Deficits in Social Cognition and Response Flexibility in Pediatric Bipolar Disorder

McClure, Erin B.; Treland, Julia E.; Snow, Joseph; Schmajuk, Mariana; Dickstein, Daniel P.; Towbin, Kenneth E.; Charney, Dennis S.; Pine, Daniel S.; Leibenluft, Ellen

doi:10.1176/appi.ajp.162.9.1644

Cited by 196 publications

(199 citation statements)

References 51 publications

(78 reference statements)

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“…This supports findings of impaired social cognition and response flexibility in euthymic adolescents with bipolar disorder [53]. Another study showed increased subcortical activity to positive stimuli but increased DLPFC activity to negative stimuli in adolescents with bipolar disorder [52].…”

Section: Pediatric Bipolar Disordersupporting

confidence: 81%

Neuroimaging in bipolar disorder: A critical review of current findings

Keener

Phillips²

2007

Curr Psychiatry Rep

102

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Bipolar I disorder (BPI) is among the top 10 most debilitating illnesses globally. In this critical review, we first review recent functional neuroimaging findings in two core domains of pathology in BPI: emotion processing and executive control. These abnormalities in core domains represent potential endophenotypes of the illness. We then show that an emerging number of studies have demonstrated that neuroimaging can help to identify endophenotypic markers whose identification would help to clarify diagnosis and discriminate the depression in BPI from that of unipolar depression and identify at-risk individuals who will subsequently develop the illness (to facilitate early intervention). We end by reviewing the new directions in neuroimaging in BPI, including studies of children with bipolar disorder, potential medication effects, and the use of newer neuroimaging techniques to help us achieve the previously mentioned goals of improving BPI patients' mental well-being.

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Section: Pediatric Bipolar Disordersupporting

confidence: 81%

Neuroimaging in bipolar disorder: A critical review of current findings

Keener

Phillips²

2007

Curr Psychiatry Rep

102

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“…BD children and adolescents demonstrate deficits in executive function 206 and emotion processing, 207 and impaired social cognition and response flexibility. 208 As with adult BD, it has been proposed, therefore, that pediatric BD may be associated with functional abnormalities in neural systems supporting emotion regulation processes. 209,210 There are several findings that support this.…”

Section: Pediatric Bipolar Disorder and High-risk Populationsmentioning

confidence: 99%

A neural model of voluntary and automatic emotion regulation: implications for understanding the pathophysiology and neurodevelopment of bipolar disorder

2008

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The ability to regulate emotions is an important part of adaptive functioning in society. Advances in cognitive and affective neuroscience and biological psychiatry have facilitated examination of neural systems that may be important for emotion regulation. In this critical review we first develop a neural model of emotion regulation that includes neural systems implicated in different voluntary and automatic emotion regulatory subprocesses. We then use this model as a theoretical framework to examine functional neural abnormalities in these neural systems that may predispose to the development of a major psychiatric disorder characterized by severe emotion dysregulation, bipolar disorder.

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“…These psychological processes are of interest because children with BD have difficulty categorizing facial emotions (27) and regulating both their attention (28) and their affect (29). These deficits may be related: children with BD may mislabel facial emotions because their affective response to a face disrupts emotion categorization; such mislabeling may contribute to inappropriate emotional responses to environmental stimuli, and thus to emotional dysregulation.…”

mentioning

confidence: 99%

Limbic hyperactivation during processing of neutral facial expressions in children with bipolar disorder

Rich

Vinton

Roberson‐Nay

et al. 2006

Proc. Natl. Acad. Sci. U.S.A.

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280

303

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Reflecting a paradigm shift in clinical neuroscience, many chronic psychiatric illnesses are now hypothesized to result from perturbed neural development. However, most work in this area focuses on schizophrenia. Here, we extend this paradigm to pediatric bipolar disorder (BD), thus demonstrating traction in the developmental psychobiology perspective. To study amygdala dysfunction, we examined neural mechanisms mediating face processing in 22 youths (mean age 14.21 ؎ 3.11 yr) with BD and 21 controls of comparable age, gender, and IQ. Event-related functional MRI compared neural activation when attention was directed to emotional aspects of faces (hostility, subjects' fearfulness) vs. nonemotional aspects (nose width). Compared with controls, patients perceived greater hostility in neutral faces and reported more fear when viewing them. Also, compared with controls, patients had greater activation in the left amygdala, accumbens, putamen, and ventral prefrontal cortex when rating face hostility, and greater activation in the left amygdala and bilateral accumbens when rating their fear of the face. There were no between-group behavioral or neural differences in the nonemotional conditions. Results implicate deficient emotion-attention interactions in the pathophysiology of BD in youth and suggest that developmental psychobiology approaches to chronic mental illness have broad applicability.amygdala ͉ faces ͉ functional MRI R ecently, psychology and psychiatry have witnessed a major paradigm shift: virtually all chronic adult mental illnesses are now thought to result from long-term perturbations in neural development. Two lines of research support this perspective: family-based͞longitudinal studies and neurobiological studies. Family-based and longitudinal studies implicate developmental perturbations in a range of conditions, including behavior disorders, substance abuse, mood disorders, and psychoses (1-3). However, virtually all research on developmental neurobiology focuses on schizophrenia, where data implicate a neural circuit connecting the dorsolateral prefrontal cortex, striatum, and hippocampus (4, 5). Neurocognitive correlates of schizophrenia, such as deficient working memory, are thought to result from dysfunction in this circuit (6). An important next step is the extension of the developmental neurobiological approach to other mental illnesses and other neural systems associated with information processing and emotion regulation.For several reasons, bipolar disorder (BD) is an ideal illness in which to expand the emerging developmental paradigm by conducting neurobiologically oriented developmental research. BD causes marked disruption in social, academic, and family function. Major questions persist concerning the boundaries of the condition in children; neurobiological data might ultimately resolve them. Most importantly, research in adult patients and animals implicates a circuit encompassing the amygdala, striatum, and ventral prefrontal cortex (VPFC) in the pathophysiology of BD (7). This circu...

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Deficits in Social Cognition and Response Flexibility in Pediatric Bipolar Disorder

Cited by 196 publications

References 51 publications

Neuroimaging in bipolar disorder: A critical review of current findings

Neuroimaging in bipolar disorder: A critical review of current findings

A neural model of voluntary and automatic emotion regulation: implications for understanding the pathophysiology and neurodevelopment of bipolar disorder

Limbic hyperactivation during processing of neutral facial expressions in children with bipolar disorder

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