Childhood maltreatment is associated with attachment insecurities, dissociation and alexithymia in bipolar disorder

Kefeli M. C., Turow R. G., Yildirim A., Boysan M.

PSYCHIATRY RESEARCH, vol.260, pp.391-399, 2018 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 260
  • Publication Date: 2018
  • Doi Number: 10.1016/j.psychres.2017.12.026
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus
  • Page Numbers: pp.391-399
  • Van Yüzüncü Yıl University Affiliated: Yes


Child maltreatment is a public health issue that is a well-established risk factor for many psychological conditions, including bipolar disorder. The current study is one of the first to investigate associations among child maltreatment, dissociative symptomatology, alexithymia, anxiety, depression, and attachment insecurities. 40 patients with bipolar disorder-I and 40 healthy subjects matched for age, gender, and education participated in the study. The Dissociative Experiences Scale (DES), Somatoform Dissociation Questionnaire (SDQ), Childhood Trauma Questionnaire (CTQ-28), Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scale (DASS-21), and Experiences in Close Relationships-Revised (ECR-R) were completed by participants. In comparison to control participants, patients with bipolar disorder-I reported significantly more frequent abusive experiences in childhood, higher levels of attachment insecurities, more severe pathological and somatoform dissociation, as well as higher scores on measures of alexithymia, anxiety, depression and psychological stress. Reports of psychopathology among first-degree relatives (OR = 102.169, 95%IC = 4.596-2271.255; P < 0.01) and childhood emotional trauma (OR = 1.032; 95%CI = 0.782-1.363, P = 0.05) significantly contributed to bipolar disorder-I diagnosis. In contrast, absorption was negatively associated with bipolar illness (OR = 0.852; 95% CI = 0.747-0.973, P < 0.05). Our results showed significant associations between childhood trauma exposure and risk of bipolar disorder. Moreover, the results demonstrate that emotional abuse exposure predicts bipolar illness.