Advertisement
Original article| Volume 60, ISSUE 9, P957-965, November 01, 2006

Neuropsychological Functioning in Adolescent Children of Mothers with a History of Bipolar or Major Depressive Disorders

      Background

      Growing evidence demonstrates an association of neuropsychological deficits with mood disorders, but it is not yet clear whether these deficits are risk factors or are concomitant with the symptoms. This study examines the neuropsychological functioning of a group of adolescent offspring who are at risk for a mood disorder by virtue of being raised by mothers who have been diagnosed with major depressive disorder (MDD) or bipolar disorder (BPD).

      Methods

      Adolescent offspring of mothers with BPD (n = 43) or MDD (n = 72) and of psychiatrically well parents (n = 50) completed a battery of neuropsychological tests to assess executive functioning, memory, and attention.

      Results

      Children of mothers with BPD showed deficits in executive functioning and selective deficits in spatial memory and attention, in comparison with children of well mothers. Deficits were not found for children of MDD mothers.

      Conclusions

      Knowledge of these neurocognitive processes could aid ultimately in determining whether neurocognitive deficits precede BPD, whether unique profiles are associated with various types of mood disorders, and who may benefit from interventions.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Biological Psychiatry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • American Psychiatric Association
        Diagnostic and Statistical Manual of Mental Disorders. 3rd rev. ed. American Psychiatric Association, Washington, DC1987
        • American Psychiatric Association
        Diagnostic and Statistical Manual of Mental Disorders. 4th ed. American Psychiatric Association, Washington, DC1994
        • Anderson C.A.
        • Hammen C.L.
        Psychosocial outcomes of children of unipolar depressed, bipolar, medically ill, and normal women: A longitudinal study.
        J Consult Clin Psychol. 1993; 61: 448-454
        • Austin M.P.
        • Mitchell P.
        • Goodwin G.M.
        Cognitive deficits in depression: Possible implications for functional neuropathology.
        Br J Psychiatry. 2001; 178: 200-206
        • Barkley R.A.
        • Grodzinsky G.
        • DuPaul G.J.
        Frontal lobe functions in attention deficit disorder with and without hyperactivity: A review and research report.
        J Abnorm Child Psychol. 1992; 20: 163-188
        • Basso M.R.
        • Lowery N.
        • Neel J.
        • Purdie R.
        • Bornstein R.A.
        Neuropsychological impairment among manic, depressed, and mixed-episode inpatients with bipolar disorder.
        Neuropsychology. 2002; 16: 84-91
        • Beebe D.W.
        • Ris M.D.
        • Brown T.M.
        • Dietrich K.N.
        Executive functioning and memory for the Rey-Osterreith complex figure task among community adolescents.
        Appl Neuropsychol. 2004; 11: 91-98
        • Beebe D.W.
        • Ris M.D.
        • Dietrich K.N.
        The relationship between CVLT-C process scores and measures of executive functioning: Lack of support among community-dwelling adolescents.
        J Clin Exp Neuropsychol. 2000; 22: 779-792
        • Borkowska A.
        • Rybakowski J.K.
        Neuropsychological frontal lobe tests indicate that bipolar depressed patients are more impaired than unipolar.
        Bipolar Disord. 2001; 3: 88-94
        • Breznitz Z.
        • Friedman S.L.
        Toddlers’ concentration: Does maternal depression make a difference?.
        J Child Psychol Psychiatry. 1988; 29: 267-279
        • Brown G.
        • Harris T.
        Social Origins of Depression: A Study of Psychiatric Disorders in Women. Tavistock, London1978
        • Burt D.B.
        • Zembar M.J.
        • Niederehe G.
        Depression and memory impairment: A meta-analysis of the association, its pattern, and specificity.
        Psychol Bull. 1995; 117: 285-305
        • Channon S.
        Executive dysfunction in depression: The Wisconsin Card Sorting Test.
        J Affect Disord. 1996; 39: 107-114
        • Clark L.
        • Iversen S.D.
        • Goodwin G.M.
        Sustained attention in bipolar disorder.
        Br J Psychiatry. 2002; 180: 313-319
        • Coello E.
        • Ardila A.
        • Rosselli M.
        Is there a cognitive marker in major depression?.
        Int J Neurosci. 1990; 50: 137-145
        • Cohler B.J.
        • Grunebaum H.U.
        • Weiss J.L.
        • Gamer E.
        • Gallant D.H.
        Disturbance of attention among schizophrenic, depressed and well mothers and their young children.
        J Child Psychol Psychiatry. 1977; 18: 115-135
        • DelBello M.P.
        • Chrousos G.P.
        • Dorn L.D.
        • Burke L.
        • Helmers K.
        • Kling M.A.
        • et al.
        Hypothalamic-pituitary-adrenal axis dysregulation in sexually abused girls.
        J Clin Endocrinol Metab. 1994; 78: 249-255
        • DelBello M.P.
        • Geller B.
        Review of studies of child and adolescent offspring of bipolar parents.
        Bipolar Disord. 2001; 3: 325-334
        • Delis D.C.
        • Kramer J.
        • Kaplan E.
        • Ober B.A.
        California Verbal Learning Test for Children (CVLT-C). Psychological Corporation, New York1994
        • DeMulder E.
        • Tarullo L.
        • Klimes-Dougan B.
        • Free K.
        • Radke-Yarrow M.
        Personality disorders of affectively ill mothers: Links to maternal behavior.
        J Personal Disord. 1995; 9: 199-212
        • Dickstein D.P.
        • Treland J.E.
        • Snow J.
        • McClure E.B.
        • Mehta M.S.
        • Towbin K.E.
        • et al.
        Neuropsychological performance in pediatric bipolar disorder.
        Biol Psychiatry. 2004; 55: 32-39
        • Downey G.
        • Coyne J.C.
        Children of depressed parents: An integrative review.
        Psychol Bull. 1990; 108: 50-76
        • Doyle A.E.
        • Wilens T.E.
        • Kwon A.
