Abstract
ObjectivesThe aim of this study was to identify psychosocial factors related to the onset of bipolar I disorder (BD). To do so, the Bipolar Disorder Etiology Scale (BDES), based on psychological behaviorism, was developed and validated. Using the BDES, common factors related to both major depressive disorder (MDD) and BD and specific factors related only to BD were investigated.MethodThe BDES, which measures 17 factors based on psychological behaviorism hypotheses, was developed and validated. This scale was administered to 113 non-clinical control subjects, 30 subjects with MDD, and 32 people with BD. ANOVA and post hoc analyses were conducted. Subscales on which MDD and BD groups scored higher than controls were classified as common factors, while those on which the BD group scored higher than MDD and control groups were classified as specific factors.ResultsThe BDES has acceptable reliability and validity. Twelve common factors influence both MDD and BD and one specific factor influences only BD. Common factors include the following: learning grandiose self-labeling, learning dangerous behavior, reinforcing impulsive behavior, exposure to irritability, punishment of negative emotional expression, lack of support, sleep problems, antidepressant problems, positive arousal to threat, lack of social skills, and pursuit of short-term pleasure. The specific factor is manic emotional response.ConclusionsManic emotional response was identified as a specific factor related to the onset of BD, while parents’ grandiose labeling is a candidate for a specific factor. Many factors are related to the onset of both MDD and BD.
Highlights
Bipolar I disorder causes severe psychological and financial strain on the patients, their family members, and the public health care administration system
The scale was administered to a non-clinical control group, individuals with major depressive disorder (MDD), and individuals with bipolar I disorder (BD) to identify the common factors related to both MDD and bipolar I disorder and specific factors related only to bipolar I disorder
Reliability and validity of the Bipolar Disorder Etiology Scale based on psychological behaviorism
Summary
Bipolar I disorder causes severe psychological and financial strain on the patients, their family members, and the public health care administration system. High criticism, which consists of expressed emotion, is significantly associated with relapse rate, relapse interval, and relapse symptom severity [6]. Some of these findings have been proved to be crossculturally consistent [7]. Studies must seek answers to the following question: ‘‘What kind of trauma, or which characteristics of trauma and abuse are associated with bipolar I disorder?’’ Expressed emotion is a more specific concept than lack of social support, social strain, trauma, or abuse; more specific interventions can be used.
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