Differentiating Bipolar Spectrum Disorders: The Diagnostic Utility of the BIS/BAS Scales

The present study examined discriminative validities of the Behavioral Inhibition System/Behavioral Approach System (BIS/BAS) scales in differentiating bipolar spectrum disorders (BSDs) from other disorders. Participants were youth recruited from a combination of community mental health center and university medical facility. Receiver Operating Characteristic (ROC) analyses tested the BIS/BAS scales in distinguishing between BSD-positive and BSD-negative youth. We calculated diagnostic likelihood ratios in keeping with recommendations from evidence-based medicine. Binary logistic regressions tested for incremental value in combining subscales. BAS subscales discriminated between participants with BSD-positive and BSD-negative diagnoses, with areas under the curve ranging from .54 to .64. The BIS/BAS scales achieved statistical significance in identifying cases with BSDs, but effect sizes for discriminative comparisons were too small to be clinically useful. Upgrading clinical training to: (a) include prevalence of BSDs and (b) teaching clinicians more evidence based assessment strategies is important to improve assessment and diagnosis of BSDs.Master of Art

Comparing the CASI-4R and the PGBI-10 M for Differentiating Bipolar Spectrum Disorders from Other Outpatient Diagnoses in Youth

We compared 2 rating scales with different manic symptom items on diagnostic accuracy for detecting pediatric bipolar spectrum disorder (BPSDs) in outpatient mental health clinics. Participants were 681 parents/guardians of eligible children (465 male, mean age = 9.34) who completed the Parent General Behavior Inventory-10-item Mania (PGBI-10M) and mania subscale of the Child and Adolescent Symptom Inventory-Revised (CASI-4R). Diagnoses were based on KSADS interviews with parent and youth. Receiver operating characteristic (ROC) analyses and diagnostic likelihood ratios (DLRs) determined discriminative validity and provided clinical utility, respectively. Logistic regressions tested for incremental validity in the CASI-4R mania subscale and PGBI-10M in predicting youth BPSD status above and beyond demographic and common diagnostic comorbidities. Both CASI-4R and PGBI-10M scales significantly distinguished BPSD (N=160) from other disorders (CASI-4R: Area under curve (AUC) = .80, p .05). Diagnostic likelihood ratios indicated low scores on either scale (CASI: 0–5; PGBI-10M: 0–6) cut BPSD odds to 1/5 of those with high scores (CASI DLR− = 0.17; PGBI-10M DLR− = 0.18). High scores on either scale (CASI: 14+; PGBI-10M: 20+) increased BPSD odds about fourfold (CASI DLR+ = 4.53; PGBI-10M DLR+ = 3.97). Logistic regressions indicated the CASI-4R mania subscale and PGBI-10M each provided incremental validity in predicting youth BPSD status. The CASI-4R is at least as valid as the PGBI-10M to help identify BPSDs, and can be considered as part of an assessment battery to screen for pediatric BPSDs

Extreme Cognitions in Bipolar Spectrum Disorders: Associations With Personality Disorder Characteristics and Risk for Episode Recurrence

Bipolar spectrum disorders (BSDs) are often characterized by cognitive inflexibility and affective extremities, including “extreme” or polarized thoughts and beliefs, which have been shown to predict a more severe course of illness. However, little research has evaluated factors that may be associated with extreme cognitions, such as personality disorders, which are often characterized by extreme, inflexible beliefs and also are associated with poor illness course in BSDs. The present study evaluated associations between BSDs, personality disorder characteristics, and extreme cognitions (polarized responses made on measures of attributional style and dysfunctional attitudes), as well as links between extreme cognitions and the occurrence of mood episodes, among euthymic young adults with BSDs (n = 83) and demographically-matched healthy controls (n = 89) followed prospectively for three years. The relationship between personality disorder characteristics and negative and positive extreme cognitions was stronger among BSD participants than among healthy controls, even after statistically accounting for general cognitive styles. Furthermore, extreme negative cognitions predicted the prospective onset of major depressive and hypomanic episodes. These results suggest that extreme cognitive styles are most common in individuals with BSDs and personality disorder characteristics, and they provide further evidence that extreme negative cognitions may confer risk for mood dysregulation

The interaction of affective states and cognitive vulnerabilities in the prediction of non-suicidal self-injury

Non-suicidal self-injury (NSSI) is a serious public health concern and remains poorly understood. This study sought to identify both cognitive and affective vulnerabilities to NSSI and examine their interaction in the prediction of NSSI. A series of regressions indicated that low levels of positive affect moderated the relationships between self-criticism and brooding and NSSI. The associations of self-criticism and brooding with greater frequency of NSSI were attenuated by higher levels of positive affect. The interaction of cognitive and affective vulnerabilities is discussed within the context of current NSSI theory

Associations between sleep disturbance, cognitive functioning and work disability in Bipolar Disorder

Bipolar Disorder (BD) is associated with impairment in a number of areas including poor work functioning, often despite the remission of mood symptoms. The present study aimed to examine the role of sleep disturbance and cognitive functioning in occupational impairment in BD. Twenty-four euthymic BD participants and 24 healthy control participants completed a week of prospective assessment of sleep disruption via self-report and actigraphy, a battery of neuropsychological tests of executive functioning, working memory, and verbal learning, and assessments of work functioning. BD participants experienced significantly poorer cognitive functioning as well as greater months of unemployment and greater incidence of being fired than controls. Moderation analyses revealed that both poor sleep and cognitive functioning were associated with poor work performance in BD participants, but not control participants. Sleep and cognitive functioning may be impaired in euthymic BD and are associated with poor work functioning in this population. More research should be conducted to better understand how sleep and cognitive functioning may interact in BD

Age-related differences in amphetamine sensitization: Effects of prior drug or stress history on stimulant sensitization in juvenile and adult rats

The Transiting Exoplanet Survey Satellite (TESS) is an all-sky survey mission aiming to search for exoplanets that transit bright stars. The high-quality photometric data of TESS are excellent for the asteroseismic study of solar-like stars. In this work, we present an asteroseismic analysis of the red-giant star HD~222076 hosting a long-period (2.4 yr) giant planet discovered through radial velocities. Solar-like oscillations of HD~222076 are detected around 203μHz by TESS for the first time. Asteroseismic modeling, using global asteroseismic parameters as input, yields a determination of the stellar mass (M⋆=1.12±0.12M⊙), radius (R⋆=4.34±0.21R⊙), and age (7.4±2.7Gyr), with precisions greatly improved from previous studies. The period spacing of the dipolar mixed modes extracted from the observed power spectrum reveals that the star is on the red-giant branch burning hydrogen in a shell surrounding the core. We find that the planet will not escape the tidal pull of the star and be engulfed into it within about 800Myr, before the tip of the red-giant branch is reached