Abstract
BackgroundBipolar disorder (BD) and the anxiety disorders are highly comorbid. The present study sought to examine perfectionism and goal attainment values as potential mechanisms of known associations between anxiety, stress and BD symptomatology. Measures of perfectionism and goal attainment values were administered to 269 members of BD pedigrees, alongside measures of anxiety and stress, and BD mood symptoms. Regression analyses were used to determine whether perfectionism and goal attainment values were related to depressive and (hypo)manic symptoms; planned mediation models were then used to test the potential for perfectionism to mediate associations between anxiety/stress and BD symptoms.ResultsSelf-oriented perfectionism was associated with chronic depressive symptoms; socially-prescribed perfectionism was associated with chronic (hypo)manic symptoms. Self-oriented perfectionism mediated relationships between anxiety/stress and chronic depressive symptoms even after controlling for chronic hypomanic symptoms. Similarly, socially-prescribed perfectionism mediated associations between anxiety/stress and chronic hypomanic symptoms after controlling for chronic depressive symptoms. Goal attainment beliefs were not uniquely associated with chronic depressive or (hypo)manic symptoms.ConclusionsCognitive styles of perfectionism may explain the co-occurrence of anxiety and stress symptoms and BD symptoms. Psychological interventions for anxiety and stress symptoms in BD might therefore address perfectionism in attempt to reduce depression and (hypo)manic symptoms in addition to appropriate pharmacotherapy.
Highlights
Bipolar disorder (BD) and the anxiety disorders are highly comorbid
Consistent with the psychological models of BD symptoms (Holmes et al 2008; Mansell et al 2007), we have previously reported that anxiety and stress symptoms mediated the effects of self-critical perfectionism and goal attainment beliefs on current bipolar depressive symptoms after controlling for current hypomanic symptoms (Corry et al 2013)
There were no significant differences between the two groups on measures socially-prescribed perfectionism or goal attainment values
Summary
Bipolar disorder (BD) and the anxiety disorders are highly comorbid. The present study sought to examine perfectionism and goal attainment values as potential mechanisms of known associations between anxiety, stress and BD symptomatology. A summary of 5 studies estimated that the risk of an affective disorder in first degree relatives of those with BD ranges from 24 to 31% and the risk of BD ranges from 7 to 22% (Merikangas et al 2002) Given this high genetic contribution to the development of BD, there remains the task of identifying how and when this biological vulnerability is expressed with more proximal biological, psychological and environmental triggers being important factors (Johnson 2005; Jones and Bentall 2008) BD pedigrees have higher rates of Schizoaffective Disorder (BD type), BD-I, BD-II and Major Depressive Disorder that control families (Gershon et al 1982). Studies of extended families with some members diagnosed with BD may be useful to determine the contribution of perfectionistic cognitions and beliefs relating to goal attainment to anxiety, stress, and other core mood symptoms such as depression and hypomania
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