The relationship of bipolar cases and their offspring's attachment styles with temperament and clinical features: A controlled study

Objective: This study primarily aims to investigate the attachment styles of bipolar cases and their offsprings. Second and third aim is to examine the probability of relationship between temperament and attachment style, and relationship of attachment style with clinical variables of the disorder and personality disorders. In other words; our objective is to reveal similarities and differences between secure and insecure attachment styles in terms of similarities and differences of temperament and clinical features of bipolar disorder.Methods: 44 patients with bipolar disorder and 35 healthy offsprings older than 16 years old have been recruited for this study. 84 healthy control subjects who are at the similar age, environment and sex with the patients and their offsprings have been also recruited. Patients observed at the psychiatry clinic were sought to be over 16 years old and at euthymic period. Diagnosis interview was made with SCID I and SCDI II, patient's information were filed by using SCIP-TURK. Temperaments were evaluated with TEMPS A and attachments were evaluated with EBBÖFinding and Results: It is found that bipolar cases have insecure attachments more frequent than healthy individuals. Also offsprings of bipolar cases ? similar to their parents ? have insecure attachments more frequent than the healthy control group. Avoidant and anxious/ambivalent attachment scores of bipolar cases were higher than the healthy control group and scores of the offsprings of bipolar cases were higher than their parents's scores.In bipolar cases, scores of avoidant attachment have direct proportion with scores of depressive, cyclothymic, irritable and anxious temperament; inverse proportion with the scores of hyperthymic temperament. The offsprings of bipolar cases showed that scores of anxious/ambivalent attachment have direct proportion with scores of cyclothymic and irritable temperament; inverse proportion with the scores of hyperthymic temperament. Depressive temperament in bipolar cases and irritable temperament in their offsprings project insecure attachment. Insecure attachment have been observed amongst the healthy control group who scored higher cyclothymic temperament.Premenstrual syndrome, beginning of postpartum, sub-type of atypical depression, psychotic finding, suicide, hospitalization, Depression ? Manic- Maintenance pattern, rapid cycling course, sudden beginnings and endings, low intellectual functionality and border personality disorder have been observed more frequent amongst the offsprings of bipolar cases whose parents have insecure attachments than the parents who have secure attachments and also number of depression periods were higher. The insecure attachment risk is observed to be 10.2 (3.6 ? 28.7) and 7.5 times higher in the offsprings of bipolar cases who demonstrate avoidant and anxious/ambivalent attachment style. Other leading variables are number of depressive episodes, irritable temperament, social functionality and Depression ? Manic- Maintenance pattern.Discussion: It is commentated that insecure attachment and mood disorder negatively affected each other mutually and in two ways.Insecure attaching persons amongst healthy individuals were observed to have higher cyclothymic temperament scores. If an individual's variations of mood temperament threaten secure attachment is a raising question.It is established that depressive temperament in bipolar cases and irritable temperament in their offsprings lead to insecure attachment. If hyperthymic temperament is a resistance for insecure attachment was thought as an assumption.Keywords: Bipolar disorder, attachment, temperament