Elsevier

Behavior Therapy

Volume 40, Issue 2, June 2009, Pages 131-141
Behavior Therapy

Life Events and Social Rhythms in Bipolar Spectrum Disorders: A Prospective Study

https://doi.org/10.1016/j.beth.2008.04.003Get rights and content

Abstract

This study examined the social zeitgeber theory, which suggests that affective symptoms are caused by life events disrupting vulnerable individuals’ social and circadian rhythms. Undergraduate participants were selected based on a 2-phase screening process, including a semistructured diagnostic interview. The final sample consisted of 101 bipolar spectrum participants and 100 demographically matched normal controls. Participants who completed up to 3 follow-up visits, approximately every 4 months, as part of a longitudinal study were included in the current study. Life events did not predict social rhythm regularity and social rhythm regularity inconsistently predicted affective symptoms. However, life events, particularly social rhythm disruption (SRD) events, did predict depressive symptoms and episodes, and less consistently predicted hypo(manic) symptoms and episodes. Thus, the current study obtained mixed support for social zeitgeber theory.

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Participants

Participants for this study were recruited from the Temple University site of the Longitudinal Investigation of Bipolar Spectrum (LIBS) Project (Alloy et al., 2008, Nusslock et al., 2007, Shen et al., 2008) and were selected based on a two-phase screening process. In Phase I, approximately 7,000 students at Temple University completed the revised General Behavior Inventory (GBI; Depue, Krauss, Spoont, & Arbisi, 1989). Students who met initial GBI screening criteria (n = 2737) were invited to

Procedure

After the two-phase screening process, participants were invited back for follow-up visits every 4 months. Only the first three follow-up visits (i.e., F1, F2, F3) for each participant were included in this study. At each follow-up visit, participants completed the M-SRM and LES and were also interviewed with the exp-SADS-C and the LEI for each 4-month interval. These visits were conducted by two separate interviewers, one to administer the exp-SADS-C and the other to administer the LEI, in

Sample Characteristics

The final sample included 100 normal controls and 64 individuals with bipolar II disorder and 37 individuals with cyclothymia. The control group met criteria for no psychiatric diagnoses, other than 9 (8.2%) participants who had a lifetime diagnosis of a specific phobia. Lifetime prevalence of alcohol or drug abuse or dependence in the bipolar spectrum group was 32.4% (19.4% alcohol and 21.3% drug). Other lifetime cormorbid diagnoses in the bipolar group were: generalized anxiety disorder

Discussion

The primary goal of this study was to examine social zeitgeber theory (Ehlers et al., 1988, Ehlers et al., 1993) as a potential explanation for affective symptoms and episodes in individuals with bipolar spectrum disorders. Specifically, we investigated three causal associations postulated by this theory: (1) whether the occurrence of life events, and particular types of events, predict social rhythm regularity; (2) whether life events were associated with, and temporally predicted, affective

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