Affective lability mediates the association between childhood trauma and suicide attempts, mixed episodes and co-morbid anxiety disorders in bipolar disorders
Affective lability mediates the association between childhood trauma and suicide attempts, mixed episodes and co-morbid anxiety disorders in bipolar disorders
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DOI：
10.1017/s0033291716003081
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发表时间：
2017-04-01
影响因子：
6.9
通讯作者：
Etain, B.
中科院分区：
文献类型：
--
作者：
Aas, M.;Henry, C.;Etain, B.
背景许多研究表明，童年创伤史与双相情感障碍（BD）更严重或更复杂的临床特征之间存在关联，包括自杀企图和早期发病。然而，这些协会背后的精神病理学机制仍然是未知的。在这里，我们调查了情感不稳定是否介导儿童创伤和严重的BD临床特征之间的关系。从法国和挪威共招募了342名BD参与者。使用遗传学研究诊断访谈（DIGS）或DSM-IV轴I疾病结构化临床访谈（SCID-I）评估诊断和临床特征。情感不稳定性采用情感不稳定性量表（ALS-SF）的缩写形式进行测量。使用儿童创伤问卷（CTQ）评估儿童创伤史。中介分析使用SPSS PROCESS宏。使用中介模型和协变的一生中的主要情绪发作的数量，情感不稳定性被发现统计调解童年创伤的经验和几个临床变量，包括自杀企图，混合发作和焦虑症之间的关系。未发现快速循环或发病年龄的显著中介作用。我们的数据表明，情感不稳定性可能代表了一个心理层面，介导儿童创伤经历和更严重或复杂的BD临床表现的风险之间的关联。
Background. Many studies have shown associations between a history of childhood trauma and more severe or complex clinical features of bipolar disorders (BD), including suicide attempts and earlier illness onset. However, the psychopathological mechanisms underlying these associations are still unknown. Here, we investigated whether affective lability mediates the relationship between childhood trauma and the severe clinical features of BD.Method. A total of 342 participants with BD were recruited from France and Norway. Diagnosis and clinical characteristics were assessed using the Diagnostic Interview for Genetic Studies (DIGS) or the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Affective lability was measured using the short form of the Affective Lability Scale (ALS-SF). A history of childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Mediation analyses were performed using the SPSS PROCESS macro.Results. Using the mediation model and covariation for the lifetime number of major mood episodes, affective lability was found to statistically mediate the relationship between childhood trauma experiences and several clinical variables, including suicide attempts, mixed episodes and anxiety disorders. No significant mediation effects were found for rapid cycling or age at onset.Conclusions. Our data suggest that affective lability may represent a psychological dimension that mediates the association between childhood traumatic experiences and the risk of a more severe or complex clinical expression of BD.