Childhood maltreatment and internalized shame in adults with a diagnosis of bipolar disorder

Relatively little is understood regarding the aetiology of bipolar disorder (BD) other than for the influence of a large genetic component on the development of the disorder and the impact of stressful life events on changes in current mood. However, amongst a range of psychiatric diagnoses, research consistently demonstrates a higher frequency of reports of childhood abuse and neglect compared with individuals in the general population. In addition, those who report experiences of childhood maltreatment also report high levels of internalized shame in adulthood, although there is little research demonstrating this association amongst clinical populations. An adult sample of 35 participants with a diagnosis of BD and a control group of 35 participants with no psychiatric diagnoses completed measures of childhood abuse and neglect, and internalized shame. Participants in the BD group reported a significantly greater frequency of high levels of childhood trauma compared with participants in the control group, with the reported frequency of childhood emotional abuse and neglect being particularly high. Levels of current internalized shame were also significantly higher amongst participants in the BD group. Significant correlations were observed between current internalized shame and reports of childhood emotional abuse and neglect. Clinical implications of the study's findings are discussed, and limitations of the methodology are considered.