title: Assessing disordered thoughts in preschoolers with dysregulated mood.
abstract: There is rising interest in identifying precursors to bipolar disorder symptoms, including thought disorder. Thought disorder is identified in adults through self-report and in school-aged children through parent report and child story-telling. This study is an exploration to determine if preschoolers with mood dysregulation have evidence of disordered thoughts using a story-stem completion method. Participants included two groups of 3.5-6 year-old children: 20 with mood dysregulation including manic symptoms and 11 typically developing comparison children. Children were administered story completion narratives including one story where the child character accidentally cuts him/herself while pretending to cook. The children were asked to complete the stories and their responses were analyzed for atypical themes consistent with disordered thoughts such as violence or bizarreness outside of the story or props coming to life. Thirty-five percentage of symptomatic preschoolers versus 0% of typically developing preschoolers ascribed independent actions to inanimate props (p = 0.03). Eighty percentage of symptomatic preschoolers versus 9% of typically developing preschoolers utilized props in a violent or bizarre manner outside the central story (p < 0.001). Preschool children with symptoms of dysregulated mood express themes related to the unusual use of story props which may indicate disordered thoughts. This preschool expression of dysregulated mood appears similar to and possibly continuous with school-age and adult versions of bipolar disorder.
authors.affiliation: Department of Psychiatry, University of Colorado Denver, School of Medicine, Anschutz Medical Campus, Campus Box F546, P.O. Box 6508, Aurora, CO 80045, USA.
authors.forename: Amanda K
authors.initials: AK
authors.lastname: Hutchison
authors.forename: Carol
authors.initials: C
authors.lastname: Beresford
authors.forename: Joann
authors.initials: J
authors.lastname: Robinson
authors.forename: Randal G
authors.initials: RG
authors.lastname: Ross
mesh_terms: D000339:Affect; D001714:Bipolar Disorder / Q000175:diagnosis*; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D011569:Psychiatric Status Rating Scales
references.citation: J Am Acad Child Adolesc Psychiatry. 2007 Jan;46(1):107-125
references.pmid: 17195735
references.citation: Annu Rev Clin Psychol. 2008;4:163-87
references.pmid: 17716034
references.citation: J Am Acad Child Adolesc Psychiatry. 1989 May;28(3):408-16
references.pmid: 2738008
references.citation: Child Psychiatry Hum Dev. 2009 Sep;40(3):421-37
references.pmid: 19280338
references.citation: Br J Psychiatry. 1978 Nov;133:429-35
references.pmid: 728692
references.citation: J Am Acad Child Adolesc Psychiatry. 2006 May;45(5):538-549
references.pmid: 16601400
references.citation: J Autism Dev Disord. 2008 Sep;38(8):1474-84
references.pmid: 18297385
references.citation: Biol Psychiatry. 2000 Sep 15;48(6):458-66
references.pmid: 11018219
references.citation: J Am Acad Child Adolesc Psychiatry. 2001 Apr;40(4):450-5
references.pmid: 11314571
references.citation: Arch Gen Psychiatry. 2006 Oct;63(10):1139-48
references.pmid: 17015816
references.citation: J Affect Disord. 2009 Dec;119(1-3):16-21
references.pmid: 19324422
references.citation: Schizophr Bull. 2007 May;33(3):703-14
references.pmid: 17478437
references.citation: J Clin Child Adolesc Psychol. 2009 May;38(3):315-28
references.pmid: 19437293
references.citation: Attach Hum Dev. 2007 Sep;9(3):239-54
references.pmid: 18058432
references.citation: Psychiatr Clin North Am. 2009 Mar;32(1):39-56
references.pmid: 19248915
references.citation: Biol Psychiatry. 2000 Dec 1;48(11):1037-44
references.pmid: 11094136
references.citation: Schizophr Bull. 1986;12(3):483-96
references.pmid: 3764364
references.citation: Biol Psychiatry. 2004 Apr 1;55(7):692-700
references.pmid: 15038997
references.citation: Dev Psychopathol. 2001 Spring;13(2):233-54
references.pmid: 11393645
references.citation: Schizophr Bull. 2008 Jan;34(1):109-17
references.pmid: 17515440
references.citation: J Clin Psychiatry. 2008 Dec;69(12):1960-9
references.pmid: 19192470
references.citation: Dev Psychopathol. 2006 Fall;18(4):971-88
references.pmid: 17064425
references.citation: Arch Gen Psychiatry. 2004 May;61(5):459-67
references.pmid: 15123490
references.citation: Attach Hum Dev. 2007 Sep;9(3):255-70
references.pmid: 18058433
references.citation: Child Adolesc Psychiatr Clin N Am. 2009 Apr;18(2):391-403, ix
references.pmid: 19264269
references.citation: Brain Res Brain Res Rev. 2000 Mar;31(2-3):147-56
references.pmid: 10719143
references.citation: J Can Acad Child Adolesc Psychiatry. 2009 Aug;18(3):215-20
references.pmid: 19718422
references.citation: J Am Acad Child Adolesc Psychiatry. 2000 Aug;39(8):1017-23
references.pmid: 10939230
references.citation: J Child Adolesc Psychopharmacol. 2005 Aug;15(4):534-48
references.pmid: 16190786
references.citation: J Child Psychol Psychiatry. 2009 Sep;50(9):1156-66
references.pmid: 19490311
references.citation: J Am Acad Child Adolesc Psychiatry. 1996 Oct;35(10):1331-7
references.pmid: 8885587
references.citation: J Am Acad Child Adolesc Psychiatry. 1996 Feb;35(2):204-14
references.pmid: 8720630
references.citation: Biol Psychiatry. 2003 Jun 1;53(11):952-60
references.pmid: 12788240
references.citation: J Am Acad Child Adolesc Psychiatry. 2000 Jun;39(6):771-8
references.pmid: 10846312
references.citation: Child Psychiatry Hum Dev. 2007 Dec;38(4):321-38
references.pmid: 17620007
references.citation: J Child Adolesc Psychopharmacol. 2002 Spring;12(1):3-9
references.pmid: 12014593
references.citation: Attach Hum Dev. 2007 Sep;9(3):223-37
references.pmid: 18058431
references.citation: J Affect Disord. 2004 May;80(1):19-28
references.pmid: 15094254