Social skills deficits among adolescents with bipolar disorder.

다국어 초록 (Multilingual Abstract)

This study investigated social skills deficits among adolescents with bipolar disorder (<italic>n</italic> = 18) as compared with a control group of adolescents (<italic>n</italic> = 18) free from major psychiatric disturbance. We hypothesized that symptom-free bipolar adolescents would be indistinguishable from controls on ratings of social skills knowledge, but would exhibit significant social skills performance deficits relative to controls. Axis I diagnoses for bipolar patients were determined via the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime Version (K-SADS-PL) during recruitment for a pilot study of Family-Focused Therapy for Adolescents (FFT-A), a modified version of Miklowitz & Goldstein's (1997) family-focused intervention for adults with bipolar disorder. Bipolar participants completed social skills assessments when they were experiencing minimal symptoms. The control group consisted of individuals who responded to advertisements requesting participation from teens not diagnosed with psychological disturbance. These teens were subsequently screened for psychopathology using the K-SADS-PL.
To assess social skills performance assets and deficits, participants completed the Matson Evaluation of Social Skills with Youngsters (MESSY), a self-report scale that requires subjects to rate the frequency of various prosocial behaviors. The teen's parent or guardian simultaneously completed the T-MESSY (teacher/parent rated version). Knowledge of appropriate social skills was measured using the Interpersonal Negotiation Strategy Interview (INS), a structured interview that asks participants to formulate solutions to hypothetical social dilemmas. Raters blind to psychiatric condition rated the participant's responses, as well as his/her social interactions with the examiner during the assessment using the Interactional Skills Ratings (ISR) scale.
In line with our hypotheses, bipolar adolescents exhibited age-appropriate knowledge of social skills during a period of symptom remission, but displayed more social skills performance deficits on both self- and parent-rated assessments than controls. Bipolar participants were indistinguishable from controls on blinded ratings of interactions with the examiner. Implications of the findings for biological models of the onset of bipolar disorder, and psychosocial interventions are discussed.