        • Seidman L.J.
        • Faraone S.V.
        • Fried R.
        • et al.
        Neuropsychological functioning in youth with bipolar disorder.
        Biol Psychiatry. 2005; 58: 540-548
        • Endicott J.
        • Spitzer R.L.
        • Fleiss J.L.
        • Cohen J.
        The Global Assessment Scale.
        Arch Gen Psychiatry. 1976; 33: 766-771
        • Fossati P.
        • Amar G.
        • Raoux N.
        • Ergis A.M.
        • Allilaire J.F.
        Executive functioning and verbal memory in young patients with unipolar depression and schizophrenia.
        Psychiatry Res. 1999; 89: 171-187
        • Fossati P.
        • Ergis A.M.
        • Allilaire J.F.
        Problem-solving abilities in unipolar depressed patients: Comparison of performance on the modified version of the Wisconsin and the California sorting tests.
        Psychiatry Res. 2001; 104: 145-156
        • Giedd J.N.
        Structural magnetic resonance imaging of the adolescent brain.
        Ann N Y Acad Sci. 2004; 1021: 77-85
        • Gourovitch M.L.
        • Torrey E.F.
        • Gold J.M.
        • Randolph C.
        • Weinberger D.R.
        • Goldberg T.E.
        Neuropsychological performance of monozygotic twins discordant for bipolar disorder.
        Biol Psychiatry. 1999; 45: 639-646
        • Greve K.W.
        • Brooks J.
        • Crouch J.A.
        • Williams M.C.
        • Rice W.J.
        Factorial structure of the Wisconsin Card Sorting Test.
        Br J Clin Psychol. 1997; 36: 283-285
        • Greve K.W.
        • Williams M.C.
        • Haas W.G.
        • Littell R.R.
        • Reinoso C.
        The role of attention in Wisconsin Card Sorting Test performance.
        Arch Clin Neuropsychol. 1996; 11: 215-222
        • Grunebaum H.
        • Cohler B.J.
        • Kauffman C.
        • Gallant D.
        Children of depressed and schizophrenic mothers.
        Child Psychiatry Hum Dev. 1978; 8: 219-228
        • Halperin J.M.
        • Sharma V.
        • Greenblatt E.
        • Schwartz S.
        Assessment of the continuous performance test: Reliability and validity in a nonreferred sample.
        J Consult Clin Psychol. 1991; 3: 603-608
        • Hay D.F.
        • Pawlby S.
        • Sharp D.
        • Asten P.
        • Mills A.
        • Kumar R.
        Intellectual problems shown by 11-year-old children whose mothers had postnatal depression.
        J Child Psychol Psychiatry. 2001; 42: 871-889
        • Heaton R.K.
        • Chelune G.J.
        • Tally J.L.
        • Kay G.G.
        • Curtiss G.
        Wisconsin Card Sort Test Manual: Revised and Expanded. Psychological Assessment Resources, Odessa, FL1993
        • Hedeker D.
        • Gibbons R.D.
        • Flay B.R.
        Random-effects regression models for clustered data: With an example from smoking prevention research.
        J Consult Clin Psychol. 1994; 62: 757-765
        • Heim C.
        • Newport D.J.
        • Bonsall R.
        • Miller A.H.
        • Nemeroff C.B.
        Altered pituitary-adrenal axis responses to provocative challenge tests in adult survivors of childhood abuse.
        Am J Psychiatry. 2001; 158: 575-581
        • Herjanic B.
        • Reich W.
        Development of a structured psychiatric interview for children: Agreement between child and parent on individual symptoms.
        J Abnorm Child Psychol. 1982; 10: 307-324
        • Hoff A.L.
        • Shukla S.
        • Aronson T.
        • Cook B.
        • Ollo C.
        • Baruch S.
        • et al.
        Failure to differentiate bipolar disorder from schizophrenia on measures of neuropsychological function.
        Schizophr Res. 1990; 3: 253-260
        • Hu F.B.
        • Goldberg J.
        • Hedeker D.
        • Henderson W.G.
        Modelling ordinal responses from co-twin control studies.
        Stat Med. 1998; 17: 957-970
        • Kestenbaum C.J.
        Children and adolescents at risk for manic-depressive illness: Introduction and overview.
        Adolesc Psychiatry. 1982; 10: 245-255
        • Kizilbash A.H.
        • Vanderploeg R.D.
        • Curtiss G.
        The effects of depression and anxiety on memory performance.
        Arch Clin Neuropsychol. 2001; 17: 57-67
        • Klimes-Dougan B.
        Cognitive Functioning in Children of Depressed Parents: Cross-sectional and Longitudinal Findings. 1994 (June, Paper presented at the annual meeting of the Society for Research in Child and Adolescent Psychopathology. London, England.)
        • Kurstjens S.
        • Wolke D.
        Effects of maternal depression on cognitive development of children over the first 7 years of life.
        J Child Psychol Psychiatry. 2001; 42: 623-636
        • Lauer R.E.
        • Giordani B.
        • Boivin M.J.
        • Halle N.
        • Glasgow B.
        • Alessi N.E.
        • et al.
        Effects of depression on memory performance and metamemory in children.
        J Am Acad Child Adolesc Psychiatry. 1994; 33: 679-685
        • Leibenluft E.
        • Charney D.S.
        • Pine D.S.
        Researching the pathophysiology of pediatric bipolar disorder.
        Biol Psychiatry. 2003; 53: 1009-1020
        • Lezak M.D.
        Neuropsychological Assessment. 2nd ed. Oxford University Press, New York1983
        • Liu D.
        • Diorio J.
        • Day J.C.
        • Francis D.D.
        • Meaney M.J.
        Maternal care, hippocampal synaptogenesis and cognitive development in rats.
        Nat Neurosci. 2000; 3: 799-806
        • Meyer S.E.
        • Carlson G.A.
        • Wiggs E.A.
        • Martinez P.E.
        • Ronsaville D.S.
        • Klimes-Dougan B.
        • et al.
        A prospective study of the association among impaired executive functioning, childhood attentional problems, and early onset bipolar disorder.
        Dev Psychopathol. 2004; 16: 461-476
      1. Meyer SE, Carlson GA, Wiggs EA, Ronsaville DS, Martinez PE, Klimes-Dougan B, et al (in press). A prospective high-risk study of the association among maternal negativity, apparent frontal lobe dysfunction, and the development of bipolar disorder. Dev Psychopathol.

