Background: Childhood trauma is negatively associated with depression severity in bipolar disorder; however, the underlying mechanisms remain unclear. We investigated whether personality traits (neuroticism, extraversion, openness, agreeableness, conscientiousness) mediate the relationship between childhood trauma and the severity of bipolar depression. Methods: Data from 209 individuals with bipolar disorder recruited for the Prechter Longitudinal Study of Bipolar Disorder were analysed. Using structural equation modelling, we examined the direct and indirect associations between childhood trauma (Childhood Trauma Questionnaire) and depression severity (Hamilton Depression Rating Scale) – with the personality traits (NEO Personality Inventory–Revised) as mediators. Results: The direct effect of childhood trauma on depression severity (standardised β = 0.32, 95% bootstrap confidence interval [CI] = 0.20–0.45, p < 0.001) and the indirect effect via neuroticism (standardised β = 0.03, 95% bootstrap CI [0.002, 0.07], p = 0.039) were significant; supporting a partial mediation model. The indirect effect accounted for 9% of the total effect of childhood trauma on depression severity (standardised β = 0.09, 95% bootstrap CI [0.002, 0.19], p = 0.046). The final model had a good fit with the data (comparative fit index = 0.96; root mean square error of approximation = 0.05, 90% CI = [0.02, 0.07]). Conclusion: Personality traits may be relevant psychological mediators that link childhood trauma to a more severe clinical presentation of bipolar depression. Consequently, a person’s personality structure may be a crucial operative factor to incorporate in therapeutic plans when treating individuals with bipolar disorder who report a history of childhood trauma.
Journal Article Cohort Profile Update: The Heinz C. Prechter Longitudinal Study of Bipolar Disorder Get access Anastasia K Yocum, Anastasia K Yocum Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Steve Anderau, Steve Anderau Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Holli Bertram, Holli Bertram Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Helen J Burgess, Helen J Burgess Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Amy L Cochran, Amy L Cochran Department of Mathematics and Department of Population Health Sciences, University of Wisconsin, Madison, WI, USA https://orcid.org/0000-0001-6024-796X Search for other works by this author on: Oxford Academic PubMed Google Scholar Patricia J Deldin, Patricia J Deldin Department of Psychiatry, University of Michigan, Ann Arbor, MI, USADepartment of Psychology, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Simon J Evans, Simon J Evans Phenome Health, Seattle, WA, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Peisong Han, Peisong Han Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Paul M Jenkins, Paul M Jenkins Department of Psychiatry, University of Michigan, Ann Arbor, MI, USADepartment of Pharmacology, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Ravleen Kaur, Ravleen Kaur Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar ... Show more Scott A Langenecker, Scott A Langenecker Department of Psychiatry, University of Utah, Salt Lake, UT, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar David F Marshall, David F Marshall Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Emily Mower Provost, Emily Mower Provost Department of Computer Science and Engineering, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar K Sue O'Shea, K Sue O'Shea Department of Psychiatry, University of Michigan, Ann Arbor, MI, USADepartment of Cell and Developmental Biology, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Kelly A Ryan, Kelly A Ryan Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Sarah H Sperry, Sarah H Sperry Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Shawna N Smith, Shawna N Smith Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Ivy F Tso, Ivy F Tso Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Kritika M Versha, Kritika M Versha Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Brittany M Wright, Brittany M Wright Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Sebastian Zöllner, Sebastian Zöllner Department of Psychiatry, University of Michigan, Ann Arbor, MI, USADepartment of Biostatistics, University of Michigan, Ann Arbor, MI, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Melvin G McInnis Melvin G McInnis Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA Corresponding author. Department of Psychiatry and Eisenberg Family Depression Center, University of Michigan School of Medicine, 4152 Plymouth Road, Ann Arbor, MI 48109, USA. E-mail: mmcinnis@umich.edu https://orcid.org/0000-0002-0375-6247 Search for other works by this author on: Oxford Academic PubMed Google Scholar International Journal of Epidemiology, Volume 52, Issue 6, December 2023, Pages e324–e331, https://doi.org/10.1093/ije/dyad109 Published: 04 August 2023 Article history Received: 10 March 2022 Editorial decision: 02 June 2023 Accepted: 24 July 2023 Published: 04 August 2023
Abstract Objective The increase in smartphone usage has enabled the possibility of more accessible ways to conduct neuropsychological evaluations. The objective of this study was to determine the feasibility of using smartphone typing dynamics with mood scores to supplement cognitive assessment through trail making tests. Methods Using a custom‐built keyboard, naturalistic keypress dynamics were unobtrusively recorded in individuals with bipolar disorder ( n = 11) and nonbipolar controls (n = 8) on an Android smartphone. Keypresses were matched to digital trail making tests part B (dTMT‐B) administered daily in two periods and weekly mood assessments. Following comparison of dTMT‐Bs to the pencil‐and‐paper equivalent, longitudinal mixed‐effects models were used to analyze daily dTMT‐B performance as a function of typing and mood. Results Comparison of the first dTMT‐B to paper TMT‐B showed adequate reliability (intraclass correlations = 0.74). In our model, we observed that participants who typed slower took longer to complete dTMT‐B ( b = 0.189, p < .001). This trend was also seen in individual fluctuations in typing speed and dTMT‐B performance ( b = 0.032, p = .004). Moreover, participants who were more depressed completed the dTMT‐B slower than less depressed participants ( b = 0.189, p < .001). A practice effect was observed for the dTMT‐Bs. Conclusion Typing speed in combination with depression scores has the potential to infer aspects of cognition (visual attention, processing speed, and task switching) in people's natural environment to complement formal in‐person neuropsychological assessments that commonly include the trail making test.
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