Category: Bipolar Disorders

PS3- #B53 - Impact of Bipolar-Anxiety Comorbidity on Stressful Event Generation

Friday, Nov 17
11:00 AM – 12:00 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Bipolar Disorder | Comorbidity | Stress

Background: Bipolar disorder (BD) is highly comorbid with several types of psychopathology, including anxiety disorders (McElroy et al., 2001). Individuals with bipolar disorder and comorbid anxiety disorders (BD-Anx) tend to experience a more negative course of BD, including less time euthymic, poorer quality of life and role functioning, and a greater likelihood of suicide attempts (Kessler et al., 2006). In addition, studies on the stress-generation model have found that individuals with BD contribute to the generation of stressful life events, thereby potentially engendering prospective depressive and (hypo)manic episodes and other negative consequences (Bender et al., 2010).  Stress generation has been explored more frequently with mood than anxiety disorders, but there is evidence that some anxiety disorders, particularly social anxiety, also contribute to stress generation (Brown et al., 1998). Therefore, comorbid BD-Anx may be associated with the generation of greater dependent stress than BD alone.


The current longitudinal study compared individuals with BD alone to those with BD-Anx to determine whether BD-Anx comorbidity was associated with increased occurrence of stressful life events. Participants included 121 college students (63% female, 53% Caucasian, M age = 19.05, SD = 1.28) who were allocated to one of three groups: a BD group (N= 29), a comorbid BD-Anx group (N=23), and a demographically-matched healthy control group (N=69). Diagnostic classification was determined using the expanded-Schedule for Affective Disorders and Schizophrenia-Lifetime (SADS) at baseline and Change version at each follow-up. At a prospective assessment (6 months later), participants also completed a life event interview that assessed the frequency of positive and negative life events.



Results: Controlling for race, gender, and age, a One-Way ANOVA revealed significant group differences in the reported number of negative dependent life events at follow-up (F = 13.296, p < .001). After using a Bonferroni correction, post-hoc comparisons revealed that individuals in the comorbid BD-Anx group (M = 13.65, SD = 9.84) experienced significantly more negative life events than those in the BD group (M = 7.87, SD = 6.14; t = -2.63, p = .011) and the control group (M = 6.04, SD = 4.28; t = -5.16, p < .001).



Conclusion: These results indicate that individuals with comorbid BD-Anx experience more dependent negative life events than individuals with BD alone. This finding indicates that the presence of anxiety may exacerbate the generation of stressful life events in BD, which may partially account for the association between BD-Anx comorbidity and exacerbated symptomatology.

Adela Scharff

Research Assistant
Temple University
Philadelphia, Pennsylvania

Jared O'Garro-Moore

Temple University

Lauren B. Alloy

Joseph Wolpe Distinguished Faculty in Psychology, Laura H. Carnell Professor of Psychology
Temple University
Philadelphia, Pennsylvania