{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T09:00:32Z","timestamp":1792227632297,"version":"4.4.0"},"reference-count":97,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2006,10,25]],"date-time":"2006-10-25T00:00:00Z","timestamp":1161734400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dev Psychopathol"],"published-print":{"date-parts":[[2006,12]]},"abstract":"<jats:p>\n                    Mood disorder symptoms and their associated functional impairments are \nhypothesized to come about as the result of the conjoint, interactive \ninfluences of genetic, biological, and psychological vulnerabilities, \nfamily distress, and life stress at different points of development. We \ndiscuss a developmental psychopathology model that delineates pathways to \nhigh family conflict and mood exacerbation among early-onset bipolar \npatients. New data from a treatment development study indicate that \nadolescent bipolar patients in high expressed emotion families have more \nsymptomatic courses of illness over 2 years than adolescents in low \nexpressed emotion families. Chronic and episodic stressors are also \ncorrelated with lack of mood improvement while adolescents are in \ntreatment. Family-focused treatment (FFT) given in conjunction with \npharmacotherapy appears to ameliorate the course of bipolar disorder in \nadults. This treatment has recently been modified to address the \ndevelopmental presentation of bipolar disorder among adolescents. We \npresent data from an open trial of FFT and pharmacotherapy (\n                    <jats:italic>N<\/jats:italic>\n                    = \n20) indicating that bipolar adolescents stabilize in mania, depression, \nand parent-rated problem behaviors over 2 years. Future research should \nfocus on clarifying the developmental pathways to early-onset bipolar \ndisorder and the role of protective factors and preventative psychosocial \ninterventions in delaying the first onset of the disorder.\n                    <jats:fn>\n                      <jats:p>This research was supported by National \nInstitute of Mental Health Grants MH43931, MH62555, and MH073871; a \nDistinguished Investigator Award from the National Alliance for Research \non Schizophrenia and Depression; and a grant from the Robert Sutherland \nFoundation.<\/jats:p>\n                    <\/jats:fn>\n                  <\/jats:p>","DOI":"10.1017\/s0954579406060603","type":"journal-article","created":{"date-parts":[[2006,10,25]],"date-time":"2006-10-25T17:21:00Z","timestamp":1161796860000},"page":"1247-1265","source":"Crossref","is-referenced-by-count":63,"title":["Early-onset bipolar disorder: A family treatment perspective"],"prefix":"10.1017","volume":"18","author":[{"given":"DAVID J.","family":"MIKLOWITZ","sequence":"first","affiliation":[{"name":"University of Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ADRINE","family":"BIUCKIANS","sequence":"additional","affiliation":[{"name":"University of Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JEFFREY A.","family":"RICHARDS","sequence":"additional","affiliation":[{"name":"University of Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2006,10,25]]},"reference":[{"key":"S0954579406060603_ref096","doi-asserted-by":"crossref","unstructured":"Zahn-Waxler, C. , Iannotti, R. , Cummings, E. 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