Sunday, May 18, 2025
5/18/2025
Positive Emotion in Bipolar Disorder Onset and Illness Course in Emerging Adults - PROJECT SUMMARY Those at-risk for BD and diagnosed with BD demonstrate significant positive emotion dysregulation (PED), and that PED is related to the severity of illness, functional outcomes, and comorbid conditions. Evidence strongly suggests that PED is central in BD and predicts maladaptive risk-taking behaviors, placing it as a top NIMH priority. PIs Gruber, Johnson and others have provided robust empirical support for PED in at-risk and clinically diagnosed BD populations over 15 years, including dozens of laboratory studies. Prior work, though, has not established whether PED predicts the onset of BD, nor the progression of symptoms during early phases of the disorder. This project will use multi-modal behavioral and neuroimaging approach to provide evidence of the import of PED to BD risk across three groups over a longitudinal 24-month period, including emerging adults with early onset of BD disorder, those at high risk but not yet diagnosed with BD, and those at low risk for BD. Of import, we will conduct novel work to examine how PED can predict initial onset of BD among emerging adults and can predict the course of BD among the high risk and the early onset groups. We will focus on emerging adults as the age group with the highest risk of mood onset and functioning difficulties. We will recruit a large, diverse community sample, and we will identify those at high and low risk for BD using a well-validated risk indicator, and we will use diagnostic interviews to assess BD diagnoses. Participants in all three groups will complete a multi-modal laboratory assessment of PED, including behavioral and neural indices. We will test the predictive value of these processes across a 24-month longitudinal follow-up of the high-risk group and the early onset group. Accordingly, this proposal has three specific aims: Aim 1: PED and Behavioral Mechanisms: Extend well-established behavioral findings of elevated PED in the BD early-onset > BD high- risk > BD low-risk groups. AIM 2: PED and Neural Mechanisms: Employ a well-validated fMRI task to assess dynamic neural processes associated with positive emotion reactivity and emotion regulation, to show (a) greater magnitude of neural signature for emotion reactivity (b) diminished magnitude of neural signature for emotion regulation, and (c) and diminished task-based functional connectivity between the PFC and parietal regions during emotion regulation across the early-onset BD, high-risk BD and low-risk BD groups. AIM 3. PED and Associations with BD Onset and Illness Course: Establish the predictive value of PED-relevant behavioral and neural processes predict onset of BD in the high-risk group and predict mania symptom severity in the BD high-risk and BD early-onset groups across a 24-month longitudinal period. This project fits with NIMH goals of integrating basic research with clinical science to enhance outcomes for those with mental illness.
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