Stressful Life Events and Social Rhythm Disruption in the Onset of Manic and Depressive Bipolar Episodes

Malkoff-Schwartz, Susan; Frank, Ellen; Anderson, Barbara; Sherrill, Joel; Siegel, Lori; Patterson, Declan; Kupfer, David J.

doi:10.1001/archpsyc.55.8.702

Cited by 269 publications

(206 citation statements)

References 42 publications

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“…For example, Hunt, Bruce-Jones, and Silverstone (1992) found an approximate fourfold elevation in the rates of severe life events in the month before relapse compared to other months among patients with bipolar disorder. Malkoff-Schwartz et al (1998) found an approximate twofold increase in severe life events in the 8 weeks preceding an episode compared to a control period. One study failed to find an increase in life events in the 3 months before episodes (McPherson, Herbison, & Romans, 1993).…”

Section: Studies That Do Not Distinguish Polarity Of Symptomsmentioning

confidence: 81%

“…Not surprisingly, then, investigators also have examined negative life events and bipolar depression. Although researchers have considered other types of life events, no support has been obtained for schedule-disrupting life events (Malkoff-Schwartz et al, 1998 nor goal attainment life events as triggers of depression (Johnson et al, 2000;Johnson, Kizer, Ruggero, Goodnick, & Miller, 2004). The focus of this section, then, is on negative life events and depression.…”

Section: Life Events and Depressionmentioning

confidence: 99%

“…Based on these findings, researchers developed a scale to code the extent to which life events disrupted schedules (Malkoff-Schwartz et al, 1998). Ratings for this scale focused on any event that might shift a person's schedule, including starting college or ending a relationship, rather than just those events that disrupted sleep.…”

Section: Schedule-disrupting Life Eventsmentioning

confidence: 99%

“…Ratings for this scale focused on any event that might shift a person's schedule, including starting college or ending a relationship, rather than just those events that disrupted sleep. In two retrospective studies, people with bipolar disorder reported more schedule-disrupting life events before manic than depressive onset (Malkoff-Schwartz et al, 1998. As noted above, though, such analyses are potentially problematic, given the longer window of recall for depressive periods.…”

Section: Schedule-disrupting Life Eventsmentioning

confidence: 99%

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Life events in bipolar disorder: Towards more specific models

Johnson

2005

Clinical Psychology Review

180

167

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This article reviews the evidence concerning life events as a predictor of symptoms within bipolar disorder. First, key methodological issues in this area are described, and criteria used for including studies in this review are defined. Then findings that negative life events predict worse outcomes within bipolar disorder are reviewed. Beyond general studies on relapse, it is important to differentiate predictors of depression from predictors of mania. When severe negative life events occur, they appear to trigger increases in bipolar depression. Nonetheless, many depressions are unrelated to negative life events and appear to be triggered by other variables. The strongest evidence suggests that negative life events do not trigger mania, except perhaps in certain contexts. Retrospective findings for schedule-disrupting life events as a trigger for manic symptoms await further assessment within a longitudinal study. Life events involving goal attainment do appear to trigger manic symptoms. Overall, it is time to differentiate among specific types of life events, as these different forms of events point towards mechanisms linking stressors with symptom expression. These mechanisms provide clues into ways to integrate the social environment with biological vulnerability (see Bipolar disorder is clearly a biological disorder. Nonetheless, over the past 15 years, a wealth of research has made it abundantly clear that psychosocial variables shape outcomes of this disorder. Much of this psychosocial research has focused on whether life events predict the timing and severity of symptoms within this disorder. This paper reviews the evidence that life events are related to symptom expression within bipolar disorder. This basic question has challenged researchers for over 20 years. Given the growing literature, this paper focus on addressing two more specific questions. Which types of symptoms are related to life events? What types of life events influence symptoms? Given the growing number of studies available on these issues, this review will focus on those studies with the most rigorous methodologies. To set the stage for this endeavor, it is important to first review the major methodological issues in research on life events and bipolar disorder, including issues related to design, measurement, and sampling.

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Section: Studies That Do Not Distinguish Polarity Of Symptomsmentioning

confidence: 81%

Section: Life Events and Depressionmentioning

confidence: 99%

Section: Schedule-disrupting Life Eventsmentioning

confidence: 99%

Section: Schedule-disrupting Life Eventsmentioning

confidence: 99%

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Life events in bipolar disorder: Towards more specific models

Johnson

2005

Clinical Psychology Review

180

167

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“…Akiskal (1996) has suggested that the behavior of the hyperthymic temperament may bring about situations that trigger manic episodes. For example, the excessively driven, workaholic lifestyle may promote sleep deprivation, a common trigger for mania (Wehr, 1991;Malkoff-Schwartz et al, 1998). In short, achievement striving may be part of a pathway that intensifies risk for manic symptoms.…”

Section: Discussionmentioning

confidence: 99%

Can personality traits predict increases in manic and depressive symptoms?

Lozano

Johnson

2001

Journal of Affective Disorders

147

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Background-There has been limited research investigating personality traits as predictors of manic and depressive symptoms in bipolar individuals. The present study investigated the relation between personality traits and the course of bipolar disorder. The purpose of this study was to identify specific personality traits that predict the course of manic and depressive symptoms experienced by bipolar individuals.Methods-The sample consisted of 39 participants with bipolar I disorder assessed by the Structured Clinical Interview for DSM-IV. Personality was assessed using the NEO Five-Factor Inventory. The Modified Hamilton Rating Scale for Depression and the Bech-Rafaelsen Mania Rating Scale were used to assess symptom severity on a monthly basis.Results-Consistent with previous research on unipolar depression, high Neuroticism predicted increases in depressive symptoms across time while controlling for baseline symptoms. Additionally, high Conscientiousness, particularly the Achievement Striving facet, predicted increases in manic symptoms across time.Limitations-The current study was limited by the small number of participants, the reliance on a shortened version of a self-report personality measure, and the potential state-dependency of the personality measures.Conclusions-Specific personality traits may assist in predicting bipolar symptoms across time. Further studies are needed to tease apart the state-dependency of personality.

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