Ninety-four children, 2-3 years of age, were assessed using two structured, behavioral observation systems: in a psychiatric play interview in the absence of mother, and in interaction with mother. Fifteen mothers had Bipolar Disorder, 37 Major Depressive Disorder, 9 Minor Depressive Disorder, and 33 with no history of psychiatric disorder. Approximately one-half of the husbands of the mothers with affective disorder had affective disorder as well. All children were assigned a rating of degree of risk for the later development of psychopathology based on their performance in each of the two assessment settings. This pair of assessments produced four groups of children: a low risk group who received ratings of low risk for the later development of psychopathology in both assessments, two mixed-risk groups composed of children who received a rating of high risk in one setting, and low risk in the other, and a high risk group of children who received ratings of high risk in both assessments. At this time, case by case analysis of the ten children in the high risk group is complete. Of these ten children, only 3 were girls. Two of the boys were from families in which neither parent had a history of psychiatric illness; of the remaining 8 children, 5 were from families in which both parents had affective disorder, and 3 from families with one ill parent. Two major constellations of behavioral symptoms were discernible in these high-risk toddlers. One consisted of an isolated or distant type of relationship with mother, dysphoria, and anhedonia. The other consisted of an angry type of relationship with mother, and predominantly angry mood. The children in both groups demonstrated dysregulation of emotions under stress.
