Research reportEmotion-relevant impulsivity predicts sustained anger and aggression after remission in bipolar I disorder
Section snippets
. Introduction
Although not a universal concern, bipolar disorder (BD) is related to elevated rates of aggression and violence in adults (, ) as well as children (, ). In the NESARC community-based representative sample, 25.34% of those with bipolar I disorder and 13.58% of those with bipolar disorder II reported aggressive behavior after age 15 as compared to <1% in the general population (Latalova, 2009), and rates of violence among those with BD were 5.9 times the rate in the general population (Van Dorn
Sources of anger and aggression in BD
Previous research has suggested that anger and aggression within BD can be related to comorbid conditions and trauma exposure. One possibility is that anger and aggression follow from comorbid conditions, such as substance-related diagnoses (, , ) and PTSD (Garno et al., 2008). There is also evidence that aggression within BD is related to childhood abuse (, ) and adulthood violent victimization (, ). It remains unclear, however, whether such variables predict aggression and anger during
Method
Study procedures were approved by the university Institutional Review Board. Data were gathered as part of a broader study (Muhtadie and Johnson, 2015).
Sample characteristics
The 58 participants had a mean age of 35.93 (SD=12), and a mean level of education of 15.23 years (SD=1.96). The sample was 54.2% women, and 42.4% employed. Per the SCID, 20.9% were diagnosed with PTSD, 55.2% with an anxiety disorder other than PTSD, and 57.6% with an alcohol or substance use disorder during their lifetime. Fully 80.6% of the sample reported a history of traumatic events.
In a previous report (Johnson et al., in press), we described that the bipolar group attained significantly
Discussion
Previous research documented that persons diagnosed with BD reported significantly more difficulty with anger, verbal aggression, physical aggression, and hostility than did control participants, and that these difficulties were sustained across follow-up (Ballester et al., 2014) and even during a state of remission (Johnson et al., in press). Not all persons with BD have such difficulties, however. The goal of this study was to identify variables that might explain why some people show
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2020, Behaviour Research and TherapyCitation Excerpt :It includes items from the Urgency and Positive Urgency measures, and items covering reflexive reactions to emotion states (Carver et al., 2011). Across undergraduate and clinical samples, the Feelings Trigger Action scale is significantly correlated with aggression, and effects withstand control for other forms of impulsivity, psychiatric syndromes, medications, and trauma history (Johnson et al., 2013; Johnson & Carver, 2016). The scale has been shown to be statistically separable from measures of non-emotion-related impulsivity, such as indices of inattention and lack of follow-through (Carver et al., 2011).