BAS and Bipolar Disorder: Prospective Biobehavioral High Risk Design

描述(由申请人提供)：本申请是由天普大学劳伦·B·科洛博士同时提交的两点合作修订拨款的一部分，同时提交了一份相同的(预算/人员除外)申请。尽管双相情感障碍(BD)具有重要的公共卫生意义，但人们对它的研究还不够深入，尤其是从生物、心理和社会综合角度。这一应用与NIMH了解BD的原因和预防目标的使命相关。尽管目前的工作强调了BD的行为方法系统(BAS)超敏理论的强大前景，但到目前为止的研究设计还不足以确定“BAS超敏”是否真的提供了BD的易感性。因此，这项应用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，无论是单独的还是与BAS相关的生活事件结合在一起，是否提供了在关键的“风险年龄”首次发生BD的易感性。为此，将对400名15-19岁(包括男性和女性、高加索人和少数族裔)的15-19岁个体(包括男性和女性、高加索人和少数族裔)进行一项大规模的前瞻性纵向研究，这些人是根据BAS(n=200)和BAS(n=200)的高敏感度和中等敏感度而被选为高风险和低风险的，但没有BD的既往病史。在第一时间，我们将全面评估这些P的BAS(和BIS)敏感性易损性特征(脑电、行为任务、认知方式和自我报告)，以及他们的冲动、社交/昼夜节律、一生和家族精神病病史，以及目前的症状/损害。PS的母亲也将被评估BAS(和BIS)敏感性，以及她们自己和PS的父亲的精神病理学史和精神病家族史。每6个月对PS进行前瞻性跟踪，评估与BAS相关的生活事件、认知和社会支持，以及BD发作、症状和/或病程和进展的首发和复发情况。每年，我们将通过2周的活动描记来评估Ps的BAS运动活动的周期性及其社会/昼夜节律。结果将有助于制定评估，以确定具有双相内表型的个体，他们可能在这种功能障碍发生之前发展为BD，从而谁能从早期预防干预中受益最大。最后，该项目将有助于制定以BAS为目标的治疗和预防BD的干预措施。

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.