title: Parental relationships and behavioral approach system dysregulation in young adults with bipolar disorder.
abstract: OBJECTIVE
  Expressed emotion (EE), or the presence of criticism/hostility/emotional overinvolvement in a family relationship, predicts poorer outcomes in bipolar disorder; however, the mechanism of this is unclear. The present study investigated whether, in a sample of young adults (aged 18-40 years) with bipolar disorder, parental criticism was associated with Behavioral Approach System (BAS) dysregulation, including emotional reactivity to negative feedback and cognitive schemas of self-criticism/perfectionism.
  
  
  METHODS
  Twenty-two young adults with bipolar I disorder and 22 matched control participants completed an interview, questionnaires, and a computer-based task with false negative feedback; emotional reactivity to this feedback was assessed.
  
  
  RESULTS
  Compared to control participants, clinical participants exhibited higher levels (p = 0.001) of self-criticism, and a trend towards a greater decrease in positive affect after negative feedback (p = 0.053), even when controlling for mood symptoms. Among clinical participants, perceived criticism from paternal caregivers was associated with self-criticism and perfectionism, and low perceived paternal care was associated with decrease in positive affect.
  
  
  CONCLUSIONS
  Strain in parental relationships may be associated with BAS dysregulation for individuals with bipolar disorder.
authors.affiliation: Emory University.
authors.forename: Anjana
authors.initials: A
authors.lastname: Muralidharan
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Kotwicki
authors.forename: Colleen
authors.initials: C
authors.lastname: Cowperthwait
authors.forename: W Edward
authors.initials: WE
authors.lastname: Craighead
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000523:psychology* / Q000628:therapy; D016022:Case-Control Studies; D019260:Expressed Emotion; D005195:Family Relations; D005260:Female; D005845:Georgia; D006791:Hostility; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012114:Residential Treatment; D012647:Self-Assessment; D013334:Students; D014495:Universities; D055815:Young Adult
keywords: Behavioral Approach System; bipolar disorder; emotion regulation; expressed emotion; family relationships