BAS and Bipolar Spectrum: Biopsychosocial Integration

描述(由申请人提供)：此申请是两个站点合作续签赠款的一部分，同时由天普大学Lauren B.ello博士以相同标题提交相同的(预算/人员除外)申请。 虽然已经对双相(双相)障碍进行了重要的生物学工作，但较少的工作研究了这种障碍的发病、病程和进展中的心理社会因素。因此，在这项建议中，涉及双频谱障碍的行为方法系统(BAS)的理论与这些条件下的心理社会因素的工作相结合，以提供理论上一致和方法上严格的生物心理社会框架，以指导对双频谱障碍的过程和进展的前瞻性研究。在目前的拨款中，一个独特的样本，206名最初表现出较轻微的躁郁症(循环胸腺症[Cyc]和BiII)的SS，其中许多人现在进展到更严重的病程，以及214名人口统计学匹配的正常对照(NORs)，他们没有任何精神病理学的终生病史，并前瞻性地进行了平均21个月的前瞻性跟踪，对生活事件、认知和精神状态/症状进行独立和盲目的自我报告和面谈评估(每16周一次)。在本样本拟议的持续跟进开始时，实验室将使用心理生理学(脑电对左侧额叶皮质活动的评估)、行为(任务坚持性与无助性)、认知(自我效能/希望与绝望)和主观情绪(欣快感、愤怒/易怒、抑郁)指数对BAS图谱进行实验室评估，以检验与NOR SS相比，BiSS表现出异常调节的BAS活动的假设。此外，生活事件，尤其是那些与BAS相关的生活事件，实验室的BAS概况和认知脆弱性将在持续3年的前瞻性随访中被检验，以预测BiS和Nor SS中的轻躁/躁狂和抑郁症状和发作。最后，这些相同的因素将被用来预测BiSS的病程和进展到BiII和BiI状态的总体恶化。

DESCRIPTION (provided by applicant): This application is part of a 2-site collaborative renewal grant with an identical (except for budget/personnel) application submitted concurrently by Dr. Lauren B. Alloy (Temple University) under the same title. Although important biological work has been conducted on Bipolar (Bi) disorder, less work has examined psychosocial factors in the onset, course, and progression of this disorder. Thus, in this proposal, theories implicating the Behavioral Approach System (BAS) in Bi Spectrum disorders are integrated with work on psychosocial factors in these conditions to provide a theoretically consistent and methodologically rigorous biopsychosocial framework to guide a prospective study of the course and progression of Bi disturbance. In the current grant, a unique sample of 206 Ss initially exhibiting milder Bi disturbance (Cyclothymia [Cyc] and Bi II), many of whom now are progressing to a more severe course, and 214 demographically-matched Normal controls (Nors) with no lifetime history of any psychopathology has been assembled and followed prospectively for an average of 21 months with independent and blind self-report and interview assessments (every 16 weeks) of life events, cognition, and psychiatric status/symptoms. At the outset of the proposed continued follow-up of this sample, laboratory assessments of BAS profiles, both in the resting state and in response to BAS-relevant cues, using psychophysiological (EEG assessments of left frontal cortical activity), behavioral (task persistence vs. helplessness), cognitive (self-efficacy/hopefulness vs. hopelessness), and subjective affect (euphoria, anger/irritability, depression) indices will be conducted to test the hypothesis that Bi Ss exhibit dysregulated BAS activity compared to Nor Ss. Moreover, life events, with a focus on those that are BAS-relevant, laboratory BAS profile, and cognitive vulnerability will be examined in the prediction of -Hypomania/Mania and Depression symptoms and episodes among Bi and Nor Ss in the continued 3-year prospective follow-up. Finally, these same factors will be examined to predict general worsening of course and progression to Bi II and Bi I status among the Bi Ss.