The impact of interpersonal life events and sociotropy on the course of bipolar disorder

Biological models have facilitated our understanding of the etiology of bipolar disorder, but have yet to explain why bipolar patients vary in the timing and symptom pattern of episodes. Research within the unipolar depression literature has suggested cognitive vulnerabilities (sociotropy and autonomy) and environmental stressors (interpersonal and achievement events) may interact to increase patients\u27 depressive symptoms and susceptibility to relapse. Analysis of the vulnerability event matching model with bipolar disorder found bipolar patients high in sociotropy had elevated symptom severity at both low and high levels of interpersonal stress but were not at increased risk for relapse. The purpose of this study was to examine the role of interpersonal life events and sociotropy on relapse with a bipolar sample. Patients who met DSM-IV criteria for bipolar disorder and had been recovered for two months were monitored monthly for relapse. Participants were interviewed for life events at 2, 6, 12, 18, and 24 months using the Bedford College Life Events and Difficulties Schedule (LEDS; Brown & Harris, 1978). Sociotropy was measured at 6 months using the Dysfunctional Attitudes Scale (DAS; Weisman & Beck, 1978). It was hypothesized that participants who experienced a severe interpersonal event during well-periods would have a quicker time to relapse than participants who experienced severe events without interpersonal loss and participants who experienced no events. It was also predicted that sociotropy would moderate the relationship between severe interpersonal life events and time to relapse as evidenced by a significant interaction term for sociotropy by life event subgroup. Results evidenced a trend towards significance for life events on time to relapse when examined independently from sociotropy and a significant interaction effect for interpersonal life events and sociotropy on time to relapse. The implications of findings are discussed