Article ID Journal Published Year Pages File Type
5811127 Medical Hypotheses 2015 7 Pages PDF
Abstract

Because affective pathogenesis is a hard problem for psychiatry, it behoves researchers to develop and test novel models of causality. We examine the notion that the adaptive drive to social investment - prestige - provides clues to the bipolar spectrum. A seven node bipolar spectrum is proposed, based on a putative gradient of “bipolarity”. It is conceived that this gradient may correlate with the drive to social investment (prestige). In order to test this hypothesis with proof of concept data, a case control study categorised 228 subjects into a seven node bipolar spectrum. Whilst controlling for mood elevation and depression, differences in strategic prestige (leadership) motivation (MSPM) between spectrum groups were examined. The bipolar I (S1) node had a greater strategic prestige (leadership) motivation score than the controls (S7) by 21.17 points, 95% CI [8.16, 34.18], p < .001, d = 1.05, while the bipolar II (S2) node was higher than the control group by 16.73 points, 95% CI [0.92, 32.54], p = .030, d = 0.84. Whilst the pseudounipolar (S3) node (those with depression and bipolar family histories; n = 17) had only a marginally statistical difference in MSPM compared to controls (p = .051), the mean difference (16.98) and d value (0.86) indicated an elevated MSPM level. Prestige (leadership) motivation score positively correlated with dimensional lifetime bipolarity (Mood Disorder Questionnaire) score (rp = 0.47), supporting the spectrum prestige motivation gradient notion. Evidence is presented for a genetic disposition to elevated strategic prestige (leadership) motivation. Sensitivity to Social Inclusion (MSIS), Contingency of Self-Worth (CSW.av) and tension significantly predicted strategic prestige (leadership) motivation (MSPM) score in a multiple regression. - suggesting that a vulnerability of the social self may be a feature of bipolar disorders. The prestige model of spectrum bipolarity offers a new conceptualisation of affective disorders and has received preliminary support.

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