BAS and Bipolar Disorder: Prospective Biobehavioral High Risk Design

描述（由申请人提供）：该申请是两个站点合作修订资助的一部分，同时由Lauren B. Alloy博士（天普大学）提交的相同申请（预算/人员除外）。尽管双相情感障碍（BD）具有重大的公共卫生意义，但对其的研究还不够充分，特别是从综合生物心理社会的角度。这一应用与NIMH的使命有关，即了解BD的原因和预防目标。尽管目前的工作强调了行为方法系统（BAS）双相障碍超敏感理论的强大前景，但迄今为止的研究设计不足以确定“BAS超敏感”是否确实提供了双相障碍的脆弱性。因此，本应用程序的总体目标是使用生物行为高风险设计来测试BAS超敏感是否单独或与BAS相关的生活事件相结合，在关键的“风险年龄”期间，易患双相障碍。为此，将对400名（两个地点）15-19岁的个体（包括男性和女性，高加索人和少数族裔Ps）进行大规模前瞻性纵向研究，根据BAS高（n=200）和BAS中度（n=200）敏感性，选择BD高风险和低风险，但没有BD病史的个体进行研究。在时间1，我们将全面评估这些Ps的BAS（和BIS）敏感性脆弱性特征（包括脑电图、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、精神病理的一生和家族史，以及当前的症状/损伤。Ps的母亲也将被评估BAS（和BIS）敏感性，以及他们自己和Ps的父亲的精神病理史和家族精神病理史。每6个月对Ps进行前瞻性随访，评估与BAS相关的生活事件、认知和社会支持，以及首次发作和复发的BD发作、症状和/或BD的病程和进展。每年，我们将通过2周的活动记录仪评估Ps的BAS运动活动的周期性和他们的社会/昼夜节律。结果将有助于评估的发展，这些评估可能在双相情感障碍发生之前识别出可能发展为双相情感障碍的个体，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的治疗和预防双相障碍的干预措施。

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.