The Mediating Role of Time Perspective in the Relationship between Chronotype and Suicide in Bipolar Disorder
Abstract
:1. Introduction
2. Method
2.1. Sample and Procedure
2.2. Measures
2.2.1. Sociodemographic and Clinical Data Form
2.2.2. The Young Mania Rating Scale (YMRS)
2.2.3. The Hamilton Depression Rating Scale (HDRS)
2.2.4. The Beck Scale for Suicidal Ideation (BSSI)
2.2.5. The Zimbardo Time Perspective Inventory (ZTPI)
2.2.6. The Morningness–Eveningness Questionnaire (MEQ)
3. Statistical Analysis
4. Results
5. Mediation Analysis
Sub-Problem
6. Discussion
7. Limitations and Future Directions
8. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Glossary
BD | Bipolar disorder |
TP | Time perspective |
HDRS | Hamilton Depression Rating Scale |
YMRS | Young Mania Rating Scale |
ZTPI | Zimbardo Time Perspective Inventory |
MEQ | Morning–Evening Questionnaire |
BSSI | Beck Scale for Suicidal Ideation |
DSM-5 | Diagnostic and Statistical Manual of Mental Disorders |
References
- Laursen, T.M. Life expectancy among persons with schizophrenia or bipolar affective disorder. Schizophr Res. 2011, 131, 101–104. [Google Scholar] [CrossRef]
- Angst, F.; Stassen, H.H.; Clayton, P.J.; Angst, J. Mortality of patients with mood disorders: Follow-up over 34–38 years. J. Affect. Disord. 2002, 68, 167–181. [Google Scholar] [CrossRef] [PubMed]
- Plans, L.; Barrot, C.; Nieto, E.; Rios, J.; Schulze, T.G.; Papiol, S.; Mitjans, M.; Vieta, E.; Benabarre, A. Association between completed suicide and bipolar disorder: A systematic review of the literature. J. Affect. Disord. 2019, 242, 111–112. [Google Scholar] [CrossRef] [PubMed]
- Abreu, L.N.D.; Lafer, B.; Baca-Garcia, E.; Oquendo, M.A. Suicidal ideation and suicide attempts in bipolar disorder type I: An update for the clinician. Braz. J. Psychiatry 2009, 31, 271–280. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Meng, D.; Zhao, Y.; Guo, J.; Xu, H.; Fu, Y.; Ma, X.; Zhu, L.; Mu, L. Time perspective and bed time procrastination: The role of the chronotype–time perspective relationship. Nat. Sci. Sleep 2021, 13, 1307–1318. [Google Scholar] [CrossRef]
- Vitale, J.A.; Weydahl, A. Chronotype, physical activity, and sport performance: A systematic review. Sport Med. 2017, 47, 1859–1868. [Google Scholar] [CrossRef] [Green Version]
- Rönnlund, M.; Carelli, M.G. Time perspective biases are associated with poor sleep quality, daytime sleepiness, and lower levels of subjective well-being among older adults. Front. Psychol. 2018, 9, 1356. [Google Scholar] [CrossRef]
- Nowack, K.; Van Der Meer, E. Are larks future-oriented and owls present-oriented? Age-and sex-related shifts in chronotype-time perspective associations. Chronobiol. Int. 2013, 30, 1240–1250. [Google Scholar] [CrossRef]
- Natale, V.; Cicogna, P.C. Morningness-eveningness dimension: Is it really a continuum? Pers. Individ Dif. 2002, 32, 809–816. [Google Scholar] [CrossRef]
- Melo, M.C.A.; Abreu, R.L.C.; Linhares, N.V.B.; de Bruin, P.F.C.; de Bruin, V.M.S. Chronotype and circadian rhythm in bipolar disorder: A systematic review. Sleep Med. Rev. 2017, 34, 46–58. [Google Scholar] [CrossRef]
- Fares, S.; Hermens, D.F.; Naismith, S.L.; White, D.; HickieI, B.; Robillard, R. Clinical correlates of chronotypes in young persons with mental disorders. Chronobiol. Int. 2015, 32, 1183–1191. [Google Scholar] [CrossRef] [PubMed]
