The present study examines the relationship between Perceived Criticism (PC) and Sensitivity to Criticism (SC) in youth with Bipolar Spectrum Disorder (BPSD), their symptomatic experiences, and family functioning. We hypothesized that findings for youth would be consistent with findings for adults indicating that PC and SC would be associated with a worse clinical presentation, and that associations between family criticism and sensitivity and youth symptoms would be stronger for youth with BPSD than with other clinical diagnoses. We examined 828 youths ages 4–18 years (M = 10.9, SD = 3.4) and their caregivers from diverse ethnic and socioeconomic backgrounds using the Longitudinal Expert evaluation of All Data (LEAD) diagnoses (Spitzer, Comprehensive Psychiatry, 24, 399-411 1983), the parent-reported General Behavior Inventory (Youngstrom et al., Psychological Assessment, 13, 267–276 2001), The Perceived Criticism Scale (Hooley and Teasdale, Journal of Abnormal Psychology, 98, 229–235 1989), and the Family Assessment Device (Epstein et al., Journal of Marital and Family Therapy, 9, 171–180 1983). We found significant positive association between parent reports of youth criticalness and more severe manic and depression symptoms, greater mood lability, higher suicidality, and worse overall functioning. Youth with BPSD were significantly more critical and had higher SC than youth without BPSD. Interactions between BPSD and family criticalness and sensitivity were found in their links with youth symptoms. Negative associations between criticism and sensitivity and youth global family functioning were significant only for youth with BPSD. The positive association between criticism and youth mood lability was significant only for youth with BPSD. Our findings suggest that family factors and interactional patterns impact and are influenced by functioning in youth with BPSD and that family-based treatments should be considered routinely with these youth.

本研究探讨了双相谱系障碍 (BPSD) 青年的感知批评 (PC) 和批评敏感度 (SC)、他们的症状体验和家庭功能之间的关系。我们假设青少年的调查结果与成人的调查结果一致，表明 PC 和 SC 与更差的临床表现相关，家庭批评与敏感性和青少年症状之间的关联对于患有 BPSD 的青少年来说比其他临床诊断更强. 我们使用所有数据的纵向专家评估 ( LEAD  ) 诊断（斯皮策， 综合精神病学，24, 399-411 1983), 家长报告的一般行为量表 (Youngstrom et al., Psychological Assessment, 13 , 267–276 2001), 感知批评量表 (Hooley and Teasdale, Journal of Abnormal Psychology, 98 , 229–235 1989 年）和家庭评估设备（Epstein 等人，《婚姻与家庭治疗杂志》，9, 171–180 1983)。我们发现，父母对青少年的批评与更严重的躁狂和抑郁症状、更大的情绪不稳定性、更高的自杀率和更差的整体功能之间存在显着的正相关关系。与没有 BPSD 的青年相比，患有 BPSD 的青年明显更加挑剔，并且具有更高的 SC。在与青少年症状的联系中发现了 BPSD 与家庭批判性和敏感性之间的相互作用。批评和敏感性与青年全球家庭功能之间的负相关仅对患有 BPSD 的青年显着。批评与青少年情绪不稳定性之间的正相关关系仅对患有 BPSD 的青少年显着。