Abstract
A personal history of childhood maltreatment has been associated with unfavorable outcomes in bipolar disorder (BD). The impact of early life stressors on the course of BD may be influenced by individual differences in coping skills. The coping construct relies on neurocognitive mechanisms that are usually influenced by childhood maltreatment. The objective of the present study was to verify the association between childhood maltreatment and coping skills in individuals with BD Type 1. Thirty female euthymic outpatients with BD Type 1 were evaluated using the Childhood Trauma Questionnaire and two additional instruments to measure their coping preferences: Ways of Coping Questionnaire (coping strategies) and Brief COPE (coping styles). Reports of physical abuse (B = .64, p < .01) and emotional abuse (B = .44, p = .01) were associated with the use of maladaptive strategies that focused on emotional control. Adaptive strategies and styles of coping, such as focusing on the problem, were chosen less frequently by women who had experienced emotional neglect (B = .53, p < .01) and physical abuse (B = -.48, p < .01) in childhood. The small sample size in the present study prevented subgroup analyses. The sample did not include male BD participants. Our results indicate that early traumatic events may have a long-lasting deleterious influence on coping abilities in female BD patients. Future prospective studies may investigate whether the negative impact of childhood maltreatment over the course of BD is mediated by individual differences in coping abilities.
Highlights
Adverse experiences in childhood have been recognized as common events in individuals with bipolar disorder (BD), with approximately half (49%) of these individuals reporting at least some form of abuse or neglect during childhood (Garno, Goldberg, Ramirez, & Ritzler, 2005; Leverich et al, 2002)
Clinical and Demographic Data Age Age of first mood episode Duration of illness Number of episodes Number of hospitalizations HAM-D (21-item) score YMRS score Childhood Maltreatment Components of CTQ (5-25) Emotional abuse Emotional neglect Physical abuse Physical neglect Sexual abuse Total CTQ (25-125) Coping Ways of Coping Questionnaire (WCQ) (1-5) Religious or fantastic thoughts Focused on the problem Focused on emotion Search for emotional support Brief COPE (0-3) Focused on the problem Adaptive and focused on emotion Maladaptive
The present results support the hypothesis that traumatic events during childhood negatively interfere with the way adult individuals with BD cope with stress
Summary
Adverse experiences in childhood have been recognized as common events in individuals with bipolar disorder (BD), with approximately half (49%) of these individuals reporting at least some form of abuse or neglect during childhood (Garno, Goldberg, Ramirez, & Ritzler, 2005; Leverich et al, 2002). Childhood maltreatment has been significantly associated with impairment in cognitive performance among various samples. A robust body of evidence indicates that exposure to early life stressors, not just CMT, can negatively impact the clinical course of BD (Kapczinski et al, 2008; Post, & Leverich, 2006). This impact is exerted through changes in immune, endocrine, and molecular mechanisms that modulate neuroplasticity (Bender, Alloy, Sylvia, Urosevic, & Abramson, 2010; GrassiOliveira et al, 2008; Kauer-Sant’Anna et al, 2007) and may be influenced by individual differences in stress responsivity. One’s coping abilities may be impaired by the effects of stress mediators on relevant neurofunctional circuits (Grassi-Oliveira, Daruy-Filho, & Brietzke, 2010)
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