Behavioral and Emotional Correlates of the CBCL-Pediatric Bipolar Disorder Profile in Preschool Children

Abstract

A growing body of literature indicates that the CBCL-Pediatric Bipolar Disorder (CBCL-PBD) profile identifies a distinctive group of youths at heightened risk for severe psychopathology, comorbidity, and marked impairment in functioning. However, no clear consensus has been reached yet on how best to conceptualize this group of children. Existing studies have focused on diagnostic variables associated with the CBCL-PBD profile in school-age children and adolescents. Thus, little is known about psychosocial correlates of the profile and characteristics of the profile in young children. Therefore, the current study seeks to examine early developmental correlates of preschool children with and without the CBCL-BPD profile across multiple domains. Participants were an unselected community sample of 493 parents and their three-year-old children. Demographic factors, children's temperament and clinical symptomatology, parental psychopathology and personality, parenting behavior, and life stress and marital functioning were assessed using a broad range of measures, including questionnaires, semi-structure diagnostic interviews, and standardized observational protocols. Results showed that children meeting criteria for the profile were reported to have temperaments characterized by increased negative affectivity and extraversion, and decreased effortful control compared to children without the profile. Similarly, the profile positive children were observed to be low in exuberance and high in disinhibition/noncompliance in a laboratory setting. In addition, children with the profile were more likely to exhibit symptoms of oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD) and depression. They also showed poorer overall functioning, social competence, and language development. Further, children positive for the profile tended to come from homes characterized by higher maternal negative emotionality and lifetime anxiety disorder. Elevated levels of current depressive symptoms in both parents and hypomanic symptoms in the primary caregiver were also found. Finally, parents of the CBCL-PBD children were more likely to have parenting style lacking in structure and discipline, and to a lesser extent, low in responsiveness and high in hostility. Our findings suggest that the CBCL-PBD profile in a non-clinical sample of preschool children is associated with a constellation of behavioral and emotional problems, functional impairment, parental negative emotionality and affective symptoms, and maladaptive parenting.