title: Conflict monitoring and adaptation in individuals at familial risk for developing bipolar disorder.
abstract: OBJECTIVE
  To examine conflict monitoring and conflict-driven adaptation in individuals at familial risk for developing bipolar disorder.
  
  
  METHODS
  We recruited 24 adolescents who had a parent with bipolar disorder and 23 adolescents with healthy parents. Participants completed an arrow version of the Eriksen Flanker Task that included trials with three levels of conflict: neutral, congruent, and incongruent flanks. Differences in performance were explored based upon the level of conflict in the current and previous trials.
  
  
  RESULTS
  Individuals at risk for developing bipolar disorder performed more slowly than youth with healthy parents in all trials. Analyses evaluating sequential effects revealed that at-risk subjects responded more slowly than youth of healthy parents for all trial types when preceded by an incongruent trial, for incongruent trials preceded by congruent trials, and for neutral and congruent trials when preceded by neutral trials. In contrast to the comparison group, at-risk adolescents failed to display a response time advantage for incongruent trials preceded by an incongruent trial. When removing subjects with attention-deficit hyperactivity disorder (ADHD), differences between groups in response time fell below significant level, but a difference in sequence modulation remained significant. Subjects at risk for bipolar disorder also displayed greater intra-subject response time variability for incongruent and congruent trials compared with the comparison adolescents. No differences in response accuracy were observed between groups.
  
  
  CONCLUSIONS
  Adolescents at risk for developing bipolar disorder displayed specific deficits in cognitive flexibility, which might be useful as a potential marker related to the development of bipolar disorder.
authors.affiliation: Division of Bipolar Disorders Research, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219-0516, USA.
authors.forename: Luis R
authors.initials: LR
authors.lastname: Patino
authors.forename: Caleb M
authors.initials: CM
authors.lastname: Adler
authors.forename: Neil P
authors.initials: NP
authors.lastname: Mills
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Strakowski
authors.forename: David E
authors.initials: DE
authors.lastname: Fleck
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Welge
authors.forename: Melissa P
authors.initials: MP
authors.lastname: DelBello
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology*; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D055815:Young Adult