COURSE OF CYCLOTHYMIA--ROLE COGNITION AND STRESS

尽管许多重要的生物学研究已经在 双相情感障碍，几乎没有方法上的严谨或理论上的指导 研究人员研究了精神障碍的发病和病程中的心理社会因素。 这种紊乱。此外，尽管个人表现出 环胸症是双相情感障碍的一种亚综合征形式，处于高度兴奋状态。 全面发展成综合症双相I型或II型障碍的风险， 人们对以下几个方面知之甚少：1)环胸腺 个人最终确实会患上综合症双相情感障碍 或2)参与发展的机制。 环胸症患者中的症状性双相情感障碍。因此， 这项提案的总体目标是在理论上提供一个 对生活事件的一致和方法上的严格审查， 认知过程与人格因素的关系 环胸症与完全性综合征的初始发病和病程 循环胸腺症患者中的双相情感障碍。的应用程序 认知素质-压力理论(贝克理论和 无望理论)，这些理论对单极非常有用 抑郁症，将检查循环胸腺症和双相情感障碍。 为此，一项为期3年的大规模前瞻性研究旨在 在课程中考察生活事件、认知和个性因素 环胸症与双相I型或II型的初始发病和病程 将会进行骚乱。300个不带胸腺的环胸腺 严重抑郁或完全综合征躁狂的终生病史 发作期和300名人口学上匹配的正常对照组 不会追随终生病史或任何精神病态 前瞻性地进行独立和盲目的自我报告和面试 评估(每16周一次)生活事件、认知和 精神状态/症状，以便预测发病、病程和 综合征和亚综合征的后续复发/复发 抑郁和狂躁。 这项研究将有助于：1)了解心理社会 环状胸腺症的病程及首发和 完全双相情感障碍的后续病程；2)阐明 单相抑郁与双相抑郁的关系；3) 治疗和预防双相情感障碍的干预措施进展 无序。

Although much important biological research has been conducted on Bipolar disorder, little methodologically rigorous or theory guided work has examined psychosocial factors in the onset and course of this disorder. Moreover, although individuals exhibiting Cyclothymia, a subsyndromal form of bipolar disorder, are at high risk for developing full blown syndromal bipolar I or II disorder, little is known about: 1) the predictors of which cyclothymic individuals eventually do develop syndromal Bipolar disorder and which do not; or 2) the mechanisms involved in the development of syndromal Bipolar disorders among cyclothymics. Thus, the overarching goal of this proposal is to provide a theoretically consistent and methodologically rigorous examination of life events, cognitive processes, and personality factors in the course of Cyclothymia and initial onset and course of full blown syndromal Bipolar disorder among cyclothymics. The application of the cognitive diathesis-stress theories (Beck's theory and the Hopelessness theory), which have been so useful for unipolar depression, will be examined for cyclothymia and Bipolar disorder. To this end, a large scale, 3-year prospective study designed to examine life events, cognition, and personality factors in the course of cyclothymia and initial onset and course of Bipolar I or II disorder will be conducted. Three hundred Cyclothymics with not lifetime history of major depressive or full syndromal manic episodes and 300 demographically- matched normal controls with not lifetime history or any psychopathology will be followed prospectively with independent and blind self-report and interview assessments (every 16 weeks) of life events, cognition, and psychiatric status/symptoms in order to predict onset, course, and subsequent relapses/recurrences of syndromal and subsyndromal depression and mania. This study will contribute to: 1) knowledge about psychosocial factors in the course of Cyclothymia and initial onset and subsequent course of full blown bipolar disorder; 2) elucidation of the relationship between unipolar and bipolar depression; 3) development of interventions for treating and preventing bipolar disorder.