Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia.
Orygen, Parkville, VIC, Australia.
Aust N Z J Psychiatry. 2023 Jul;57(7):1031-1042. doi: 10.1177/00048674221115644. Epub 2022 Aug 4.
Childhood trauma is negatively associated with depression severity in bipolar disorder; however, the underlying mechanisms remain unclear. We investigated whether personality traits (neuroticism, extraversion, openness, agreeableness, conscientiousness) mediate the relationship between childhood trauma and the severity of bipolar depression.
Data from 209 individuals with bipolar disorder recruited for the Prechter Longitudinal Study of Bipolar Disorder were analysed. Using structural equation modelling, we examined the direct and indirect associations between childhood trauma (Childhood Trauma Questionnaire) and depression severity (Hamilton Depression Rating Scale) - with the personality traits (NEO Personality Inventory-Revised) as mediators.
The direct effect of childhood trauma on depression severity (standardised β = 0.32, 95% bootstrap confidence interval [CI] = 0.20-0.45, < 0.001) and the indirect effect via neuroticism (standardised β = 0.03, 95% bootstrap CI [0.002, 0.07], = 0.039) were significant; supporting a partial mediation model. The indirect effect accounted for 9% of the total effect of childhood trauma on depression severity (standardised β = 0.09, 95% bootstrap CI [0.002, 0.19], = 0.046). The final model had a good fit with the data (comparative fit index = 0.96; root mean square error of approximation = 0.05, 90% CI = [0.02, 0.07]).
Personality traits may be relevant psychological mediators that link childhood trauma to a more severe clinical presentation of bipolar depression. Consequently, a person's personality structure may be a crucial operative factor to incorporate in therapeutic plans when treating individuals with bipolar disorder who report a history of childhood trauma.
童年创伤与双相情感障碍的抑郁严重程度呈负相关；然而，其潜在机制尚不清楚。我们研究了人格特质（神经质、外向性、开放性、宜人性、尽责性）是否在童年创伤与双相情感障碍抑郁严重程度之间起中介作用。
分析了为 Prechter 纵向双相情感障碍研究招募的 209 名双相情感障碍患者的数据。使用结构方程模型，我们检验了童年创伤（童年创伤问卷）与抑郁严重程度（汉密尔顿抑郁评定量表）之间的直接和间接关联——以人格特质（NEO 人格量表修订版）为中介。
童年创伤对抑郁严重程度的直接影响（标准化 β=0.32，95% bootstrap 置信区间[CI]=0.20-0.45， <0.001）和通过神经质的间接影响（标准化 β=0.03，95% bootstrap CI[0.002，0.07]， =0.039）均具有统计学意义；支持部分中介模型。童年创伤对抑郁严重程度的总效应的间接效应占 9%（标准化 β=0.09，95% bootstrap CI[0.002，0.19]， =0.046）。最终模型与数据拟合良好（比较拟合指数=0.96；均方根误差近似值=0.05，90% CI=[0.02，0.07]）。
人格特质可能是相关的心理中介，将童年创伤与更严重的双相情感障碍抑郁临床表现联系起来。因此，当治疗报告有童年创伤史的双相情感障碍患者时，个体的人格结构可能是治疗计划中一个至关重要的操作性因素。
