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Quidé Y, Tozzi L, Corcoran M, Cannon DM, Dauvermann MR. The Impact of Childhood Trauma on Developing Bipolar Disorder: Current Understanding and Ensuring Continued Progress. Neuropsychiatr Dis Treat 2020; 16:3095-3115. [PMID: 33364762 PMCID: PMC7751794 DOI: 10.2147/ndt.s285540] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/18/2020] [Indexed: 12/12/2022] Open
Abstract
Childhood trauma (CT) has been repeatedly linked to earlier onset and greater severity of bipolar disorder (BD) in adulthood. However, such knowledge is mostly based on retrospective and cross-sectional studies in adults with BD. The first objective of this selective review is to characterize the short-term effects of CT in the development of BD by focusing on studies in young people. The second objective is to describe the longer-term consequences of CT by considering studies with adult participants. This review first outlines the most prominent hypotheses linking CT exposure and the onset of BD. Then, it summarizes the psychological and biological risk factors implicated in the development of BD, followed by a discussion of original studies that investigated the role of CT in young people with early-onset BD, youths at increased risk of developing BD, or young people with BD with a focus on subclinical and clinical outcome measures. The review considers additional biological and psychological factors associated with a negative impact of CT on the long-term course of BD in later adulthood. Finally, we discuss how the integration of information of CT can improve ongoing early identification of BD and mitigate severe clinical expression in later adulthood.
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Affiliation(s)
- Yann Quidé
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Leonardo Tozzi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Mark Corcoran
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Dara M Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Maria R Dauvermann
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
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Du Rocher Schudlich T, Youngstrom EA, Martinez M, KogosYoungstrom J, Scovil K, Ross J, Feeny NC, Findling RL. Physical and sexual abuse and early-onset bipolar disorder in youths receiving outpatient services: frequent, but not specific. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 43:453-63. [PMID: 25118660 DOI: 10.1007/s10802-014-9924-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The objective of this study was to determine if physical and sexual abuse showed relationships to early-onset bipolar spectrum disorders (BPSD) consistent with findings from adult retrospective data. Participants (N = 829, M = 10.9 years old ± 3.4 SD, 60% male, 69% African American, and 18% with BPSD), primarily from a low socio-economic status, presented to an urban community mental health center and a university research center. Physical abuse was reported in 21%, sexual abuse in 20%, and both physical and sexual abuse in 11% of youths with BPSD. For youths without BPSD, physical abuse was reported in 16%, sexual abuse in 15%, and both physical and sexual abuse in 5% of youths. Among youth with BPSD, physical abuse was significantly associated with a worse global family environment, more severe depressive and manic symptoms, a greater number of sub-threshold manic/hypomanic symptoms, a greater likelihood of suicidality, a greater likelihood of being diagnosed with PTSD, and more self-reports of alcohol or drug use. Among youth with BPSD, sexual abuse was significantly associated with a worse global family environment, more severe manic symptoms, a greater number of sub-threshold manic/hypomanic symptoms, greater mood swings, more frequent episodes, more reports of past hospitalizations, and a greater number of current and past comorbid Axis I diagnoses. These findings suggest that if physical and/or sexual abuse is reported, clinicians should note that abuse appears to be related to increased severity of symptoms, substance use, greater co-morbidity, suicidality, and a worse family environment.
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Affiliation(s)
- Tina Du Rocher Schudlich
- Department of Psychology, Western Washington University, MS 9172, 516 High Street, Bellingham, WA, 98225-9172, USA,
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Marshall DF, Passarotti AM, Ryan KA, Kamali M, Saunders EFH, Pester B, McInnis MG, Langenecker SA. Deficient inhibitory control as an outcome of childhood trauma. Psychiatry Res 2016; 235:7-12. [PMID: 26707783 PMCID: PMC6639093 DOI: 10.1016/j.psychres.2015.12.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 11/04/2015] [Accepted: 12/09/2015] [Indexed: 01/27/2023]
Abstract
Childhood trauma has been linked to the development and severity of psychiatric disorders as well as deficits in cognitive functioning. This study aimed to investigate the performance of bipolar disorder (BD) patients and healthy controls (HC), with or without a history of childhood trauma, on a parametric Go/No-Go (PGNG) task measuring important aspects of executive functions, namely attention and inhibitory control. Two hundred and thirty-three individuals with BD and 90 HC completed diagnostic interview, childhood trauma questionnaire (CTQ), symptom severity scales, and a PGNG task. Four comparison groups were created using a 1.0 standard deviation cut-off of the mean of the HC total CTQ score: BD-trauma, BD-normative, HC-trauma and HC-normative. We assessed interactions between diagnosis and trauma on Go/No-Go levels of interest by using a two-way multivariate analysis of covariance. Results showed a significant main effect of trauma on inhibitory control accuracy, as the trauma group exhibited significantly poorer accuracy on inhibition trials compared to the normative group. There was also a main effect of diagnosis on response time. These findings suggest that early trauma might adversely impact the development of cognitive systems and brain circuits that support inhibitory aspects of executive functioning in individuals with a history of trauma.
