4.2. Trauma Versus No Trauma Groups
When comparing the trauma and no-trauma at-risk subgroups, no statistically significant differences were found in the number of symptoms or incidences across all psychopathologies examined. However, this does not discount the potential role of trauma in the early developmental signs of BD. Existing literature provides substantial evidence linking interpersonal trauma and childhood trauma to the development, persistence, and recurrence of BD (Hillegers et al., 2004; T. Li et al., 2023a; Nierenberg et al., 2023; Watson et al., 2014; Wrobel et al., 2023). Therefore, it was unexpected to observe that having experienced an interpersonal traumatic event did not appear to be associated with differential early developmental signs of BD in this study.
It is also important to address that offspring children and adolescents of parents with BD are susceptible to the development of not only BD, but also other psychopathologies as well, such as depression and anxiety (DelBello & Geller, 2002). That is, even the no trauma group is still susceptible to developing BD and other psychopathologies which might account for why there was no statistically significant difference between the trauma and no trauma sub-groups. Also, the low number of children who experienced anxiety symptoms, ranging from two to seventeen, might also justify the observation that there was no statistically significant difference in the anxiety symptoms between the trauma and no trauma groups.
Previous research has typically investigated childhood trauma using retrospective cohorts (T. Li et al., 2023a; Palmier-Claus et al., 2016; Watson et al., 2014), which rely on individuals’ recollections of their experiences. It is interesting to consider how a person’s lived experience and personal history might shape their perceptions of trauma and its impact, potentially influencing clinical trajectories over time. Factually, patients with BD seem to have higher emotional memory which is associated with the high recall of traumatic or emotionally adverse events in those populations (Fijtman et al., 2020). This study investigated the prospective effects of traumatic events on early developmental signs of BD.
Furthermore, previous studies often used the Childhood Trauma Questionnaire (CTQ), which assesses emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect. Specifically, BD’s clinical course has been most strongly correlated with trauma related to emotional abuse and emotional neglect (T. Li et al., 2023a; Rowe et al., 2024; Watson et al., 2014). It is important to note that the traumatic events assessed using the PTSD measure in this study do not overlap with these categories. This discrepancy may largely account for the unexpected result of no statistically significant differences in the number of symptoms or incidences of psychopathologies between the trauma and no-trauma groups.
Interestingly, the rate of participants who self-reported having experienced a childhood traumatic event was as high as 78% in previous studies (Rowe et al., 2024). In the current study, the percentage of children who claimed they had experienced a traumatic event was only 30% at baseline and 37% at two-year follow-up. Children may have been reluctant to share their traumatic experiences, particularly since five of the nine interpersonal traumatic events inquired about involved their family or home environment, to which they would be returning. Therefore, this study might not have an accurate representation of children who actually experienced trauma.