Development and assessment issues in the diagnosis of early-onset bipolar disorder

Psychologists face challenges on a daily basis. Among the challenges they face are making diagnostic decisions. Recently, bipolar disorder has shown an increase in diagnosis in children and adolescents. Once felt to be an adult disorder, journals are describing the use of the diagnosis with children and adolescents. While the diagnosis has been considered as relevant, no psychological measures have been developed to make an accurate diagnosis. Developing a new psychological measure for bipolar disorder in children is critical. Due to the lack of data on what constitutes normal behavior as well as the absence of an accurate measurement of early-onset bipolar disorder, it is necessary to develop such a measure. The purpose of this study was to evaluate a newly developed measure based on the literature on bipolar disorder in children. The measure was developed through a review of the current literature, DSMIV-TR criteria for bipolar disorder, and ideas developed within a bipolar disorder research team at Texas A&M University. Because of the item content, the new measure is entitled the Mania Assessment Scale for Children (MASC). The first steps in understanding a new measure for early-onset bipolar disorder is to determine the factor structure of the scale as well as the reliability and validity. Results indicated that the MASC is best understood as a measure with a single score, or factor. Once the underlying structure of the MASC was determined, the study evaluated which behaviors of typically developing children may be misconstrued as indicative of bipolar disorder. Group differences on the measure are also evaluated. Results from statistical analysis showed that there were significant group differences between age groups, but not gender and ethnic groups. In addition, there was a statistically significant difference between clinical and non-clinical groups. To conclude, a discussion of the findings and recommendations for future research is presented. Overall, it is hoped that the study will help psychologists better understand the complexity of behaviors associated with the diagnosis of bipolar disorder in children and adolescents.