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What is the Effect of Social Rhythm Disrupting Events on Mood in Individuals with Bipolar Disorder?

Levenson, Jessica (2013) What is the Effect of Social Rhythm Disrupting Events on Mood in Individuals with Bipolar Disorder? Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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The social zeitgeber hypothesis suggests that life events have the capacity to lead to the onset of affective episodes in those vulnerable to bipolar disorder via biological and social rhythm disruption. However, few studies have systematically evaluated the role of life events that disrupt social routines in the exacerbation of mood symptoms. This report examined the effect of social rhythm disrupting (SRD) events on recurrence during preventative treatment in a sample of 82 patients with bipolar disorder who achieved remission from an acute episode, and assessed whether treatment assignment (interpersonal and social rhythm therapy (IPSRT) vs. intensive clinical management (ICM)) moderated this effect. We also examined the effect of short term (STC) and long term (LTC) threat (unpleasant) events. Recurrence was determined by blinded senior psychiatrists who were not otherwise involved in the conduct of the study and who were asked to determine whether the participant met Research Diagnostic Criteria for a new affective episode. Life events were measured with the Bedford College Life Events and Difficulty Schedule (LEDS) and were rated for degree of SRD and threat. Chi-square tests, Kaplan-Meier survival analyses, and Cox proportional hazards models showed that patients who had a recurrence were more likely to experience independent SRD, STC, and LTC events prior to recurrence than those who survived the two-year preventative phase without a recurrence, and this event occurred closer in time to recurrence than to a corresponding non-recurrence point in the non-recurrence group. In contrast, events that were rated for SRD and threat were not more likely to occur among individuals experiencing a recurrence than events rated for threat only. Nor did such a combined event occur more closely in time to a recurrence than events rated for threat only. Last, among those who experienced an SRD event, those who received preventative IPSRT were more likely to have a recurrence than those who received preventative ICM. Future studies should focus on the types of SRD events that are related to mood worsening, as well as on novel methods of examining these scientific aims that make use of longitudinal datasets.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairFrank,
Committee MemberKupfer, David Jkupferdj@upmc.eduDJKUPFER
Committee MemberManuck, Stephen Bmanuck@pitt.eduMANUCK
Committee MemberPogue-Geile, Michaelmfpg@pitt.eduMFPG
Committee MemberRoecklein, Kathryn Akroeck@pitt.eduKROECK
Date: 30 September 2013
Date Type: Publication
Defense Date: 6 June 2012
Approval Date: 30 September 2013
Submission Date: 20 May 2013
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 151
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Psychology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Life events; bipolar disorder; social zeitgeber; social rhythms; interpersonal and social rhythm therapy (IPSRT); Cox proportional hazards model; Kaplan-Meier survival analyses
Date Deposited: 30 Sep 2013 12:24
Last Modified: 19 Dec 2016 14:40


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