Lima Isabela M M, Malloy-Diniz Leandro F, de Miranda Débora M, Da Silva Antônio G, Neves Fernando S, Johnson Sheri L
Graduate Program in Molecular Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Brazilian Association of Psychiatry, Rio de Janeiro, Brazil.
Front Psychol. 2017 Dec 22;8:2240. doi: 10.3389/fpsyg.2017.02240. eCollection 2017.
Impulsivity is a core characteristic of bipolar disorder and it was observed as elevated in individuals with the disorder and in their relatives. Both impulsivity and history of maltreatment are risk factors for suicide attempts, however, these two key variables may not be independent, given the fact that parental impulsivity and associated social context could increase the risk of child maltreatment. In this study it was examined the association between the impulsivity of relatives and child maltreatment taking into consideration the conjoint and unique effects of these two variables on the risk of suicide attempts among the patients. Participants of the study consisted of 117 patients diagnosed with bipolar disorder and 25 first-degree relatives. Linear regression model was conducted to describe associations between facets of impulsivity of relatives and levels of child maltreatment reported by patients. The independent associations of suicide attempt history with the dimensions of impulsivity of the patient and maltreatment were tested by multinomial logistic regression. Impulsivity of relatives and, more specifically, inhibitory control can predict the maltreatment of the patient. Inhibitory control and emotional abuse were related, conjointly, to a greater likelihood of having a history of more than one suicide attempt. Considering that the impulsivity of relatives predicts child maltreatment, it is possible that a genetically shared impulsivity is an underlying feature associated with the history of multiple suicide attempts. These findings highlight the importance of considering child maltreatment, impulsivity and suicide attempt history in integrative models.
冲动性是双相情感障碍的一个核心特征，在该疾病患者及其亲属中均观察到冲动性有所升高。冲动性和虐待史都是自杀未遂的风险因素，然而，鉴于父母的冲动性及相关社会环境可能会增加儿童受虐待的风险，这两个关键变量可能并非相互独立。在本研究中，考虑到这两个变量对患者自杀未遂风险的联合作用和独特作用，对亲属的冲动性与儿童虐待之间的关联进行了研究。该研究的参与者包括117名被诊断为双相情感障碍的患者和25名一级亲属。采用线性回归模型来描述亲属冲动性的各个方面与患者报告的儿童虐待程度之间的关联。通过多项逻辑回归检验自杀未遂史与患者冲动性维度和虐待之间的独立关联。亲属的冲动性，更具体地说是抑制控制，可以预测患者受到的虐待。抑制控制和情感虐待共同与多次自杀未遂史的可能性增加有关。鉴于亲属的冲动性可预测儿童虐待，遗传共享的冲动性有可能是与多次自杀未遂史相关的一个潜在特征。这些发现凸显了在综合模型中考虑儿童虐待、冲动性和自杀未遂史的重要性。