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Affiliation(s)
- David F. Marshall
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA,Corresponding author at: Department of Psychiatry, University of Michigan, 2101 Commonwealth Blvd, Suite C, Ann Arbor, MI 48105, USA. Tel.: + 1 734 763 9259, Fax: + 1 734 936 9262,
| | | | - Kelly A. Ryan
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Masoud Kamali
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Erika F. H. Saunders
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA,Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
| | - Bethany Pester
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Melvin G. McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Scott A. Langenecker
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA,Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
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Russo M, Mahon K, Shanahan M, Solon C, Ramjas E, Turpin J, Burdick KE. The association between childhood trauma and facial emotion recognition in adults with bipolar disorder. Psychiatry Res 2015; 229:771-6. [PMID: 26272021 PMCID: PMC4603568 DOI: 10.1016/j.psychres.2015.08.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/11/2015] [Accepted: 08/03/2015] [Indexed: 11/30/2022]
Abstract
Many patients with bipolar disorder (BD) have difficulties in facial emotion recognition, which may also be impaired in maltreated children and in subjects who have a positive history of childhood traumatic experiences. Childhood trauma is reported with a high prevalence in BD and it is considered a risk factor for the disorder. As the relationship between facial emotion recognition and childhood trauma in BD has not yet been directly investigated, in this study we examined whether the presence of a childhood trauma in affectively stable BD patients was associated with poorer performance in emotion recognition. Seventy-five BD I and II participants completed the Childhood Trauma Questionnaire retrospectively assessing five types of childhood trauma (emotional, physical and sexual abuse, and emotional and physical neglect) and the Emotion Recognition Task evaluating the ability to correctly identify six basic facial emotions (happiness, sadness, anger, disgust, fear and surprise). Our results suggest that the presence of childhood trauma in participants with BD is associated with a more severe clinical presentation (earlier onset, longer duration of illness, and higher depressive symptom ratings) and that BD patients with a positive childhood history of emotional neglect perform worse than those without such a history in recognizing anger.
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Affiliation(s)
- Manuela Russo
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Katie Mahon
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Megan Shanahan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carly Solon
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elizabeth Ramjas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Justin Turpin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Katherine E. Burdick
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA,James J Peters VA Medical Center, Bronx, NY, USA
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Rausch J, Gäbel A, Nagy K, Kleindienst N, Herpertz SC, Bertsch K. Increased testosterone levels and cortisol awakening responses in patients with borderline personality disorder: gender and trait aggressiveness matter. Psychoneuroendocrinology 2015; 55:116-27. [PMID: 25796037 DOI: 10.1016/j.psyneuen.2015.02.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 02/04/2015] [Accepted: 02/04/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Borderline personality disorder (BPD) is characterized by antagonism, negative affectivity, disinhibition, and impairments in interpersonal functioning, including enhanced impulsive aggression. Interpersonal dysfunctions may be related to alterations in endocrine systems. The current study investigated alterations in basal activity of the hypothalamus-pituitary-gonadal (HPG) reproductive and the hypothalamus-pituitary-adrenal (HPA) stress system in BPD patients and their association to anger-related aggression with a particular focus on effects of gender and comorbid conditions of depression and posttraumatic stress disorder (PTSD). METHOD Saliva testosterone levels as well as cortisol awakening responses were assessed in 55 medication-free female and male patients with BPD and compared to 47 gender-, age-, and intelligence-matched healthy volunteers. In addition, analyses controlling for current depression and PSTD and bivariate correlations between testosterone and cortisol levels on the one hand and anger and aggressiveness on the other hand were performed. RESULTS The results revealed increased saliva testosterone levels in female and male patients with BPD as well as elevated cortisol awakening responses in female, but not male patients with BPD compared to healthy volunteers. Cortisol awakening responses were positively related to anger and aggressiveness in female patients with BPD, but no associations were found with testosterone levels. CONCLUSION In line with previous reports, the present results suggest endocrine alterations in BPD which may be associated with interpersonal impairments, such as increased anger-related aggressive behavior and could have implications for the development of new (psychopharmaco-) therapeutic interventions that may help to restore the alterations in the HPA and HPG systems.
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Affiliation(s)
- Juliane Rausch
- Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany
| | - Andrea Gäbel
- Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany
| | - Krisztina Nagy
- Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany
| | - Nikolaus Kleindienst
- Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Sabine C Herpertz
- Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany
| | - Katja Bertsch
- Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany.
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