Disturbances in reality testing as markers of risk in offspring of parents with bipolar disorder: A systematic review from a developmental psychopathology perspective

Angela J. Narayan, Timothy A. Allen, Kathryn R. Cullen, Bonnie Klimes-Dougan

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)723-740
Number of pages18
JournalBipolar Disorders
Volume15
Issue number7
DOIs
StatePublished - Nov 2013

Keywords

  • Bipolar disorder
  • Developmental pathways
  • Family risk
  • Psychosis
  • Thought problems

Fingerprint

Dive into the research topics of 'Disturbances in reality testing as markers of risk in offspring of parents with bipolar disorder: A systematic review from a developmental psychopathology perspective'. Together they form a unique fingerprint.

Cite this