Stress, social rhythms, and behavioral activation: Psychosocial factors and the bipolar illness course

Hlastala, Stefanie A.

doi:10.1007/s11920-003-0087-0

Cited by 6 publications

(3 citation statements)

References 58 publications

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“… 17 , 45 We found no support for sensitization effects in recurrent mania, despite theoretical arguments that such effects exist. 26 , 27 , 66 , 72 , 73 However, identifying sensitization typically requires larger samples because such effects imply statistical interactions; even the NESARC might have been underpowered in this regard.…”

Section: Discussionmentioning

confidence: 99%

Contributions of the social environment to first-onset and recurrent mania

et al. 2014

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In treated cohorts, individuals with bipolar disorder are more likely to report childhood adversities and recent stressors than individuals without bipolar disorder; similarly, in registry-based studies, childhood adversities are more common among individuals who later become hospitalized for bipolar disorder. Because these types of studies rely on treatment-seeking samples or hospital diagnoses, they leave unresolved the question of whether or not social experiences are involved in the etiology of bipolar disorder. We investigated the role of childhood adversities and adulthood stressors in liability for bipolar disorder using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, n=33,375). We analyzed risk for initial-onset and recurrent DSM-IV manic episodes during the study’s 3-year follow-up period. Childhood physical abuse and sexual maltreatment were associated with significantly higher risks of both first onset mania (odds ratio (OR) for abuse: 2.23; 95% confidence interval (CI): 1.71–2.91; OR for maltreatment: 2.10; CI: 1.55–2.83) and recurrent mania (OR for abuse: 1.55; CI: 1.00–2.40; OR for maltreatment: 1.60; CI=1.00–2.55). In addition, past-year stressors in the domains of interpersonal instability and financial hardship were associated with a significantly higher risk of incident and recurrent mania. Exposure to childhood adversity potentiated the effects of recent stressors on adult mania. Our findings demonstrate a role of social experiences in the initial onset of bipolar disorder, as well as in its prospective course, and are consistent with etiologic models of bipolar disorder that implicate deficits in developmentally established stress-response pathways.

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Section: Discussionmentioning

confidence: 99%

Contributions of the social environment to first-onset and recurrent mania

et al. 2014

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“…Social rhythm therapy (SRT), which aims to stabilize circadian and sleep domains via daily scheduling, is efficacious for treating BD (Frank et al, 2008, Goldstein et al, 2014). The social rhythm disruption (SRD) theory of affective disorders hypothesizes rhythm disruption, whether social or biological, induces mood changes in vulnerable individuals (Ehlers et al, 1988, Hlastala, 2003, Boland et al, 2012). Stress can be a precipitating factor for rhythm disruption, sleep disturbances, and mood changes (Ellicott et al, 1990, Post, 1992).…”

Section: Mood Cycling Mouse Models: a Focus On The Role Of Circadian mentioning

confidence: 99%

Animal models of bipolar mania: The past, present and future

2016

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Bipolar disorder (BD) is the sixth leading cause of disability in the world according to the World Health Organization and affects nearly 6 million (~2.5% of the population) adults in the United State alone each year. BD is primarily characterized by mood cycling of depressive (e.g., helplessness, reduced energy and activity, and anhedonia) and manic (e.g., increased energy and hyperactivity, reduced need for sleep, impulsivity, reduced anxiety and depression), episodes. The following review describes several animal models of bipolar mania with a focus on more recent findings using genetically modified mice, including several with the potential of investigating the mechanisms underlying ‘mood’ cycling (or behavioral switching in rodents). We discuss whether each of these models satisfy criteria of validity (i.e., face, predictive, and construct), while highlighting their strengths and limitations. Animal models are helping to address critical questions related to pathophysiology of bipolar mania, in an effort to more clearly define necessary targets of first-line medications, lithium and valproic acid, and to discover novel mechanisms with the hope of developing more effective therapeutics. Future studies will leverage new technologies and strategies for integrating animal and human data to reveal important insights into the etiology, pathophysiology, and treatment of BD.

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“…On the side of environmental stress, diminished perceived social support and psychosocial stress appear to be particularly predictive of mood instability in BD [ 123 , 126 – 128 ]. In this regard, there is evidence that SRD and disruption to the attainment of psychosocial goals are associated with the number of reported manic episodes [ 121 , 129 ]. In addition, social rhythm irregularity predicts time to affective relapse [ 121 ], and there is some evidence that persons diagnosed with BD experience higher numbers of SLEs and greater SRD than people without psychiatric illness [ 130 ].…”

Section: Diathesis-stressmentioning

confidence: 99%

Functional Outcome in Bipolar Disorder: The Big Picture

Levy

Manove

2012

Depression Research and Treatment

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Previous research on functional outcome in bipolar disorder (BD) has uncovered various factors that exacerbate psychosocial disability over the course of illness, including genetics, illness severity, stress, anxiety, and cognitive impairment. This paper presents an integrated view of these findings that accounts for the precipitous decline in psychosocial functioning after illness onset. The proposed model highlights a number of reciprocal pathways among previously studied factors that trap people in a powerful cycle of ailing forces. The paper discusses implications to patient care as well as the larger social changes required for shifting the functional trajectory of people with BD from psychosocial decline to growth.

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Stress, social rhythms, and behavioral activation: Psychosocial factors and the bipolar illness course

Cited by 6 publications

References 58 publications

Contributions of the social environment to first-onset and recurrent mania

Contributions of the social environment to first-onset and recurrent mania

Animal models of bipolar mania: The past, present and future

Functional Outcome in Bipolar Disorder: The Big Picture

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