Life events in bipolar disorder: Towards more specific models
Open accessAbstract
This article reviews the evidence concerning life events as a predictor of symptoms within bipolar disorder. First, key methodological issues in this area are described, and criteria used for including studies in this review are defined. Then findings that negative life events predict worse outcomes within bipolar disorder are reviewed. Beyond general studies on relapse, it is important to differentiate predictors of depression from predictors of mania. When severe negative life events occur, they appear to trigger increases in bipolar depression. Nonetheless, many depressions are unrelated to negative life events and appear to be triggered by other variables. The strongest evidence suggests that negative life events do not trigger mania, except perhaps in certain contexts. Retrospective findings for schedule-disrupting life events as a trigger for manic symptoms await further assessment within a longitudinal study. Life events involving goal attainment do appear to trigger manic symptoms. Overall, it is time to differentiate among specific types of life events, as these different forms of events point towards mechanisms linking stressors with symptom expression. These mechanisms provide clues into ways to integrate the social environment with biological vulnerability (see [Monroe, S.M., & Johnson, S.L. (1990)). the dimensions of life stress and the specificity of disorder. Journal of Applied Social Psychology, 20, 167-1694; Harris, T.O. (1991). Life stress and illness: the question of specificity. Annals of Behavioral Medicine, 13, 211-219]).
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The study focused on major life events and chronic difficulties occurring during the year before hospitalization to limit recall bias.
“We focused on major life events and chronic difficulties occurring during the year prior to hospitalization to limit recall bias (see Paykel 1997; Johnson 2005).”
From Life stress and suicide in adolescents (2019) · cites this paper as Johnson 2005
Recall of major life events may be unreliable after one year.
“Furthermore, recall of major life events may be unreliable after one year (Johnson 2005; Paykel 1997).”
From Life stress and suicide in adolescents (2019) · cites this paper as Johnson 2005
Two factors reduce the recall bias concern: the STRAIN asks about major stressors from the past year, which can be recalled accurately, and the analyses controlled for psychiatric symptoms that might bias recall.
“These concerns are tempered by (a) the STRAIN’s focus on major stressors over the past year, which studies show can be recalled accurately (Johnson 2005; Paykel 1997) and (b) controlling for psychiatric symptoms (e.g., depression) that may bias recall.”
From Life stress and suicide in adolescents (2019) · cites this paper as Johnson 2005
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References 110 · Cited by 214
Research works printed but not linked: 7
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- Authors
- Johnson, S. L.
- Affiliations
- University of Miami (US)
- Corresponding author
- Johnson, Sheri L.
- ORCID
- Johnson, Sheri L.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2005-12
- Volume
- 25
- Issue
- 8
- Pages
- 1008-1027
- ISSN
- 0272-7358 (ISSN-L)
- PMC
- PMC3137243
- OpenAlex
- W2003554858
- Cited by
- 214
- References
- 110
- Citations by year
- 2026: 5 · 2025: 1 · 2024: 6 · 2023: 15 · 2022: 4 · 2021: 6 · 2020: 11 · 2019: 6 · 2018: 11 · 2017: 16 · 2016: 11 · 2015: 15 · 2014: 12 · 2013: 16 · 2012: 14
- FWCI
- 4.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R29MH055950)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- bipolar disorder, life events, negative life events, bipolar depression, mania, relapse, goal achievement
- MeSH terms
- Bipolar Disorder, Follow-Up Studies, Humans, Life Change Events, Models, Psychological, Risk Factors, Social Environment
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