Corry Justine, Green Melissa, Roberts Gloria, Fullerton Janice M, Schofield Peter R, Mitchell Philip B
School of Psychiatry, University of New South Wales, Randwick, NSW, 2031, Australia.
Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, 2031, Australia.
Int J Bipolar Disord. 2017 Oct 6;5(1):34. doi: 10.1186/s40345-017-0102-8.
Bipolar disorder (BD) and the anxiety disorders are highly comorbid. The present study sought to examine perfectionism and goal attainment values as potential mechanisms of known associations between anxiety, stress and BD symptomatology. Measures of perfectionism and goal attainment values were administered to 269 members of BD pedigrees, alongside measures of anxiety and stress, and BD mood symptoms. Regression analyses were used to determine whether perfectionism and goal attainment values were related to depressive and (hypo)manic symptoms; planned mediation models were then used to test the potential for perfectionism to mediate associations between anxiety/stress and BD symptoms.
Self-oriented perfectionism was associated with chronic depressive symptoms; socially-prescribed perfectionism was associated with chronic (hypo)manic symptoms. Self-oriented perfectionism mediated relationships between anxiety/stress and chronic depressive symptoms even after controlling for chronic hypomanic symptoms. Similarly, socially-prescribed perfectionism mediated associations between anxiety/stress and chronic hypomanic symptoms after controlling for chronic depressive symptoms. Goal attainment beliefs were not uniquely associated with chronic depressive or (hypo)manic symptoms.
Cognitive styles of perfectionism may explain the co-occurrence of anxiety and stress symptoms and BD symptoms. Psychological interventions for anxiety and stress symptoms in BD might therefore address perfectionism in attempt to reduce depression and (hypo)manic symptoms in addition to appropriate pharmacotherapy.
双相情感障碍（BD）与焦虑症高度共病。本研究旨在检验完美主义和目标达成价值观，作为焦虑、压力与双相情感障碍症状之间已知关联的潜在机制。对269名双相情感障碍谱系成员进行了完美主义和目标达成价值观的测量，同时测量了焦虑、压力及双相情感障碍的情绪症状。采用回归分析来确定完美主义和目标达成价值观是否与抑郁及（轻）躁狂症状相关；随后使用计划中介模型来检验完美主义在焦虑/压力与双相情感障碍症状之间起中介作用的可能性。
自我导向型完美主义与慢性抑郁症状相关；社会规定型完美主义与慢性（轻）躁狂症状相关。即使在控制了慢性轻躁狂症状之后，自我导向型完美主义仍在焦虑/压力与慢性抑郁症状之间起中介作用。同样，在控制了慢性抑郁症状之后，社会规定型完美主义在焦虑/压力与慢性轻躁狂症状之间起中介作用。目标达成信念与慢性抑郁或（轻）躁狂症状并无独特关联。
完美主义的认知风格可能解释了焦虑和压力症状与双相情感障碍症状的共现情况。因此，针对双相情感障碍中焦虑和压力症状的心理干预，除了适当的药物治疗外，可能还需解决完美主义问题，以试图减轻抑郁和（轻）躁狂症状。
