The Impact of Child Maltreatment on Emotional Regulation, Impulsivity, and Neurocognition in Patients with Bipolar Disorder
TL;DR
Emotional forms of CM were particularly associated with emotion dysregulation in euthymic individuals with BD type I, while associations with impulsivity and neurocognition were more limited.
Abstract
Child maltreatment (CM) has been associated with adverse outcomes in bipolar disorder (BD), although evidence from Chile remains limited. We examined associations between CM, emotion dysregulation, impulsivity, and neurocognition in euthymic individuals with BD type I. CM, emotion dysregulation, impulsivity, and neurocognition were assessed using the Childhood Trauma Questionnaire-Short Form, Difficulties in Emotion Regulation Scale, Barratt Impulsiveness Scale-11, Montreal Cognitive Assessment (MoCA), and Digit Symbol Substitution Test (DSST), respectively. Associations were examined using Spearman correlations and multivariable linear regression models adjusted for age and sex, with false discovery rate (FDR) correction for multiple testing. In adjusted analyses, emotional abuse and emotional neglect were associated with higher total emotion dysregulation scores (β = 1.95, FDR-adjusted p = 0.011; and β = 2.47, FDR-adjusted p = 0.001, respectively). Emotional neglect was also associated with higher total impulsivity (β = 1.19, FDR-adjusted p = 0.026), while physical abuse was associated with lower MoCA scores (β = −0.28, FDR-adjusted p = 0.0498). No CM dimension was significantly associated with DSST performance after FDR correction. Secondary adjusted analyses showed that emotional neglect was associated with greater emotional rejection and emotional interference. Exploratory bivariate analyses also identified associations between emotional and physical neglect and a higher number of lifetime suicide attempts. Although several differences emerged in sensitivity analyses using high/low CM categories, none remained significant after FDR correction. Emotional forms of CM were particularly associated with emotion dysregulation in euthymic individuals with BD type I, while associations with impulsivity and neurocognition were more limited. Larger longitudinal studies are needed to clarify the temporal and potentially mechanistic relationships between CM and psychological functioning in BD.