60 times higher than the international population rate of 0.015% annually. Suicidal acts typically occur early in bipolar disorders and in association with severe depressive or mixed states. The high lethality of suicidal acts in bipolar disorders is suggested by a much lower ratio of attempts:suicide (approximately 3:1) than in the general population (approximately 30:1). Risk factors can help to identify patients at increased suicidal risk, but ongoing clinical assessment is essential to limit risk. Empirical short-term interventions to manage acute suicidal risk include close clinical supervision, rapid hospitalization, and electroconvulsive therapy. Remarkably, however, evidence of the long-term effectiveness of most treatments against suicidal behavior is rare. A notable exception is lithium prophylaxis, which is associated with consistent evidence of major (approximately 80%), sustained relative reductions of risk of suicides and attempts, and lower lethality (increased attempts:suicide ratio). Such benefits are unproved for other treatments commonly used to treat bipolar disorder patients, including anticonvulsants, antipsychotics, antidepressants, and psychosocial interventions. Applying available knowledge systematically, with close and sustained clinical supervision, can enhance management of suicidal risk in bipolar disorders patients.     

Patients with bipolar disorder show a selective deficit in the episodic simulation of future events

A substantial body of evidence suggests that autobiographical recollection and simulation of future happenings activate a shared neural network. Many of the neural regions implicated in this network are affected in patients with bipolar disorder (BD), showing altered metabolic functioning and/or structural volume abnormalities. Studies of autobiographical recall in BD reveal overgeneralization, where autobiographical memory comprises primarily factual or repeated information as opposed to details specific in time and in place and definitive of re-experiencing. To date, no study has examined whether these deficits extend to future event simulation. We examined the ability of patients with BD and controls to imagine positive, negative and neutral future events using a modified version of the Autobiographical Interview (Levine, Svoboda, Hay, Winocur, & Moscovitch, 2002) that allowed for separation of episodic and non-episodic details. Patients were selectively impaired in imagining future positive, negative, and neutral episodic details; simulation of non-episodic details was equivalent across groups.     

Sustained attention and visual processing speed in children and adolescents with bipolar disorder and other psychiatric disorders

To investigate the cognitive functioning of children and adolescents with bipolar illness, 112 child and adolescent psychiatric inpatients and day-hospital patients at a state psychiatric hospital were administered the Wechsler Intelligence Scale for Children-III (WISC-III) as part of an admission psychological assessment. There were 22 patients with Bipolar Disorder and 90 with other psychiatric disorders; all were between 8 and 17 years of age. The patients with Bipolar Disorder had a mean age of 14 yr., a mean Verbal IQ of 78, a mean Performance IQ of 76, and a mean Full Scale IQ of 75. When their WISC-III scores were compared with those who had Schizophrenia Spectrum disorders (Schizophrenia and Schizoaffective Disorder), Psychosis Not Otherwise Specified, Attention Deficit Hyperactivity Disorder, and Conduct Disorder and Oppositional Defiant Disorder, there were no significant between-group mean differences for Verbal IQ, but patients with Bipolar Disorder had a significantly lower mean Performance IQ than those with ADHD and those with Conduct Disorder and Oppositional Defiant Disorder. Contrary to the expectation that the patients with Bipolar Disorder might have better sustained attention (higher Digit Span scores) than those with Schizophrenia Spectrum disorders and worse visual processing speed (lower Coding scores) than the other diagnostic groups, the bipolar patients' Digit Span and Coding scores did not differ significantly from those of the other groups. The patients with Psychosis, Not Otherwise Specified had significantly lower mean Performance IQ, Full Scale IQ, and Coding than the ADHD and the Conduct Disorder and Oppositional Disorder groups.     

Expressed emotion and attributions in the relatives of bipolar patients: an analysis of problem-solving interactions

Among the relatives of schizophrenic and depressed patients, high expressed emotion (EE) attitudes are associated with "controllability attributions" about the causes of patients' symptoms and problem behaviors. However, previous studies have judged EE attitudes and causal attributions from the same assessment measure, the Camberwell Family Interview (CFI; C. E. Vaughn & J. P. Leff, 1976). The authors examined causal attributions among relatives of 47 bipolar patients, as spontaneously expressed to patients in family problem-solving interactions during a postillness period. Relatives rated high EE during the patients' acute episode (based on the CFI) were more likely than relatives rated low EE to spontaneously attribute patients' symptoms and negative behaviors to personal and controllable factors during the postillness interactional assessment. Thus, the EE-attribution linkage extends to the relatives of bipolar patients evaluated during a family interaction task.