Psychological evaluation of clinical disturbance in children at risk for psychopathology.

Abstract

Children of one schizophrenic or one manic-depressive parent were evaluated for clinical disturbance in the St. Louis risk research project between 1967 and 1971. This investigation employed a psychological battery using the Wechsler Intelligence Scale for Children or Wechsler Adult Intelligence Scale, figure drawings, Thematic Apperception Test (TAT), Rorschach Inkblot Test, and Beery-Buktenica Developmental Form Sequence, plus blind clinical disturbance ratings from the test batteries. Tests were administered individually to children (chronological age: 6-20 years) from intact families with one schizophrenic, manic-depressive, or physically ill parent, or two normal parents (TV = 339). Children of psychiatrically ill parents were found to be more disturbed than children of nonpsychotic parents. Children with a schizophrenic parent demonstrated performance on psychometric evaluation that was in some ways continuous with that of adult schizophrenics. Children of schizophrenic and manicdepressive parents differed from one another and from controls on two measures. In the aggressive content of their TAT stories, children with a schizophrenic parent showed less aggression than normals, and children with a manic-depressive parent showed more aggression than normals. On the Rorschach, children of schizophrenics gave more primitive responses than children of manic-depressives, and the children of normal parents gave an intermediate number of such responses.Offspring of psychotic parents are consid-Psychiatric interviews and diagnoses have ered to be at risk for the development of been a frequent means of assessing clinical schizophrenia and other types of psychopa-disturbance in children of schizophrenics thology in adulthood (

The neuropsychology and neuroanatomy of bipolar affective disorder: a critical review

“…Of the high‐risk children, those who showed ‘expansive’ behavior patterns – similar to adult hypomanic behavior – were more likely to show this cognitive pattern, suggesting that this discrepancy might be a trait marker of a genetic vulnerability to bipolar disorder. However, given that the only other study to employ the WISC in a sample of offspring of bipolar parents found no significant differences between children of bipolars and control children [70], any conclusions drawn from the high‐risk literature are clearly premature. Nevertheless, while there may be some evidence of relatively poorer visuospatial performance, there does not appear to be evidence of general cognitive impairment in high‐risk children, suggesting that much of the intellectual impairment takes place after onset of the disorder.…”

fMRI during affect discrimination in bipolar affective disorder

“…For example, individuals with bipolar affective disorder demonstrate difficulty with emotional discrimination and labeling, as well as inappropriate and incongruent affective responses [7–9]. It has also been reported that offspring of patients with bipolar affective disorder demonstrate early disturbances in behavioral modulation, which may be reflective of an underlying predisposing factor for the illness [10–12].…”

A Clinician/Researcher Looks at Andrew and His Family: A Commentary

“…Some investigators have noted unusual aggressiveness in high-risk children (Worland, Lander, & Hesselbrock, 1979), while another group (Kron, Decina, Kestenbaum, et al, 1982), failed to find any single personality type (that is, 32% extraverted, 29% introverted, 19% impulsive, and the rest mixed types). The answer here seems mixed.…”

“…The answer here seems mixed. Some investigators have noted unusual aggressiveness in high-risk children (Worland, Lander, & Hesselbrock, 1979), while another group (Kron, Decina, Kestenbaum, et al, 1982), failed to find any single personality type (that is, 32% extraverted, 29% introverted, 19% impulsive, and the rest mixed types). It does not appear that Andrew was an excessively aggressive child unless Dr. Wright's description of Andrew's demandingness as a toddler was examined as a type of aggressiveness.…”