The present study examines the relationship between Perceived Criticism (PC) and Sensitivity to Criticism (SC) in youth with Bipolar Spectrum Disorder (BPSD), their symptomatic experiences, and family functioning. We hypothesized that findings for youth would be consistent with findings for adults indicating that PC and SC would be associated with a worse clinical presentation, and that associations between family criticism and sensitivity and youth symptoms would be stronger for youth with BPSD than with other clinical diagnoses. We examined 828 youths ages 4–18 years (M = 10.9, SD = 3.4) and their caregivers from diverse ethnic and socioeconomic backgrounds using the Longitudinal Expert evaluation of All Data (LEAD) diagnoses (Spitzer, Comprehensive Psychiatry, 24, 399-411 1983), the parent-reported General Behavior Inventory (Youngstrom et al., Psychological Assessment, 13, 267–276 2001), The Perceived Criticism Scale (Hooley and Teasdale, Journal of Abnormal Psychology, 98, 229–235 1989), and the Family Assessment Device (Epstein et al., Journal of Marital and Family Therapy, 9, 171–180 1983). We found significant positive association between parent reports of youth criticalness and more severe manic and depression symptoms, greater mood lability, higher suicidality, and worse overall functioning. Youth with BPSD were significantly more critical and had higher SC than youth without BPSD. Interactions between BPSD and family criticalness and sensitivity were found in their links with youth symptoms. Negative associations between criticism and sensitivity and youth global family functioning were significant only for youth with BPSD. The positive association between criticism and youth mood lability was significant only for youth with BPSD. Our findings suggest that family factors and interactional patterns impact and are influenced by functioning in youth with BPSD and that family-based treatments should be considered routinely with these youth.
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This research was supported in part by NIH R01 MH066647 (PI: E. Youngstrom).
Conflict of Interest
Dr. Du Rocher Schudlich, Ms. Chase Ochrach, Dr. Eric Youngstrom, and Dr. Jennifer Younstrom all declare that they have no conflicts of interest. Dr. Findling receives or has received research support, acted as a consultant and/or has received honoraria from Acadia, Adamas, Aevi, Akili, Alcobra, Alkermes, Allergan, Amerex, American Academy of Child & Adolescent Psychiatry, American Psychiatric Press, Arbor, Axsome, Daiichi-Sankyo, Gedeon Richter, Genentech, KemPharm, Luminopia, Lundbeck, MedAvante-ProPhase,Merck, NIH, Neurim, Noven, Nuvelution, Otsuka, PCORI, PaxMedica,Pfizer, Physicians Postgraduate Press, Q BioMed, Receptor Life Sciences, Roche, Sage, Signant Health, Sunovion, Supernus Pharmaceuticals, Syneos, Syneurx, Takeda, Teva, Tris, TouchPoint,and Validus.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from legal guardians and informed assent was obtained from youth. The authors affirm that human research participants provided informed consent regarding publishing their data.
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Du Rocher Schudlich, T.D., Ochrach, C., Youngstrom, E.A. et al. I’m Not Being Critical, You’re Just Too Sensitive: Pediatric Bipolar Disorder and Families. J Psychopathol Behav Assess 43, 84–94 (2021). https://doi.org/10.1007/s10862-020-09848-x
- Bipolar disorder
- Children and adolescents
- Perceived criticism
- Sensitivity to criticism