Life Events and Mania

Ambelas, Aris

doi:10.1192/bjp.150.2.235

Cited by 115 publications

(16 citation statements)

References 16 publications

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“…Of these, two were chart reviews (Ambelas, 1979, 1987). Ambelas (1979) found that manic patients in their initial hospitalization were significantly more likely to have experienced a pre-admission event in the month prior to admission, as compared to manic patients in a repeat hospitalization.…”

Section: Existing Research On Kindling In Bipolar Disordermentioning

confidence: 99%

“…Ambelas (1979) found that manic patients in their initial hospitalization were significantly more likely to have experienced a pre-admission event in the month prior to admission, as compared to manic patients in a repeat hospitalization. A follow-up chart review indicated that mean scaled stress scores were significantly higher before first than subsequent admissions (Ambelas, 1987). Perris (1984b) assessed the frequency of life events in the three- and twelve-month intervals prior to onset of a depressive index episode in an inpatient sample with various affective disorder diagnoses.…”

Section: Existing Research On Kindling In Bipolar Disordermentioning

confidence: 99%

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Life stress and kindling in bipolar disorder: Review of the evidence and integration with emerging biopsychosocial theories

Bender

Alloy

2011

Clinical Psychology Review

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Most life stress literature in bipolar disorder (BD) fails to account for the possibility of a changing relationship between psychosocial context and episode initiation across the course of the disorder. According to Post’s (1992) influential kindling hypothesis, major life stress is required to trigger initial onsets and recurrences of affective episodes, but successive episodes become progressively less tied to stressors and may eventually occur autonomously. Subsequent research on kindling has largely focused on unipolar depression (UD), and the model has been tested in imprecise and inconsistent ways. The aim of the present paper is to evaluate evidence for the kindling model as it applies to BD. We first outline the origins of the hypothesis, the evidence for the model in UD, and the issues needing further clarification. Next, we review the extant literature on the changing relationship between life stress and bipolar illness over time, and find that evidence from the methodologically strongest studies is inconsistent with the kindling hypothesis. We then integrate this existing body of research with two emerging biopsychosocial models of BD: the Behavioral Approach System dysregulation model, and the circadian and social rhythm theory. Finally, we present therapeutic implications and suggestions for future research.

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Section: Existing Research On Kindling In Bipolar Disordermentioning

confidence: 99%

Section: Existing Research On Kindling In Bipolar Disordermentioning

confidence: 99%

Life stress and kindling in bipolar disorder: Review of the evidence and integration with emerging biopsychosocial theories

Bender

Alloy

2011

Clinical Psychology Review

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“…For example, human beings are subjected to various and variable forms of life stress, which can be approximated as a complex 'noisy environment' interacting with the human organism (Glassner and Haldipur, 1983;Kennedy et al, 1983;Bidzinska, 1984;Ambelas, 1987;Swann et al, 1990;Charney et al, 1993;Castine et al, 1998). In addition, biological systemsFand brains in particularFthemselves are intrinsically noisy.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, at the behavioral level, individuals face a variety of life stress, which differs in strength and impact and reaches from everyday hassles to social isolation up to the loss of significant others. In turn, such life stress might be viewed as a complex variable 'noisy environment' that individuals have to deal with and which will interact with any disease process (Glassner and Haldipur, 1983;Kennedy et al, 1983;Bidzinska, 1984;Ambelas, 1987;Swann et al, 1990;Charney et al, 1993;Castine et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

On Episode Sensitization in Recurrent Affective Disorders: The Role of Noise

Huber

Braun

Krieg

2003

Neuropsychopharmacol

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Episode sensitization is postulated as a key mechanism underlying the long-term course of recurrent affective disorders. Functionally, episode sensitization represents positive feedback between a disease process and its disease episodes resulting in a transition from externally triggered to autonomous episode generation. Recently, we introduced computational approaches to elucidate the functional properties of sensitization. Specifically, we considered the dynamics of episode sensitization with a simple computational model. The present study extends this work by investigating how naturally occurring, internal or external, random influences ('noise') affect episode sensitization. Our simulations demonstrate that actions of noise differ qualitatively in dependence on both the model's activity state as well as the noise intensity. Thereby induction as well as suppression of sensitization can be observed. Most interestingly, externally triggered sensitization development can be minimized by tuning the noise to intermediate intensities. Our findings contribute to the conceptual understanding of the clinical kindling model for affective disorders and also indicate interesting roles for random fluctuations in kindling and sensitization at the neuronal level. Neuropsychopharmacology (2003) 28, S13-S20.

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“…Early studies used cross-sectional designs comparing rates of life events in patients experiencing a first episode versus a recurrence (Ambelas, 1979, 1987; Perris, 1984) or retrospective designs that examined the frequency of life events occurring prior to participants’ earlier vs. later episodes (Bidzinska, 1984; Dunner et al, 1979; Ehnvall & Ågren, 2002; Johnsonet et al, 2000) with some not finding support for a kindling effect in BD (Kennedy et al, 1983; Glassner & Haldipur, 1983). These mixed findings were attributed to long intervals for recall and the use of stress checklists that may be biased by participants’ current mood or fallible memory.…”

Section: The Kindling Hypothesis In Bipolar Disordermentioning

confidence: 99%

Kindling of Life Stress in Bipolar Disorder: Effects of Early Adversity

et al. 2017

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Most theoretical frameworks regarding the role of life stress in bipolar disorders (BD) do not incorporate the possibility of a changing relationship between psychosocial context and episode initiation across the course of the disorder. The kindling hypothesis theorizes that over the longitudinal course of recurrent affective disorders, the relationship between major life stressors and episode initiation declines (Post, 1992). The present study aimed to test an extension of the kindling hypothesis in BD by examining the effect of early life adversity on the relationship between proximal life events and prospectively assessed mood episodes. Data from 145 bipolar participants (59.3% female, 75.2% Caucasian, and mean age of 20.19 years; SD = 1.75 years) were collected as part of the Temple-Wisconsin Longitudinal Investigation of Bipolar Spectrum Project (112 Bipolar II; 33 Cyclothymic disorder). Participants completed a self-report measure of early adversity at baseline and interview-assessed mood episodes and life events at regular four-month follow-ups. Results indicate that early childhood adversity sensitized bipolar participants to the effects of recent stressors only for depressive episodes and not hypomanic episodes within BD. This was particularly the case with minor negative events. The current study extends prior research examining the kindling model in BD using a methodologically rigorous assessment of life stressors and mood episode occurrence. Clinicians should assess experiences of early adversity in individuals with BD as it may impact reactivity to developing depressive episodes in response to future stressors.

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Life Events and Mania

Cited by 115 publications

References 16 publications

Life stress and kindling in bipolar disorder: Review of the evidence and integration with emerging biopsychosocial theories

Life stress and kindling in bipolar disorder: Review of the evidence and integration with emerging biopsychosocial theories

On Episode Sensitization in Recurrent Affective Disorders: The Role of Noise

Kindling of Life Stress in Bipolar Disorder: Effects of Early Adversity

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