- Kivelä, L.; Papadopoulos, M.R.; Antypa, N. Chronotype and Psychiatric Disorders. Curr. Sleep Med. Rep. 2018, 4, 94–103. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- McElroy, S.L.; Crow, S.; Biernacka, J.M.; Winham, S.; Geske, J.; Barboza, A.B.C.; Prieto, M.L.; Chauhan, M.; Seymour, L.R.; Mori, N.; et al. Clinical phenotype of bipolar disorder with comorbid binge eating disorder. J. Affec. Disord. 2013, 150, 981–986. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Esaki, Y.; Obayashi, K.; Saeki, K.; Fujita, K.; Iwata, N.; Kitajima, T. Higher prevalence of intentional self-harm in bipolar disorder with evening chronotype: A finding from the APPLE cohort study. J. Affect. Disord. 2020, 277, 727–732. [Google Scholar] [CrossRef] [PubMed]
- Romo-Nava, F.; Blom, T.J.; Cuellar-Barboza, A.B.; Winham, S.J.; Colby, C.L.; Nunez, N.A.; Biernacka, J.M.; Frye, M.A.; McElroy, S.L. Evening chronotype as a discrete clinical subphenotype in bipolar disorder. J. Affect. Disord. 2020, 266, 556–562. [Google Scholar] [CrossRef]
- Zimbardo, P.G.; Boyd, J.N. Putting time in perspective:a valid, reliable individual-differences metric. J. Pers. Soc. Psychol. 1999, 77, 1271–1288. [Google Scholar] [CrossRef]
- Chin, J.; Holden, R.R. Multi dimensional future time perspective as moderators of the relationships between suicide motivation, preparation, and its predictors. Suicide Life Threat. Behav. 2013, 43, 395–405. [Google Scholar] [CrossRef]
- Laghi, F.; Baiocco, R.; D’Alessio, M.; Gurrieri, G. Suicidal ideation and time perspective in high school students. Eur. Psychiatry 2009, 24, 41–46. [Google Scholar] [CrossRef]
- Ripke, B. Time perspective in suicide attempters. Eur. Psychiatry 2002, 17, 206. [Google Scholar] [CrossRef]
- Ariapooran, S.; Rajabi, M.; Goodarzi, A.; Malayer, H. Relationship between social support, time perspective and suicide ideations in patients with multiple sclerosis. Asian Soc. Sci. 2016, 12, 192–200. [Google Scholar] [CrossRef]
- Yufit, R.I. Suicide, Bereavement and Time Perspective. In Suicide and Bereavement; Danto, B.L., Kutscher, A.H., Eds.; Arno Press: New York, NY, USA, 1977. [Google Scholar]
- Macleod, A.K.; Pankhania, B.; Lee, M.; Mitchell, D. Parasuicide, depression and the anticipation of positive and negative future experiences. Psychol. Med. 1997, 27, 973–977. [Google Scholar] [CrossRef] [PubMed]
- MacLeod, A.K.; Tata, P.; Evans, K.; Tyrer, P.; Schmidt, U.; Davidson, K.; Thornton, S.; Catalan, J. Recovery of positive future thinking within a high-risk parasuicide group: Results from a pilot randomized controlled trial. Br. J. Clin Psychol. 1998, 37, 371–379. [Google Scholar] [CrossRef] [PubMed]
- Milfont, T.L.; Schwarzenthal, M. Explaining why larks are future-oriented and owls are present-oriented: Self-control mediates the chronotype-time perspective relationships. Chronobiol. Int. 2014, 31, 581–588. [Google Scholar] [CrossRef] [PubMed]
- Stolarski, M.; Ledzińska, M.; Matthews, G. Morning is tomorrow, evening is today: Relationships between chronotype and time perspective. Biol. Rhythm Res. 2013, 44, 181–196. [Google Scholar] [CrossRef]
