"Past research has looked at mental health conditions, including bipolar disorder, and even at memory function in people with childhood trauma, but few have looked at inhibitory control, or what some people call impulse control," says David Marshall. (Credit: Frank Meffert/Flickr)

bipolar disorder

After child abuse, impulses are harder to control

A new study about impulse control adds to a growing body of evidence about the lasting effects of child abuse and neglect.

Quick “go or don’t go” thinking—so crucial to everyday situations—appears to be less accurate and more impulsive in adults who suffered physical, emotional, or sexual trauma in their early years than in those who did not, the study finds.

Researchers analyzed data from the Heinz C. Prechter Longitudinal Study of Bipolar Disorder to see if people with bipolar disorder had more impulsive and inaccurate responses on a quick task than others without the condition, as measured on standard timed tests called a “Go/No-Go”test. But to their surprise, they found no differences between the two groups.

Instead, when they looked closer, they found a common thread running through nearly everyone with more impulsive responses.

Among the more than 320 people in the study who took the tests, 134 reported a history of childhood trauma. This included physical abuse or neglect, emotional abuse or neglect, and sexual abuse. It did not include one-time traumatic events. None of the participants had active substance abuse issues, and the participants without bipolar disorder did not have other mental health conditions.

Those with bipolar disorder and a history of trauma performed significantly worse on the “Go/No-Go” test, than those with bipolar alone. But those without bipolar disorder who had a history of trauma performed just as poorly.

The test measures how well a person can stop himself or herself from reacting incorrectly to rapid prompts that sometimes require a “go” response and sometime require a person to hold back the impulse to respond (“no-go”).

[Trauma and ADHD may lead women to self-harm]

“Past research has looked at mental health conditions, including bipolar disorder, and even at memory function in people with childhood trauma, but few have looked at inhibitory control, or what some people call impulse control,” says lead author David Marshall assistant professor of psychiatry at the University of Michigan.

“Having the data from the Prechter research effort allowed us to see that a history of childhood trauma can impact the development of this key aspect of executive functioning that we need more of as we become adults, where we are required to engage in self-monitoring and goal-directed behavior.”

Marshall got the idea for the study after noticing that a sizable portion of the bipolar disorder patients who had volunteered for the study discussed problematic childhoods in the questionnaires that all participants fill out.

The study includes people who don’t have bipolar disorder and are willing to act as comparisons for those with bipolar, so scientists can see important differences in the two populations.

Trauma and illness

“What is intriguing about this research is that childhood trauma had an effect on impulse control that was in both groups, meaning that it is independent of bipolar illness and more strongly related to adverse childhood experiences,” Marshall says.

“This substantially changes the way we think of how trauma increases risk for illnesses. There may be brain changes after trauma that act as a risk marker for development of later illnesses, including bipolar disorder. These processes are much more fluid than we previously thought.”

The new findings, published in Psychiatry Research, highlight the importance of continuous treatment for people diagnosed with bipolar disorder, and early detection and attention to the effects of childhood trauma on anyone.

“By finding early those who may be at risk of long-term mental health effects from childhood abuse and neglect, we may be able to guide them to treatments that can mitigate these effects,” Marshall says.

[Childhood trauma boosts risk of early psychosis]

While treatment recommendations vary, cognitive behavioral therapy—a form of talk therapy—can help even those whose childhood issues haven’t been addressed formally for years, Marshall says. The self-control and self-talk that are key to CBT could help individuals build problem-solving techniques to assist their thinking and analytic abilities.

Although the paper only includes a small group of people with no bipolar disorder but a history of childhood trauma, he hopes to continue assessing the question as the Prechter study continues. He and his colleagues will also watch over time as the study participants who reported childhood trauma continue to respond to surveys sent to them periodically.

Other researchers from the University of Michigan and from the University of Illinois at Chicago are coauthors of the study. The Prechter Fund, the Richard Tam Foundation, and the National Institute of Mental Health funded the work.

Source: University of Michigan

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