Johnson Sheri L, Carver Charles S
Department of Psychology, 3210 Tolman Hall, University of California, Berkeley, CA 94720-1650, USA.
University of Miami, Department of Psychology, Coral Gables, FL, and Center for Advanced Study in the Behavioral Sciences (CASBS), Stanford University, Stanford, CA, USA.
J Affect Disord. 2016 Jan 1;189:169-75. doi: 10.1016/j.jad.2015.07.050. Epub 2015 Sep 25.
Recent evidence suggests that anger and aggression are of concern even during remission for persons with bipolar I disorder, although there is substantial variability in the degree of anger and aggression across individuals. Little research is available to examine psychological models of anger and aggression for those with remitted bipolar disorder, and that was the goal of this study. Participants were 58 persons diagnosed with bipolar I disorder using the Structured Clinical Interview for DSM-IV, who were followed with monthly symptom severity interviews until they achieved remission, and then assessed using the Aggression-Short Form. We examined traditional predictors of clinical parameters and trauma exposure, and then considered three trait domains that have been shown to be elevated in bipolar disorder and have also been linked to aggression outside of bipolar disorder: emotion-relevant impulsivity, approach motivation, and dominance-related constructs. Emotion-relevant impulsivity was related to anger, hostility, verbal aggression, and physical aggression, even after controlling for clinical variables. Findings extend the importance of emotion-relevant impulsivity to another important clinical outcome and suggest the promise of using psychological models to understand the factors driving aggression and anger problems that persist into remission among persons with bipolar disorder.
近期证据表明，即便处于缓解期，双相I型障碍患者的愤怒和攻击行为仍值得关注，尽管个体间愤怒和攻击行为的程度存在很大差异。对于缓解期双相障碍患者的愤怒和攻击行为的心理模型，可供研究的资料很少，而这正是本研究的目的。研究参与者为58名使用《精神疾病诊断与统计手册》第四版（DSM-IV）结构化临床访谈被诊断为双相I型障碍的患者，他们每月接受症状严重程度访谈，直至达到缓解状态，然后使用攻击行为简表进行评估。我们考察了临床参数和创伤暴露的传统预测因素，然后考虑了三个特质领域，这些特质领域在双相障碍中已被证明有所升高，并且在双相障碍之外也与攻击行为有关：与情绪相关的冲动性、趋近动机和与支配相关的构念。即使在控制了临床变量之后，与情绪相关的冲动性仍与愤怒、敌意、言语攻击和身体攻击有关。研究结果将与情绪相关的冲动性的重要性扩展到了另一个重要的临床结果，并表明利用心理模型来理解导致双相障碍患者持续到缓解期的攻击和愤怒问题的驱动因素具有前景。
