Impact of Neurocognitive Function on Academic Difficulties in Pediatric Bipolar Disorder: A Clinical Translation

Pavuluri, Mani N.; O’Connor, Megan; Harral, Erin M.; Moss, Melissa E.; Sweeney, John A.

doi:10.1016/j.biopsych.2006.03.027

Cited by 66 publications

(55 citation statements)

References 27 publications

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“…In studies involving either youths (Dickstein et al, 2004; Joseph et al, 2008; Kyte et al, 2006; Pavuluri et al, 2006a; Pavuluri et al, 2006b) or adults with BD (Badcock et al, 2005; Green, 2006; Jabben et al, 2010; Roiser et al, 2009; Sweeney et al, 2000), but not both groups in the same study, BD is associated with cognitive deficits, including impaired attention, working memory, executive function, and response inhibition—all compared to healthy controls (HC) without psychopathology. Although several functional magnetic resonance imaging (fMRI) studies have compared youths and adults with BD on facial emotion recognition tasks (e.g., Brotman et al, 2013), fewer studies have directly compared cognitive deficits between youths and adults with BD (Wegbreit et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, in an fMRI meta-analysis, youths with BD showed more consistently decreased anterior cingulate activation during cognitive tasks than adults with BD (Wegbreit et al, 2014). These cognitive problems are important to study because many are associated with reduced psychosocial functioning and do not remit during euthymia (Andreou and Bozikas, 2013; Buoli et al, 2014; Mora et al, 2013; Pavuluri et al, 2006a; Pavuluri et al, 2009; Peters et al, 2014). Better knowledge of their pathophysiology could provide a cost-effective way to improve the lives of individuals with BD by spurring the development of novel pharmacological agents (Miskowiak et al, 2014) and cognitive remediation treatments (Dickstein et al, 2015b).…”

Section: Introductionmentioning

confidence: 99%

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Reversal-learning deficits in childhood-onset bipolar disorder across the transition from childhood to young adulthood

Wegbreit

Cushman

Weissman

et al. 2016

Journal of Affective Disorders

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Background Bipolar disorder (BD) is a severe mental illness that can have high costs for youths (<18 years old) and adults. Relative to healthy controls (HC), individuals with BD often show impaired attention, working memory, executive function, and cognitive flexibility (the ability to adapt to changing reward/punishment contingencies). In our study of youths and young adults with BD, we investigated 1) how cognitive flexibility varies developmentally in BD, and 2) whether it is independent of other executive function deficits associated with BD. Methods We measured errors on a reversal-learning task, as well as spatial working memory and other executive function, among participants with BD (N=75) and HC (N=130), 7–27 years old. Regression analyses focused on the effects of diagnosis on reversal-learning errors, controlling for age, gender, IQ, spatial span, and executive function. Similar analyses examined nonreversal errors to rule out general task impairment. Results Participants with BD, regardless of age, gender, or cognitive ability, showed more errors than HC on the response reversal stages of the cognitive flexibility task. However, participants with BD did not show more errors on non-reversal stages, even when controlling for other variables. Limitations Study limitations include the cross-sectional, rather than longitudinal, design; inability to measure non-linear age effects; and inclusion of medicated participants and those with psychiatric comorbidity. Conclusions Individuals with BD show a specific impairment in reversing a previously rewarded response, which persists across the transition from childhood to young adulthood. Tailored interventions targeting this deficit may be effective throughout this developmentally turbulent time.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reversal-learning deficits in childhood-onset bipolar disorder across the transition from childhood to young adulthood

Wegbreit

Cushman

Weissman

et al. 2016

Journal of Affective Disorders

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“…PBD is differentiated from adult-onset bipolar disorder (BD) by unique characteristics such as rapid cycling, mixed mood states, psychiatric comorbidity, and developmentally-specific psychosocial impairment 2, 3 . Compared to healthy peers, children with PBD demonstrate neurocognitive deficits, academic underperformance 4, 5 , and disruptive school behavior 6 . Peer relationships are characterized by limited peer networks, peer victimization, and poor social skills 7, 8 .…”

Section: Introductionmentioning

confidence: 99%

Child- and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: A Randomized Clinical Trial

West¹,

Weinstein²,

Peters³

et al. 2014

Journal of the American Academy of Child & Adolescent Psych

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Objective Previous studies have found that family-based psychosocial treatments are effective adjuncts to pharmacotherapy among adults and adolescents with bipolar disorder (BD). The objective of this study was to compare the efficacy of adjunctive Child- and Family-Focused Cognitive Behavioral Therapy (CFF-CBT) to psychotherapy as usual (control) for mood symptom severity and global functioning in children with BD. Method Sixty-nine youth, aged 7–13 (M = 9.19, SD = 1.61) with DSM-IV-TR bipolar I, II, or not otherwise specified (NOS) disorder were randomly assigned to CFF-CBT or control groups. Both treatments consisted of 12 weekly sessions followed by 6 monthly booster sessions delivered over a total of 9 months. Independent evaluators assessed participants at baseline, week 4, week 8, week 12 (posttreatment), and week 39 (6-month follow-up). Results Participants in CFF-CBT attended more sessions, were less likely to drop out, and reported greater satisfaction with treatment than controls. CFF-CBT demonstrated efficacy compared to the control in reducing parent-reported mania at posttreatment and depression symptoms at posttreatment and follow-up. Global functioning did not differ at posttreatment but was higher among CFF-CBT participants at follow-up. Conclusion CFF-CBT may be efficacious in reducing acute mood symptoms and improving long-term psychosocial functioning among children with BD.

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“…Additional cognitive domains were also identified as areas of impairment in BD, including response flexibility, reversal learning, processing speed, and set shifting in PBD [7••, [8][9][10]. Symptomatic treatment of mania does not alleviate these "trait-like" cognitive impairments, which are further associated with reading and math difficulties [11]. Recognizing the cognitive impairment in BD is an important step toward the development and implementation of cognitive interventions that will aim to limit the global impact of such deficits [7••].…”

Section: Cognitive Neurosciencementioning

confidence: 99%

Effects of Early Intervention on the Course of Bipolar Disorder: Theories and Realities

Pavuluri

2010

Curr Psychiatry Rep

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Given the severity and early onset of pediatric bipolar disorder, early intervention is important to bring about recovery and alter the course of the illness. There is a new and burgeoning body of literature on the biological basis of early signs of the illness and the mechanistic understanding of treatment interventions. Biological findings based on multimodal imaging, genomic studies of cellular proteins, and performance-based findings of neurocognitive studies are beginning to assemble a cohesive and interlinked model of systems neuroscience. This offers the promise of identifying biomarkers, predictors of illness, and treatment outcomes. In complement, at the tier of clinical application is a multitude of efficacy trials, yet neither a single medication nor a combination of choices seems to suffice in reality. The current review develops a point of view bridging scientific developments to where comprehensive, multipronged treatment strategies find their clinical application-a model that is similarly applicable in adult bipolar disorder.

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Impact of Neurocognitive Function on Academic Difficulties in Pediatric Bipolar Disorder: A Clinical Translation

Cited by 66 publications

References 27 publications

Reversal-learning deficits in childhood-onset bipolar disorder across the transition from childhood to young adulthood

Reversal-learning deficits in childhood-onset bipolar disorder across the transition from childhood to young adulthood

Child- and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: A Randomized Clinical Trial

Effects of Early Intervention on the Course of Bipolar Disorder: Theories and Realities

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