Behavioral and Cortisol Reactivity in Preschooler Aged Children at High-Risk for Bipolar Disorder Público

Goldstein, Hannah Meryl (2013)

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This study examined behavioral and cortisol reactivity in preschool offspring of mothers with Bipolar Disorder (BD). Maternal diagnosis was considered as a moderating factor to explain the association between behavior and cortisol. Offspring of parents with BD are at high risk for developing the disorder and other negative outcomes, but research can illuminate prodromal signs and symptoms that will aid in diagnosis, treatment, and intervention. In a case control study, 161 preschool-aged children whose mothers either had BD, Major Depressive Disorder (MDD) or no Axis I diagnoses were exposed to a stressor task designed to evoke anger, sadness, and protest. Behavior was measured with a standardized assessment. Baseline and post-stressor cortisol levels were measured through salivary samples. Offspring of mothers with BD showed significantly higher levels of protest than the other groups, but no other significant group differences were found. Additionally, maternal diagnosis was not a significant moderator of the relationship between behavioral reactivity and cortisol. The results are consistent with recent literature on high-risk offspring and pediatric BD that emphasize externalizing behaviors as a core characteristic and concern. As there is little research on children at risk for BD and no identified investigations on preschoolers, this study is an important contribution to the literature examining the onset of signs and symptoms in high-risk children.

Table of Contents


A Prospective Approach...2
Endophenotypes of BD...3
Environmental risks associated with Maternal BD...4
Behavioral reactivity and BD...5
Cortisol and BD...6
Relationship between Behavioral Reactivity and Cortisol as Moderated by Mother's Diagnosis...9

The Current Study...9



Future studies...21

Appendix 1: Behavioral Reactivity Coding...30
Table 1: Correlations Between Measures of Behavioral Reactivity...32
Table 2: Maternal Diagnostic Group and Behavioral and Cortisol Reactivity...33
Table 3: Correlations between Behavioral and Cortisol Reactivity..34

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