Study Limitations
primary and comorbid
First, the sample sizes for the neuroimaging analyses were modest. Nonetheless, we found robust and consistent results across resting and task-based fMRI after correcting for multiple comparisons and adjusting for neuroimaging site, age, and sex. Second, high-risk youth were clinically heterogeneous, and were on a variety of medication regimens, with random assignment stratified on whether the participant was taking a mood stabilizing or antipsychotic agent or neither. HR youth had primary and comorbid diagnoses that are typical of bipolar offspring samples, who are frequently treated with a combination of psychosocial and pharmacological interventions. The treatment groups were not significantly different in distributions of diagnoses or medication exposure at baseline or follow-up, and univariate analyses did not find that primary diagnosis or medication class predicted treatment-related differences in the neuroimaging results.Third, the EC condition was matched to the FFT-HR condition in duration (4 months) but not in the number of sessions (12 Finally, we could not disentangle the specific components of FFT-HR that map onto changes in psychosocial or neural variables. Within-person changes resulting from psychoeducation (