Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia.
Int J Psychiatry Clin Pract. 2021 Mar;25(1):90-102. doi: 10.1080/13651501.2021.1879867. Epub 2021 Feb 9.
The relations of childhood emotional maltreatment and alexithymia to the clinical course of bipolar disorder (BD) have been widely recognised. Difficulties in regulating emotions may explain these relationships. The current study evaluated the effects of childhood emotional maltreatment and alexithymia on depressive and manic symptoms as well as suicidal ideation in female patients with BD. Emotion dysregulation was evaluated as a mediating factor.
Three hundred hospitalised female patients with a diagnosis of BD provided information regarding their history of childhood emotional maltreatment, alexithymia, difficulties in emotion regulation, depressive and manic symptoms, and suicidal ideation. A series of structural equation models (SEMs) were calculated to assess the associations between these variables.
Childhood emotional abuse and difficulty in identifying feelings were indirectly associated with depressive and manic symptoms as well as suicidal ideation. This association was mediated by emotion dysregulation. This association remained significant after depressive and manic symptoms were controlled in the model.
This study indicates that patients with BD who experienced emotional abuse during childhood and have difficulties identifying emotions report greater emotion dysregulation. These individuals, in turn, are more likely to experience more severe depressive and manic symptoms as well as suicidal ideation.Key pointsChildhood emotional maltreatment and emotional and clinical factors in bipolar disorder were assessed.Childhood emotional abuse indirectly affected clinical factors via emotion dysregulation.Difficulty in identifying feelings was linked to clinical factors via emotional dysregulation.Emotional dysregulation affected the links of childhood emotional maltreatment and difficulty in identifying feelings on suicidal ideation after controlling for clinical symptoms.Emotional dysregulation dimensions of impulse, strategies, and goals emerge in relation to suicidal ideation.
儿童期情感虐待和述情障碍与双相情感障碍（BD）的临床病程之间的关系已得到广泛认可。情绪调节困难可能解释了这些关系。本研究评估了儿童期情感虐待和述情障碍对女性 BD 患者抑郁和躁狂症状以及自杀意念的影响。情绪失调被评估为中介因素。
300 名住院的女性 BD 患者提供了有关其儿童期情感虐待、述情障碍、情绪调节困难、抑郁和躁狂症状以及自杀意念的信息。计算了一系列结构方程模型（SEMs），以评估这些变量之间的关联。
童年期情感虐待和难以识别情绪与抑郁和躁狂症状以及自杀意念呈间接相关。这种关联受情绪失调的调节。在模型中控制抑郁和躁狂症状后，这种关联仍然显著。
本研究表明，童年期经历情感虐待且难以识别情绪的 BD 患者报告情绪失调更大。这些人反过来更有可能经历更严重的抑郁和躁狂症状以及自杀意念。
评估了儿童期情感虐待和双相情感障碍中的情感和临床因素。童年期情感虐待通过情绪失调间接影响临床因素。难以识别情绪通过情绪失调与临床因素相关。在控制临床症状后，情绪失调影响了童年期情感虐待和难以识别情绪对自杀意念的联系。情绪失调的冲动、策略和目标维度与自杀意念有关。
