@article{f59cb505c48448d1a7e92400af6d7755,
title = "Affective lability mediates the association between childhood trauma and suicide attempts, mixed episodes and co-morbid anxiety disorders in bipolar disorders",
abstract = "Background: Many studies have shown associations between a history of childhood trauma and more severe or complex clinical features of bipolar disorders (BD), including suicide attempts and earlier illness onset. However, the psychopathological mechanisms underlying these associations are still unknown. Here, we investigated whether affective lability mediates the relationship between childhood trauma and the severe clinical features of BD. Method: A total of 342 participants with BD were recruited from France and Norway. Diagnosis and clinical characteristics were assessed using the Diagnostic Interview for Genetic Studies (DIGS) or the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Affective lability was measured using the short form of the Affective Lability Scale (ALS-SF). A history of childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Mediation analyses were performed using the SPSS process macro. Results: Using the mediation model and covariation for the lifetime number of major mood episodes, affective lability was found to statistically mediate the relationship between childhood trauma experiences and several clinical variables, including suicide attempts, mixed episodes and anxiety disorders. No significant mediation effects were found for rapid cycling or age at onset. Conclusions: Our data suggest that affective lability may represent a psychological dimension that mediates the association between childhood traumatic experiences and the risk of a more severe or complex clinical expression of BD.",
keywords = "Bipolar disorders, childhood maltreatment, clinical features",
author = "M. Aas and C. Henry and F. Bellivier and M. Lajnef and S. Gard and Kahn, {J. P.} and Lagerberg, {T. V.} and Aminoff, {S. R.} and T. Bjella and M. Leboyer and Andreassen, {O. A.} and I. Melle and B. Etain",
note = "Funding Information: France: This work was supported by INSERM, Assistance Publique - H{\^o}pitaux de Paris, ENBREC (European Network of Bipolar Research Expert Centre), RTRS Sant{\'e} Mentale (Fondation Fondamental), Agence Nationale pour la Recherche (ANR), Fondation pour la Recherche sur le Cerveau (FRC) and the National Alliance for Research on Schizophrenia and Depression (NARSAD). We thank E. Abadie and J. R. Richard for their assistance. We thank the clinical psychologists who participated in the clinical assessment of patients in France (A. Raust and B. Cochet in Cr{\'e}teil, L. Zanouy in Bordeaux, R. F. Cohen and O. Wajsbrot-Elgrabli in Nancy). We thank the patients for their participation. We thank the patients who took part in the study and the NORMENT/TOP study researchers who contributed to the data collection. This research was funded by INSERM, AP-HP, ANR and FRC. These organizations had no role in the design of the study, the collection, analysis and interpretation of data, the writing of the report or in the decision to submit the paper for publication. This study was also funded by a grant from the University of Oslo, South-Eastern Norway Health Authority (no. 2013088), the Research Council of Norway and the KG Jebsen Foundation. Publisher Copyright: Copyright {\textcopyright} Cambridge University Press 2016.",
year = "2017",
month = apr,
day = "1",
doi = "10.1017/S0033291716003081",
language = "English",
volume = "47",
pages = "902--912",
journal = "Psychological Medicine",
issn = "0033-2917",
publisher = "Cambridge University Press",
number = "5",
}
