| BackgroundBipolar disorder(BD)is the result of a combination of genetic and environmental factors.About 60% of patients with bipolar disorder are misdiagnosed as monophasic depression at the initial consultation,and external environmental factors,especially childhood traumatic events,play a very important role in the development of bipolar disorder and are one of the risk factors for its onset;bipolar depression adds a significant burden to society and families.Currently,bipolar disorder has become a serious social and medical problem,with75% of bipolar disorder patients in remission having impaired levels of social functioning;due to life stress,life and work environments,and genetics,bipolar disorder patients in remission still have residual symptoms,regression in social functioning,and adverse outcomes such as relapse.Some studies have shown that childhood trauma has significant effects on cognitive patterns and emotion regulation in patients with acute episodes of bipolar disorder,and it is not well understood about the effects of childhood trauma on cognitive patterns and emotion regulation in patients with bipolar depression in remission.Objective1.To explore the effects of childhood trauma on cognitive patterns and emotion regulation in patients in remission from bipolar depression,in order to provide a basis for an in-depth understanding of the psychosocial factors of bipolar depression.2.To explore the correlation between childhood trauma and cognitive bias and emotion dysregulation in order to understand the relationship between childhood trauma and bipolar depression,and to provide new ideas for clinical counseling and treatment.MethodsA total of 60 bipolar depression patients in disease remission(consolidation treatment or maintenance treatment period)attending the Second People’s Hospital of Zhumadian between April 2019 and April 2022 were selected for this study by random sampling;60 healthy controls set up as healthy control group(HC group)during the same period were included by recruitment method.The General Conditions Questionnaire,Childhood Trauma Questionnaire(CTQ-SF),Hamilton Depression Inventory(HAMD),Young Mania Scale(YMRS),Dysfunctional Attitudes Questionnaire(DAS),Cognitive Bias Questionnaire(CBQ),Regulated Emotional Self-Efficacy(RESS),and Cognitive Emotional Regulation Style Scale(CERQ)were used as the study instruments for measurement and assessment.The SPSS 25.0statistical package was used for statistical analysis to compare the differences in childhood trauma,cognitive patterns and emotion regulation between the bipolar depression in remission patient group and the healthy control group,and to analyze the differences in childhood trauma,cognitive patterns and emotion dysregulation in the bipolar depression in remission patient group;Pearson correlation analysis and multiple regression analysis were used to explore the relationship between childhood trauma and cognitive biases,childhood trauma and emotion dysregulation in bipolar depression in remission patients.The relationship between childhood trauma and cognitive bias,childhood trauma and mood dysregulation in patients in bipolar depression remission was investigated using Pearson correlation analysis and multiple regression analysis.Results1.General demographic data: 60 cases in the healthy control group,25 females and 35 males,mean age 28.63 ± 5.22 years,years of education 12.17 ± 6.18 years,HAMD score 4.18± 0.94,YMRS score 4.33 ± 1.01.There were 60 cases in the bipolar depression group,33 males and 27 females,with a mean age of 29.23±5.38 years,12.50±5.32 years of education,HAMD score 4.27±0.85 and YMRS score 4.48±1.20.There was no statistical difference between the remission BD and HC groups in terms of gender,residence and marriage by chi-square test,and no statistical difference in terms of age,years of education,HAMD,and YMRS.2.The remission BD group had higher total scores on childhood trauma questionnaire(t=-3.313,P=0.001),physical abuse(t=-2.401,P=0.018),and emotional neglect(t=-2.269,P=0.025)than the HC group,and the differences were significant.3.The BD group in remission was significantly higher than the HC group on the total score of the Dysfunctional Attitudes Questionnaire(DAS)(P=0.002)and on the depression-distortion score of the Cognitive Bias Questionnaire(CBQ)(P=0.004),and the difference was significant.4.In terms of emotion regulation,the remission BD group was significantly lower than the HC group on the rational analysis dimension(t=2.527,P=0.013),the positive refocus dimension(t=2.749,P=0.007),and the positive reappraisal dimension(t=2.954,P=0.004),and the difference was significant;the