Bimonthly mood-suicidal ideation dynamics in bipolar spectrum disorders: A dynamic structural equation modeling study

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• Bipolar spectrum disorders (BSDs) are characterized by a high prevalence of suicidal ideation (SI).
• Mania, depression, and externalizing traits (aggression, hostility, impulsivity) are linked to SI in BSDs.
• Understanding the temporal dynamics between mood states and SI is crucial for effective intervention.

Purpose of the Study:

• To investigate the temporal within-person coupling between mood states (mania, depression) and SI in adults with BSDs.
• To examine whether externalizing traits moderate the relationship between mood and SI.
• To analyze the longitudinal dynamics of SI, mania, and depression over time.

Main Methods:

• Utilized dynamic structural equation modeling (DSEM) on longitudinal data from 434 adults with BSDs.
• Conducted bimonthly assessments over multiple years to capture within-person variability.
• Tested moderation effects of trait aggression, hostility, and impulsivity on mood-SI dynamics.

Main Results:

• Significant autoregressive effects and within-person variability observed for SI, mania, and depression.
• Increases in mania predicted subsequent SI; depression and SI exhibited a bidirectional relationship.
• Higher externalizing traits were associated with increased SI burden, stronger SI carryover, and greater SI variability.

Conclusions:

• Mania and depression display distinct temporal associations with SI in BSDs.
• Externalizing traits exacerbate SI burden and instability, highlighting their clinical significance.
• Findings support developing personalized, trajectory-informed monitoring for individuals with BSDs.