The relationship between trauma and bipolar disorder (BD) is well-established.
However, mechanisms that might explain this association remain unclear. The first
chapter involved a systematic review exploring psychological mediators between
early trauma and BD-related outcomes.
Searches on three databases led to the inclusion of twenty studies. Study quality
varied, and different approaches to analyses and outcomes meant that the findings
could not be directly compared, impacting the strength of the conclusions that can be
made.
The mediators fell into five categories: affective processes, cognitive processes,
interpersonal factors, personality-related variables and behavioural risk factors.
Outcomes included course/ severity, suicidality, comorbidities, dissociation, and
resilience. Consistent mediators included emotional dysregulation and attachment
patterns. Depressive symptoms were most frequently studied, with less focus on
manic symptoms. Future research should explore mediators affecting mania and
work towards similar methodological approaches so true mediation effects can be
understood.
The second chapter, an empirical study, looked at individuals at risk of developing
BD (BAR) compared to a non-clinical group on experiences of trauma, post-
traumatic stress disorder and sleep difficulties. 140 people participated, 64 were in
the non-clinical group and 76 were in the BAR group. The BAR group had taken part in a previous study looking at a new therapy and were happy for their information to be used in this study. Participants had a clinical interview with researchers to understand experiences of trauma and completed questionnaires looking at sleep difficulties and mood states. Number of traumas and rates of PTSD were higher in the BAR group, as were sleep difficulties. The BAR group also had higher levels of depressive symptoms. Having PTSD did not impact on levels of depression, manic symptoms or sleep difficulties for the BAR group. Research with bigger samples and longer follow-up periods would help us better understand this group and target support.
