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Disturbances in reality testing as markers of risk in offspring of parents with bipolar disorder: a systematic review from a developmental psychopathology perspective
Author(s) -
Narayan Angela J,
Allen Timothy A,
Cullen Kathryn R,
KlimesDougan Bonnie
Publication year - 2013
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/bdi.12115
Subject(s) - psychopathology , bipolar disorder , psychology , prodrome , schizophrenia (object oriented programming) , clinical psychology , typology , offspring , perspective (graphical) , psychological intervention , psychiatry , developmental psychology , mood , psychosis , genetics , artificial intelligence , biology , computer science , history , pregnancy , archaeology
Objectives This comprehensive review examined the prevalence and progression of disturbances in reality testing ( DRT ), defined as psychotic symptoms, cognitive disruptions, and thought problems, in offspring of parents with bipolar disorder (O‐ BD ). Our approach was grounded in a developmental psychopathology perspective and considered a broader phenotype of risk within the bipolar–schizophrenia spectrum as measured by categorical and dimensional assessments of DRT in high‐risk youth. Methods Relevant studies were identified from numerous sources (e.g., PubMed, reference sections, and colleagues). Inclusion criteria were: (i) family risk studies published between 1975 and 2012 in which O‐ BD were contrasted with a comparison group (e.g., offspring of parents who had other psychiatric disorders or were healthy) on DRT outcomes and (ii) results reported for categorical or dimensional assessments of DRT (e.g., schizophrenia, psychotic symptoms, cluster A personality traits, or thought problems), yielding a total of 23 studies. Results Three key findings emerged: (i) categorical approaches of DRT in O‐ BD produced low incidence base rates and almost no evidence of significant differences in DRT between O‐ BD and comparison groups, whereas (ii) many studies using dimensional assessments of DRT yielded significant group differences in DRT . Furthermore, (iii) preliminary evidence from dimensional measures suggested that the developmental progression of DRT in O‐ BD might represent a prodrome of severe psychological impairment. Conclusions Preliminary but promising evidence suggests that DRT is a probable marker of risk for future impairment in O‐ BD . Methodological strengths and weaknesses, the psychometric properties of primary DRT constructs, and future directions for developmental and longitudinal research with O‐ BD are discussed.