Effects of intervention on emotion-regulation brain pathways in youth at risk for bipolar disorder.

Bipolar disorder (BD) is a mental illness characterized by intense mood changes. During mania, a person with BD will experience increased energy and poor self-control, often leading to risky decision making with consequences for themselves or their families. During depression, they will experience feelings of worthlessness and a loss of interest in things they once enjoyed. BD develops in late teens to early 20s and affects the individual for the duration of their life. Detecting and treating individuals at risk for BD at an early stage is critical in reducing onset of illness and the associated disability. As part of an existing study that has assessed over 375 youth at risk for severe mental illness, we will select 9-16 year olds who have a family history of BD or show early milder symptoms of the disorder and offer them 3 months of pre-emptive skill building therapy. We will study the effect of therapy by comparing both the symptoms and brain function before and after the intervention. We expect that giving these individuals the skills for managing emotions, impulses, and stress will lead to less symptoms in the future and to an improvement in the emotion regulation areas of the brain. The proposed research will tell us if early intervention improves the outcomes of at-risk youth and if it the improvement can be measured at the level of the brain, paving the way for better diagnosis and use of personalized prevention methods for BD.