        • Mineka S.
        • Sutton S.K.
        Cognitive biases and the emotional disorders.
        Psychol Sci. 1992; 3: 65-69
        • Morice R.
        Cognitive inflexibility and pre-frontal dysfunction in schizophrenia and mania.
        Br J Psychiatry. 1990; 157: 50-54
        • Moritz S.
        • Birkner C.
        • Kloss M.
        • Jahn H.
        • Hand I.
        • Haasen C.
        • et al.
        Executive functioning in obsessive-compulsive disorder, unipolar depression, and schizophrenia.
        Arch Clin Neuropsychol. 2002; 17: 477-483
        • Murphy F.C.
        • Sahakian B.J.
        • Rubinsztein J.S.
        • Michael A.
        • Rogers R.D.
        • Robbins T.W.
        • et al.
        Emotional bias and inhibitory control processes in mania and depression.
        Psychol Med. 1999; 29: 1307-1321
        • Murray L.
        The impact of postnatal depression on infant development.
        J Child Psychol Psychiatry. 1992; 33: 543-561
        • Murray L.
        • Kempton C.
        • Woolgar M.
        • Hooper R.
        Depressed mothers’ speech to their infants and its relation to infant gender and cognitive development.
        J Child Psychol Psychiatry. 1993; 34: 1083-1101
        • Naglieri J.A.
        • Pickering E.
        Helping Children Learn: Intervention Handouts for Use in School and at Home. Brookes, Baltimore, MD2003
        • Norton N.J.
        • Lipsitz S.R.
        Review of software to fit generalized estimating equation regression models.
        Am Stat. 1999; 53: 160-169
        • Otto M.W.
        • Bruder G.E.
        • Fava M.
        • Delis D.C.
        • Quitkin F.M.
        • Rosenbaum J.F.
        Norms for depressed patients for the California verbal learning test: Associations with depression severity and self-report of cognitive difficulties.
        Arch Clin Neuropsychol. 1994; 9: 81-88
        • Perneger T.V.
        What’s wrong with Bonferroni adjustments.
        BMJ. 1998; 316: 1236-1248
        • Pine D.S.
        • Wasserman G.A.
        • Workman S.B.
        Memory and anxiety in prepubertal boys at risk for delinquency.
        J Am Acad Child Adolesc Psychiatry. 1999; 38: 1024-1031
        • Radke-Yarrow M.
        • Martinez P.
        • Mayfield A.
        • Ronsaville D.
        Children of Depressed Mothers: From Early Childhood to Maturity. Cambridge University Press, New York1998
        • Reitan R.M.
        • Wolfson D.
        The Halstead-Reitan Neuropsychological Test Battery. Neuropsychological Press, Tucson, AZ1985
      2. Ronsaville DS, Municchi M, Laney C, Cizza G, Meyer SE, Haim A, et al (in press): Maternal and environmental factors influence the HPA axis response to corticotropin releasing hormone infusion in offspring of mothers with or without mood disorders. Dev Psychopathol.

