Immature defense mechanisms mediate the relationship between childhood trauma and onset of bipolar disorder

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Author
Wang, Leilei
Yin, Yi
Bian, Qingtao
Zhou, Yanfang
Huang, Junchao
Zhang, Ping
Chen, Song
Fan, Hongzhen
Cui, Yimin
Luo, Xingguang
Date
2020-10-15
Journal
Journal of Affective Disorders
Publisher
Elsevier B.V.
Type
Article

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https://doi.org/10.1016/j.jad.2020.10.029
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Background: Accumulating evidence has converged to suggest that childhood trauma may contribute to bipolar disorder (BD). This study aimed to investigate the patterns of childhood trauma among patients with bipolar I (BD-I) and bipolar II (BD-II) disorders, according to DSM-IV and in contrast with healthy volunteers. We also explored whether the relationship between childhood trauma and onset of bipolar disorder is mediated by immature defense mechanisms. Methods: Participants were patients with BD-I (n=44) and BD-II (n = 42), and healthy controls (HCs, n = 43). Childhood traumatic experiences and defense mechanisms were assessed by the Childhood Trauma Questionnaire (CTQ) and the Defense Style Questionnaire (DSQ), respectively. Results: BD patients experienced more severe childhood trauma than HCs. Physical neglect sub-score and total score of the CTQ had both direct and indirect effects on the diagnosis of BD-I, and an immature defense style mediated the indirect effects. The diagnosis of BD-II was mainly related to the physical neglect and emotional abuse subs-core and total score of the CTQ, as mediated by the immature defense mechanisms. BD-I and BD-II significantly differed in the emotional abuse sub-score of the CTQ. Conclusions: Physical neglect sub-score and total score of the CTQ were associated with the diagnosis of BD (both BD-I and BD-II), as mediated by an immature defense style. Furthermore, emotional abuse might be an important risk factor for BD-II compared to BD-I. These findings may inform risk reduction and psychosocial intervention strategies to prevent and treat patients with bipolar disorders.
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Copyright © 2020. Published by Elsevier B.V.
Keyword
Bipolar disorder
Childhood trauma
Immature defense mechanisms
Identifier to cite or link to this item
http://hdl.handle.net/10713/14338
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