4.3. Limitations
This study had a few limitations. First, the at-risk group was primarily chosen to have at least one first-degree relative with a history of mania. However, the assessment of mania for first-degree relatives was based on self- or other-report, and not confirmed by a structured interview. Second, as discussed, this ABCD study is collecting prospective data and the children’s report on their recent traumatic experiences might be underestimated. Third, as this study did not explore all potential diagnoses and used symptoms rather than diagnostic criteria, the overlap between manic and ADHD symptoms warrants caution when interpreting the results.