        • Rossi A.
        • Arduini L.
        • Daneluzzo E.
        • Bustini M.
        • Prosperini P.
        • Stratta P.
        Cognitive function in euthymic bipolar patients, stabilized schizophrenic patients, and healthy controls.
        J Psychiatr Res. 2000; 34: 333-339
        • Sigurdsson E.
        • Fombonne E.
        • Sayal K.
        • Checkley S.
        Neurodevelopmental antecedents of early-onset bipolar affective disorder.
        Br J Psychiatry. 1999; 174: 121-127
        • Singer J.
        Using SAS PROC MIXED to fit multilevel models, hierarchical models, and individual growth models.
        J Educ Behav Stat. 1998; 24: 323-355
        • Smoller J.W.
        • Finn C.T.
        Family, twin, and adoption studies of bipolar disorder.
        Am J Med Genet C (Semin Med Genet). 2003; 123C: 48-58
        • Spitzer R.L.
        • Endicott J.
        The Schedule for Affective Disorders and Schizophrenia: Lifetime Version. New York State Psychiatric Institute, Biometrics Research, New York1977
        • Sullivan E.V.
        • Mathalon D.H.
        • Zipursky R.B.
        • Kersteen-Tucker Z.
        • Knight R.T.
        • Pfefferbaum A.
        Factors of the Wisconsin Card Sorting Test as measures of frontal-lobe function in schizophrenia and in chronic alcoholism.
        Psychiatry Res. 1993; 46: 175-199
        • van Gorp W.G.
        • Altshuler L.
        • Theberge D.C.
        • Wilkins J.
        • Dixon W.
        Cognitive impairment in euthymic bipolar patients with and without prior alcohol dependence.
        Arch Gen Psychiatry. 1998; 55: 41-46
        • Vythilingam M.
        • Heim C.
        • Newport J.
        • Miller A.H.
        • Anderson E.
        • Bronen R.
        • et al.
        Childhood trauma associated with smaller hippocampal volume in women with major depression.
        Am J Psychiatry. 2002; 159: 2072-2080
        • Waber D.P.
        • Holmes J.M.
        Assessing children’s copy productions of the Rey-Osterrieth Complex Figure.
        J Clin Exp Neuropsychol. 1985; 7: 264-280
        • Wechsler D.
        Wechsler Adult Intelligence Scale Manual. Psychological Corporation, New York1955
        • Wechsler D.
        Wechsler Intelligence Scale for Children–Revised. Psychological Corporation, New York1974
        • Weiss S.R.
        • Post R.M.
        Kindling: Separate vs. shared mechanisms in affective disorders and epilepsy.
        Neuropsychobiology. 1998; 38: 167-180
        • Weissman M.
        • Gammon G.
        • Davis G.
        • John K.
        • Merikangas K.
        Children of depressed parents: Increased psychopathology and early onset of major depression.
        Arch Gen Psychiatry. 1987; 44: 847-853
        • Wolfe J.
        • Granholm E.
        • Butters N.
        • Saunders E.
        • Janowsky D.
        Verbal memory deficits associated with major affective disorders: A comparison of unipolar and bipolar patients.
        J Affect Disord. 1987; 13: 83-92
        • Yurgelun-Todd D.A.
        • Gruber S.A.
        • Kanayama G.
        • Kilgore W.D.
        • Baird A.A.
        • Young A.D.
        fMRI during affect discrimination in bipolar affective disorder.
        Bipolar Disord. 2000; 2: 237-248