Behavioral inhibition and disinhibition as hypothesized precursors to psychopathology: implications for pediatric bipolar disorder.
Attention has been devoted over the past two decades to the identification of temperamental risk factors for child psychopathology. These qualities, evident in toddlerhood or earlier, have the advantage of being measurable in standardized laboratory observations well before children reach the age of onset or diagnosis of psychiatric disorders. Our group's programmatic research over the past 15 years, and that of others, has provided evidence linking "behavioral inhibition to the unfamiliar" in toddlerhood or early childhood with later social anxiety disorder. In addition, recent results by our group have suggested that "behavioral disinhibition" in early childhood, measured by the same laboratory methods, may be linked with later disruptive behavior and comorbid mood disorders. In this article, we discuss our approach to the study of temperamental precursors to disorders in high-risk children, summarize the literature linking behavioral inhibition and disinhibition to later psychopathology, and suggest directions to take in applying this methodology to the search for temperamental precursors to pediatric bipolar disorder.
Hirshfeld-Becker
Dina R
DR
Pediatric Psychopharmacology Program, Massachusetts General Hospital, Cambridge, Massacusetts 02138, USA.
Biederman
Joseph
J
Calltharp
Sara
S
Rosenbaum
Eliza D
ED
Faraone
Stephen V
SV
Rosenbaum
Jerrold F
JF
D000293:Adolescent; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002652:Child Behavior; D002653:Child Behavior Disorders / Q000453:epidemiology*; D015897:Comorbidity; D006801:Humans; D007266:Inhibition, Psychological; D010552:Personality Assessment; D010553:Personality Development; D012307:Risk Factors; D012920:Social Behavior Disorders / Q000453:epidemiology / Q000523:psychology; D013694:Temperament