Longitudinal course of depressive symptom severity among youths with bipolar disorders: Moderating influences of sustained attention and history of child maltreatment

• Published in: Journal of affective disorders 2021-03, Vol.282, p.261-271
• Main Authors: Vaughn-Coaxum, Rachel A., Merranko, John, Birmaher, Boris, Dickstein, Daniel P., Hafeman, Danella, Levenson, Jessica C., Liao, Fangzi, Gill, Mary Kay, Hower, Heather, Goldstein, Benjamin I., Strober, Michael, Ryan, Neal D., Diler, Rasim, Keller, Martin B., Yen, Shirley, Weinstock, Lauren M., Axelson, David, Goldstein, Tina R.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Attention; Bipolar disorder; Bipolar Disorder - epidemiology; Child; Child Abuse; Childhood adversity; Cognitive function; Depression; Female; Humans; Male; Physical abuse; Retrospective Studies; Sexual abuse; Young Adult
• ISSN: 0165-0327; 1573-2517; 1573-2517
• DOI: 10.1016/j.jad.2020.12.078

•For youths with a history of physical or sexual abuse, poorer sustained attention was associated with higher depression symptom severity during childhood and early adolescence.•Associations among abuse history, sustained attention, and depression symptom severity may be specific to certain substrates of attention (i.e., accuracy).•In late adolescence and early adulthood, no differential associations between attention and depression symptom severity were detected for youths with and without a history of abuse.•Average sustained attention and affective information processing scores did not differ for youths with and without a history of lifetime child abuse.•Affective information processing was not associated with history of abuse nor depression symptom severity over time. Pediatric bipolar disorders are often characterized by disruptions in cognitive functioning, and exposure to child maltreatment (e.g., physical and sexual abuse) is associated with a significantly poorer course of illness. Although clinical and developmental research has shown maltreatment to be robustly associated with poorer cognitive functioning, it is unclear whether maltreatment and cognitive function jointly influence the clinical course of bipolar symptoms. This secondary analysis examined moderating effects of lifetime childhood physical and sexual abuse, and cognitive disruptions (sustained attention, affective information processing), on longitudinal ratings of depression symptom severity in youths from the Course and Outcome of Bipolar Youth (COBY) study, examined from intake (M = 12.24 years) through age 22 (N = 198; 43.9% female; Mean age of bipolar onset = 8.85 years). A significant moderating effect was detected for sustained attention and maltreatment history. In the context of lower sustained attention, maltreatment exposure was associated with higher depression symptom severity during childhood, but not late adolescence. There was no association between maltreatment and symptom severity in the context of higher sustained attention, and no association between attention and depression symptom severity for non-maltreated youths. Depression symptom ratings at each assessment were subject to retrospective recall bias despite the longitudinal design. Cognitive assessments were administered at different ages across youths. Depressive symptoms in pediatric bipolar may be jointly moderated by impairments in attention and exposure to maltreatment. Assessment of these risks, partic