Objectives Disruptions in sleep and dysregulation in circadian functioning may represent core abnormalities in the pathophysiology of bipolar disorder (BP). However, it is not clear whether these dysfunctions are “state” or “trait” markers of BP. This report compared sleep and circadian phenotypes among three groups: offspring of bipolar parents diagnosed with (BP/OB; n=47) and without (non-BP/OB; n=386) BP at intake and offspring of matched control parents who did not have BP (controls; n=301). We also examined the association of baseline sleep parameters with subsequent development of BP among the non-BP/OB group. Methods Pittsburgh Bipolar Offspring Study youth (ages 6-18) and their parents completed assessments every two years pertaining to child's sleep and circadian phenotypes and current psychopathology. Mixed-effects models examined differences on baseline sleep and circadian variables among the three groups. Results BP/OB offspring who were in a mood episode differed significantly on sleep parameters from the non-BP/OB and the offspring of controls, such as having inadequate sleep. Mixed logistic regression procedures showed that baseline sleep and circadian variables, such as frequent waking during the night, significantly predicted the development of BP among non-BP/OB over longitudinal follow-up. Conclusions While lifetime diagnostic status accounted for differences among the groups on sleep and circadian disturbances, psychopathology explained the differences even further. Additionally, sleep disturbance may be a prognostic indicator of the development of BP in high-risk youth. Future studies are required to further disentangle whether sleep and circadian disruption are state or trait features of BP.
Objective To examine the psychometrics of the Screen for Adult Anxiety Related Disorders (SCAARED). Methods The SCAARED was adapted from the Screen for Child Anxiety Related Emotional Disorders. Participants (N=336) ages 18–27 years old were evaluated using the Structured Clinical Interview for DSM-IV Disorders (SCID). The SCAARED was completed at or within two-weeks before the SCID. The psychometrics of the SCAARED were analyzed using standard statistical analyses including principal components, and Receiver Operant Curve analyses. A replication was performed in an age/sex matched independent sample (N=158). Results The SCAARED showed four factors: somatic/panic/agoraphobia, generalized anxiety, separation anxiety, and social anxiety. The total and each factor scores demonstrated good internal consistency (α= 0.86 – 0.97) and good discriminant validity between anxiety and other disorders and within anxiety disorders for generalized and social anxiety. Area Under the Curve for the total and each of the factor scores ranged between 0.72 and 0.84 (p< 0.0001). These results were replicated in the independent sample. Conclusions The SCAARED showed excellent psychometric properties supporting its use to screen adults for anxiety disorders, longitudinal studies following youth into adulthood and studies comparing child and adult populations. Further replication studies in larger community and clinical samples are indicated.
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