TY - JOUR
T1 - The development and course of bipolar spectrum disorders
T2 - An integrated reward and circadian rhythm dysregulation model
AU - Alloy, Lauren B.
AU - Nusslock, Robin
AU - Boland, Elaine M.
N1 - Publisher Copyright:
© 2015 by Annual Reviews. All rights reserved.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - In this article, we present and review the evidence for two major biopsychosocial theories of the onset and course of bipolar spectrum disorders (BSDs) that integrate behavioral, environmental, and neurobiological mechanisms: the reward hypersensitivity and the social circadian rhythm disruption models. We describe the clinical features, spectrum, age of onset, and course of BSDs. We then discuss research designs relevant to demonstrating whether a hypothesized mechanism represents a correlate, vulnerability, or predictor of the course of BSDs, as well as important methodological issues. We next present the reward hypersensitivity model of BSD, followed by the social circadian rhythm disruption model of BSD. For each model, we review evidence regarding whether the proposed underlying mechanism is associated with BSDs, provides vulnerability to the onset of BSDs, and predicts the course of BSDs. We then present a new integrated reward circadian rhythm (RCR) dysregulation model of BSD and discuss how the RCR model explains the symptoms, onset, and course of BSDs. We end with recommendations for future research directions.
AB - In this article, we present and review the evidence for two major biopsychosocial theories of the onset and course of bipolar spectrum disorders (BSDs) that integrate behavioral, environmental, and neurobiological mechanisms: the reward hypersensitivity and the social circadian rhythm disruption models. We describe the clinical features, spectrum, age of onset, and course of BSDs. We then discuss research designs relevant to demonstrating whether a hypothesized mechanism represents a correlate, vulnerability, or predictor of the course of BSDs, as well as important methodological issues. We next present the reward hypersensitivity model of BSD, followed by the social circadian rhythm disruption model of BSD. For each model, we review evidence regarding whether the proposed underlying mechanism is associated with BSDs, provides vulnerability to the onset of BSDs, and predicts the course of BSDs. We then present a new integrated reward circadian rhythm (RCR) dysregulation model of BSD and discuss how the RCR model explains the symptoms, onset, and course of BSDs. We end with recommendations for future research directions.
KW - Bipolar spectrum disorder
KW - Circadian rhythms
KW - Reward sensitivity
KW - Social rhythms
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U2 - 10.1146/annurev-clinpsy-032814-112902
DO - 10.1146/annurev-clinpsy-032814-112902
M3 - Article
C2 - 25581235
AN - SCOPUS:84925637722
SN - 1548-5943
VL - 11
SP - 213
EP - 250
JO - Annual Review of Clinical Psychology
JF - Annual Review of Clinical Psychology
ER -