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    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
    Tan, Shuping
    Wang, Zhiren
    Li, Chiang-Shan R
    Tian, Baopeng
    Tian, Li
    Hong, L Elliot
    Tan, Yunlong
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    Date
    2020-10-15
    Journal
    Journal of Affective Disorders
    Publisher
    Elsevier B.V.
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1016/j.jad.2020.10.029
    Sponsors
    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.
    Rights/Terms
    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
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jad.2020.10.029
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