University of Worcester Worcester Research and Publications
 
  USER PANEL:
  ABOUT THE COLLECTION:
  CONTACT DETAILS:

Explaining why Childhood Abuse is a Risk Factor for Poorer Clinical Course in Bipolar Disorder: A Path Analysis of 923 People With Bipolar I Disorder

Marwaha, S., Briley, P.M., Perry, Amy, Rankin, P., Di Florio, A., Craddock, N., Jones, I., Broome, M., Gordon-Smith, Katherine and Jones, Lisa (2019) Explaining why Childhood Abuse is a Risk Factor for Poorer Clinical Course in Bipolar Disorder: A Path Analysis of 923 People With Bipolar I Disorder. Psychological Medicine. ISSN 0033-2917, ESSN: 1469-8978 (In Press)

[img]
Preview
Text
explaining_why_childhood_abuse_is_a_risk_factor_for_poorer_clinical_course_in_bipolar_disorder_a_path_analysis_of_923_people_with_bipolar_i_disorder.pdf - Published Version
Available under License Creative Commons Attribution.

Download (291kB) | Preview

Abstract

Background. Childhood abuse is a risk factor for poorer illness course in bipolar disorder, but the reasons why are unclear. Trait-like features such as affective instability and impulsivity could be part of the explanation. We aimed to examine whether childhood abuse was associated with clinical features of bipolar disorder, and whether associations were mediated by affective instability or impulsivity. Methods. We analysed data from 923 people with bipolar I disorder recruited by the Bipolar Disorder Research Network. Adjusted associations between childhood abuse, affective instability and impulsivity and eight clinical variables were analysed. A path analysis examined the direct and indirect links between childhood abuse and clinical features with affective instability and impulsivity as mediators. Results Affective instability significantly mediated the association between childhood abuse and earlier age of onset [effect estimate (θ)/standard error (SE): 2.49], number of depressive (θ/SE: 2.08) and manic episodes/illness year (θ/SE: 1.32), anxiety disorders (θ/SE: 1.98) and rapid cycling (θ/SE: 2.25). Impulsivity significantly mediated the association between childhood abuse and manic episodes/illness year (θ/SE: 1.79), anxiety disorders (θ/SE: 1.59), rapid cycling (θ/SE: 1.809), suicidal behaviour (θ/SE: 2.12) and substance misuse (θ/SE: 3.09). Measures of path analysis fit indicated an excellent fit to the data. Conclusions Affective instability and impulsivity are likely part of the mechanism of why childhood abuse increases risk of poorer clinical course in bipolar disorder, with each showing some selectivity in pathways. They are potential novel targets for intervention to improve outcome in bipolar disorder.

Item Type: Article
Additional Information:

The full-text of the online published article can be accessed via the official URL.

COPYRIGHT: © The Author(s) 2019
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Uncontrolled Keywords: affective instability, bipolar disorder, childhood abuse, impulsivity, path analysis
Divisions: Divisions (2019 onwards) > College of Health, Life and Environmental Sciences > School of Allied Health and Community
Related URLs:
Copyright Info: Open access article
Depositing User: Amy Perry
Date Deposited: 09 Oct 2019 14:15
Last Modified: 17 Oct 2019 15:53
URI: https://eprints.worc.ac.uk/id/eprint/8698

Actions (login required)

View Item View Item
 
     
Worcester Research and Publications is powered by EPrints 3 which is developed by the School of Electronics and Computer Science at the University of Southampton. More information and software credits.