BAS and Bipolar Disorder: Prospective Biobehavioral High Risk Design

描述（由申请人提供）：本申请是2个研究中心合作修订补助金的一部分，Lauren B博士同时提交了相同的（预算/人员除外）申请。天普大学（Temple University）尽管双相情感障碍（BD）具有重大的公共卫生意义，但它一直没有得到充分的研究，特别是从综合生物心理社会的角度。此应用程序与NIMH的使命相关，以了解BD的原因和预防目标。虽然目前的工作强调了强大的承诺，行为方法系统（BAS）超敏理论的BD，研究设计，以确定是否“BAS超敏反应”确实提供了脆弱性BD。因此，本申请的首要目标是使用生物行为高风险设计来测试BAS超敏反应（单独或与BAS相关生活事件组合）是否在关键“风险年龄”期间对BD首次发作提供易感性。“为此，将对400名（两个研究中心）15-19岁的个体（包括男性和女性以及高加索人和少数民族P）进行大规模前瞻性纵向研究，根据高BAS（n= 200）与中度BAS（n = 200）敏感性，选择BD的高风险与低风险，但没有BD既往史。在时间1，我们将全面评估这些Ps的BAS（和BIS）敏感性脆弱性概况（EEG，行为任务，认知风格和自我报告），以及他们的冲动性，社会/昼夜节律，精神病理学的终身和家族史，以及当前的症状/损害。Ps的母亲也将评估BAS（和BIS）的敏感性，以及他们自己和Ps的父亲的精神病理学史和精神病理学家族史。将每6个月对Ps进行前瞻性随访，评估BAS相关生活事件、认知和社会支持，以及BD发作、症状和/或BD病程和进展的首次发作和复发。每年，我们将评估Ps的BAS运动活动的周期性和他们的社会/昼夜节律与2周的活动记录。这些结果将有助于评估的发展，这些评估可能会识别出具有双相内表型的个体，这些个体可能在这种功能障碍发生之前发展为BD，因此，谁可以从早期预防干预中获益最多。最后，该项目将有助于开发针对BAS的干预措施，以治疗和预防BD。

DESCRIPTION (provided by applicant): This application is part of a 2-site collaborative revised grant with an identical (except for budget/personnel) application submitted concurrently by Dr. Lauren B. Alloy (Temple University). Despite the great public health significance of bipolar disorder (BD), it has been understudied, especially from an integrative biopsychosocial perspective. This application is relevant to NIMH's mission to understand the causes of BD and targets for prevention. Although current work underscores the strong promise of the Behavioral Approach System (BAS) Hypersensitivity Theory of BD, research designs to date are inadequate to determine whether "BAS hypersensitivity" indeed provides vulnerability to BD. Thus, the overarching goal of this application is to use a biobehavioral high-risk design to test whether BAS hypersensitivity, either alone or in combination with BAS-relevant life events, provides vulnerability to first onset of BD during a critical "age of risk." To this end, a large-scale prospective, longitudinal study of 400 (both sites) 15-19 year old individuals (including males and females and Caucasian and minority Ps), selected to be at high vs. low risk for BD based on high BAS (n=200) vs. moderate BAS (n=200) sensitivity, but with no prior history of BD, will be conducted. At Time 1, we will comprehensively assess these Ps' BAS (and BIS) sensitivity vulnerability profiles (with EEG, behavioral task, cognitive style, and self-report), as well as their impulsivity, social/circadian rhythms, lifetime and family history of psychopathology, and current symptoms/impairment. Ps' mothers will also be assessed on BAS (and BIS) sensitivity, as well as their own and the Ps' fathers' history of psychopathology and family history of psychopathology. Ps will be followed prospectively every 6 months with assessments of BAS-relevant life events, cognitions, and social support, and the development of first onsets and recurrences of BD episodes, symptoms, and/or course and progression of their BD. Yearly, we will assess the cyclicity of Ps' BAS locomotor activity and their social/circadian rhythms with 2 weeks of actigraphy. Results will contribute to the development of assessments that may identify individuals with a bipolar endophenotype who are likely to develop BD before such dysfunction occurs and, thus, who can most benefit from early preventive interventions. Finally, the project will contribute to development of BAS-targeted interventions for treatment and prevention of BD.