Assessing disordered thoughts in preschoolers with dysregulated mood

Area of Science:

• Child Psychology
• Developmental Psychiatry
• Bipolar Disorder Research

Background:

• Rising interest in identifying early precursors to bipolar disorder, including thought disorder.
• Thought disorder assessment typically relies on self-report in adults and parent/child reports in older children.
• Need for methods to assess thought disorder in preschoolers, particularly those with mood dysregulation.

Purpose of the Study:

• To explore disordered thoughts in preschoolers with mood dysregulation using a story-stem completion method.
• To determine if atypical themes indicative of disordered thoughts appear in the narrative responses of symptomatic preschoolers.
• To compare narrative responses between preschoolers with mood dysregulation and typically developing peers.

Main Methods:

• Study included 3.5-6 year-old children: 20 with mood dysregulation (including manic symptoms) and 11 typically developing controls.
• Children completed story stems, including a narrative about a character accidentally self-injuring while pretending to cook.
• Responses were analyzed for themes of violence, bizarreness, inanimate objects acting independently, or props used outside the story context.

Main Results:

• 35% of symptomatic preschoolers, versus 0% of controls, attributed independent actions to inanimate props (p=0.03).
• 80% of symptomatic preschoolers, compared to 9% of controls, used props violently or bizarrely outside the story's context (p<0.001).
• Symptomatic preschoolers demonstrated unusual use of story props, suggesting potential disordered thoughts.

Conclusions:

• Preschool children with symptoms of dysregulated mood exhibit themes related to unusual prop use, potentially indicating disordered thoughts.
• This preschool manifestation of mood dysregulation may represent an early, continuous form of what becomes bipolar disorder in later life.
• The story-stem completion method shows promise for identifying early signs of disordered thought in young children.