Rucklidge Julia J
Department of Psychology, University of Canterbury and Youth Specialty Service, Canterbury District Health Board, Private Bag 4800, Christchurch, New Zealand.
J Affect Disord. 2006 Apr;91(2-3):181-8. doi: 10.1016/j.jad.2006.01.001. Epub 2006 Feb 14.
While there has been a growing interest in the presentation of Bipolar Disorder (BD) in children and adolescents, few studies have investigated the psychosocial functioning of these individuals and its relationship to trauma and suicidal ideation.
63 adolescents aged 13-17 participated: 39 controls and 24 with Bipolar Disorder (BD). Group allocation and histories of trauma and suicidal ideation were obtained using the K-SADS-PL and WASH-U-KSADS. Adolescents completed questionnaires covering negative life events, self-esteem, hopelessness, regulation of anger, locus of control and coping.
More traumatic events and negative life experiences were reported by the BD group with over 50% of the BD sample indicating a history of trauma compared with 10% of the controls. The BD group reported lower self-esteem, more hopelessness, more negative life events, a more external locus of control and greater difficulties regulating emotion in anger-provoking situations. They were also found to have poorer coping strategies than the controls. Histories of trauma did not differentiate those with and without psychosocial problems. Further, hopelessness was found to be the best predictor of those BD adolescents reporting suicidal ideation. Comorbidity could not account for the differences found.
The sample was small and therefore disallowed comparisons among subtypes of BD. Cross-sectional design limited the ability to investigate causal relationships.
This is the first study to document the widespread psychosocial difficulties facing youth with BD, highlighting these issues as important ones to explore during assessment and treatment, particularly in management of affective storms and suicidal risk.
虽然人们对儿童和青少年双相情感障碍（BD）的表现越来越感兴趣，但很少有研究调查这些个体的心理社会功能及其与创伤和自杀意念的关系。
63名年龄在13至17岁的青少年参与研究：39名对照者和24名双相情感障碍（BD）患者。使用儿童版情感障碍和精神分裂症问卷（K-SADS-PL）及华盛顿大学版儿童版情感障碍和精神分裂症问卷（WASH-U-KSADS）获取分组情况以及创伤和自杀意念史。青少年完成了涵盖负面生活事件、自尊、绝望感、愤怒调节、控制点和应对方式的问卷。
BD组报告的创伤事件和负面生活经历更多，超过50%的BD样本表明有创伤史，而对照组这一比例为10%。BD组报告的自尊较低、绝望感更强、负面生活事件更多、控制点更外控，且在引发愤怒的情境中调节情绪的困难更大。还发现他们的应对策略比对照组更差。创伤史并不能区分有或没有心理社会问题的个体。此外，绝望感被发现是报告有自杀意念的BD青少年的最佳预测因素。共病无法解释所发现的差异。
样本量小，因此无法对BD的亚型进行比较。横断面设计限制了调查因果关系的能力。
这是第一项记录BD青少年面临的广泛心理社会困难的研究，强调这些问题是评估和治疗过程中需要探索的重要问题，特别是在情感风暴和自杀风险的管理方面。
