Testing the cognitive function model of patients with bipolar disorder in relation to traumatic experiences in childhood by the mediating role of affective lability emotion and expressed emotion

Previous studies suggest that the severity of alterations in cognitive functions in people with a diagnosis of bipolar I disorder are directly related to the deterioration in overall functioning and life quality.

The present study aimed to test the cognitive functional model of patients with bipolar disorder regarding childhood traumatic experiences based on the mediating role of emotional instability and expressed emotion.

The research method is descriptive-correlational modeling of structural equations. The sample population included all patients with bipolar disorder who were admitted to Yahyanejad hospital in Babol, Iran during 17 months (from March/April 2010 until mid-September 2020). In total, 379 subjects were selected by convenience sampling. Data collection tools were The Childhood Trauma Questionnaire (CTQ) by Bernstein and Fink (1998), the Emotional Instability Scale by Oliver and Simpson (2004), the Expressed Emotion Level by Hall & et al. (2007), and the Cognitive Abilities Questionnaire by Nejati (2013). Data analysis was performed by structural equation modeling (SEM) in SPSS version 24 and Lisrel version 8.8.

The findings showed that childhood traumatic experiences directly affect emotional instability, expressed emotion, and cognitive function in patients with bipolar disorder (P<0.5). Further, emotional instability and expressed emotion play a mediating role in the correlation between childhood traumatic experiences and cognitive function in patients with bipolar disorder (P<0.5).

According to the results, emotional instability and expressed emotion have a mediating role in the correlation between childhood traumatic experiences and cognitive function in patients with bipolar disorder. Therefore, in order to improve the cognitive function of people with bipolar disorder, instrumented variables of stability and emotion should be taken into consideration.