Adult Attachment Status and Longitudinal Symptom Patterns in Bipolar Affective Disorder

Emerging literature shows that attachment status is associated with a variety of symptoms related to affective disorders, with some studies focusing on symptoms of bipolar affective disorder (BPAD). Few studies, however, examine links between attachment and shifts in symptoms over time. The present study investigates if mood symptom intensity and variability are associated with adult romantic attachment from a sample of participants with BPAD (N=59). Participants were from the Prechter Longitudinal Study of Bipolar Disorder. Participants completed patient and clinician administered questionnaires of mania, depression, as well as a self-report of adult romantic attachment at baseline. Symptom measures were also completed by participants at intervals over time. Anxious adult attachment was associated with baseline depressive symptom intensity and patient rated mania symptom intensity. Avoidant adult attachment was associated with baseline depression symptom intensity. Additionally, overall attachment insecurity was associated with variability in clinician rated depressive symptoms. Variability in clinician rated mania symptom variability was associated with avoidant adult attachment. Lastly, avoidant adult attachment predicted shifts in clinician rated mania. Implications of findings are discussed, limitations of the study are noted, and directions for future studies are described.