The Development and Course of Bipolar Spectrum Disorders: an Integrated Reward and Circadian Rhythm Dysregulation Model

Overview

Journal Annu Rev Clin Psychol

Publisher Annual Reviews

Specialty Psychology

Date 2015 Jan 13

PMID 25581235

Citations 56

Authors

Lauren B Alloy

Robin Nusslock

Elaine M Boland

Affiliations

Soon will be listed here.

Abstract

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.

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