remission BD group was significantly lower than the HC group on the self-blame(t=-2.601,P= 0.010)and contemplation dimensions(t=-3.087,P=0.003)were significantly higher in the BD group than in the HC group during the remission period,and the difference was significant.In terms of self-efficacy to regulate depressed emotions,the BD group in remission was lower than the HC group,and the difference was significant(t=2.429,P=0.017).5.Differences in the cognitive patterns of bipolar depression remission patients with and without childhood trauma,compared to bipolar depression remission patients without childhood trauma,bipolar depression remission patients with childhood trauma had significantly higher total scores on the Dysfunctional Attitudes Questionnaire(DAS)(t=3.217,P=0.002),depression-distortion scores on the Cognitive Bias Questionnaire(CBQ)(t=4.568,P< 0.001)were significantly higher than those in remission bipolar depression without childhood trauma,with significant differences.6.Differences in mood dysregulation in bipolar depression remission patients with and without childhood trauma.Compared with patients in remission in the BD group without childhood trauma,patients in remission in the BD group with childhood trauma had higher mood dysregulation in the dimensions of self-blame(t=-2.641,P=0.001),rumination(t=-4.023,P<0.001),catastrophizing(t=-4.201,P<0.001)and blaming others(t=-2.412,P=0.017)than patients in remission in the BD group without childhood trauma.BD group during childhood trauma remission,with significant differences.In terms of self-efficacy to express positive emotions,the group with childhood trauma-relieving BD was lower than the group without childhood trauma-relieving BD,and the difference was significant(t=2.438,P=0.016).In terms of self-efficacy to regulate depression,the group with childhood trauma-remitting BD was lower than the group without childhood trauma-remitting BD,and the difference was significant(t=-2.691,P=0.008).7.Total dysfunctional attitudes(DAS)scores of patients in remission from bipolar depression with childhood trauma were positively correlated with total scores on the Childhood Trauma Scale(CTQ)(r=0.600)and emotional abuse dimension(r=0.386);depression-distortion scores on the Cognitive Bias Questionnaire(CBQ)were positively correlated with total scores on the Childhood CTQ(r=0.508)and emotional neglect dimension(r=0.370).Emotion Regulation Self-Efficacy Scale(RESS)scores were negatively correlated with total CTQ scores(r=-0.453)and somatic abuse dimension(r=-0.253).8.A linear regression analysis was conducted with emotional abuse,physical abuse,sexual abuse,emotional neglect,and somatic neglect as independent variables,and dysfunctional attitude(DAS)total score and emotion regulation self-efficacy(RESS)scale total score as dependent variables in patients in remission from bipolar depression,and an F-test of the model revealed that the model passed the F-test(F=22.157,P<0.05),and the emotional abuse The regression coefficient value was 7.534(t=4.586,P<0.01),implying that emotional abuse can have a significant positive effect relationship on dysfunctional attitudes.When F-testing the model it was found that the model passed the F-test(F=20.601,P<0.05)and the regression coefficient value for somatic abuse was-3.739(t=-3.431,P<0.01),implying that somatic abuse has a significant negative effect relationship on emotion regulation self-efficacy.Conclusions1.Childhood trauma in bipolar depression in remission with childhood trauma was mainly reflected in the physical abuse and emotional neglect dimensions.2.The cognitive bias of bipolar depression remission patients with childhood trauma is mainly reflected in the total dysfunctional attitude score and depression-distortion dimension;the emotion dysregulation of bipolar depression remission patients with childhood trauma is mainly reflected in the self-blame,contemplation,catastrophizing,and blaming others dimensions;the emotion regulation self-efficacy of bipolar depression remission patients with childhood trauma is mainly reflected in the expression of positive emotions The self-efficacy of emotion regulation in bipolar depression in remission is mainly reflected in the dimensions of expressing positive emotions and regulating depressed emotions.3.Cognitive bias and emotional dysregulation were more pronounced in bipolar depression remission patients with childhood trauma,in which the effect of emotional abuse on cognitive bias and the effect of physical abuse on emotion regulation self-efficacy of bipolar depression remission patients was positive and significant. |
PDF Full Text Request