- Goldstein, D.; Hahn, C.S.; Hasher, L.; Wiprzycka, U.J.; Zelazo, P.D. Time of day, intellectual performance, and behavioral problems in morning versus evening type adolescents: Is there a synchrony effect? Pers. Individ Dif. 2007, 42, 431–440. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Keough, K.A.; Zimbardo, P.G.; Boyd, J.N. Who’s smoking, drinking, and using drugs? Time perspective as a predictor of substance use. Basic Appl. Soc. Psych. 1999, 21, 149–164. [Google Scholar] [CrossRef]
- Patel, N.C.; Patrick, D.M.; Youngstrom, E.A.; Strakowski, S.M.; Del Bello, M.P. Response and remission in adolescent mania: Signal detection analyses of the young mania rating scale. J. Am. Acad. Child Adolesc. Psychiatry 2007, 46, 628–635. [Google Scholar] [CrossRef]
- Israel, J.A. Remission in depression: Definition and initial treatment approaches. J. Psychopharmacol. 2006, 20, 5–10. [Google Scholar] [CrossRef]
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed.; American Psychiatric Association: Arlington, TX, USA, 2013. [Google Scholar]
- Young, R.C.; Biggs, J.T.; Ziegler, V.E.; Meyer, D.A. A rating scale for mania: Reliability, validity and sensitivity. Br. J. Psychiatry 1978, 133, 429–435. [Google Scholar] [CrossRef]
- Karadağ, F.; Oral, T.; Yalçin, F.A.; Erten, E. Young Mani Derecelendirme Ölçeğinin Türkiye’de Geçerlik ve Güvenilirliği. Turk. Psikiyatri. Derg. 2001, 13, 107–114. [Google Scholar]
- Zimmerman, M.; Martinez, J.H.; Young, D.; Chelminski, I.; Dalrymple, K. Severity classification on the Hamilton depression rating scale. J. Affect. Dis. 2013, 150, 384–388. [Google Scholar] [CrossRef] [PubMed]
- Akdemir, A.; Örsel, S.D.; Dağ, İ.; Türkçapar, M.H.; İşcan, N.; Özbay, H. Hamilton depresyon derecelendirme ölçeği (HDDO)’nin geçerliliği-güvenilirliği ve klinikte kullanımı. Psikiyatr. Psikol. Psikofarmakol. Derg. 1996, 4, 251–259. [Google Scholar]
- Beck, A.T.; Kovacs, M.; Weissman, A. Assessment of suicidal intention: The Scale for Suicide Ideation. J. Consult. Clin. Psychol. 1979, 47, 343–352. [Google Scholar] [CrossRef] [PubMed]
- Ozcelik, H.S.; Ozdel, K.; Bulut, S.D.; Orsel, S. Measuring suicidal ideation: Validity and reliability of the Turkish version of the beck scale for suicide ideation among patients who presented at a psychiatry clinic with suicidal ideations. Klin. Psikofarmakol Bul. 2015, 25, 142–150. [Google Scholar]
- Akirmak, U. The validity and reliability of the Zimbardo time perspective inventory in a Turkish sample. Curr. Psychol. 2021, 40, 2327–2340. [Google Scholar] [CrossRef]
- Horne, J.A.; Östberg, O. A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. Int. J. Chronobiol. 1976, 4, 97–110. [Google Scholar]
- Pündük, Z.G.; Hakan, E.İ. Sabahçil-Akşamcil Anketi Türkçe uyarlamasinda güvenilirlik çalişmasi. Turk. Psikiyatri. Derg. 2005, 16, 40–45. [Google Scholar] [PubMed]
- Yufit, R.I.; Benzies, B.; Fonte, M.E.; Fawcett, J.A. Suicide potential and time perspective. Arch. Gen. Psychiatry 1970, 23, 158–163. [Google Scholar] [CrossRef] [PubMed]
- Yufit, R.I.; Lester, D. Assessment, Treatment, and Prevention of Suicidal Behavior; John Wiley & Sons: New York, NY, USA, 2004. [Google Scholar]
- Holman, E.A.; Zimbardo, P.G. The social language of time: The time perspective–social network connection. Basic Appl. Soc. Psychol. 2009, 31, 136–147. [Google Scholar] [CrossRef] [Green Version]
- Van Beek, W.; Berghuis, H.; Kerkhof, A.; Beekman, A. Time perspective, personality and psychopathology: Zimbardo’s time perspective inventory in psychiatry. Time Soc. 2011, 20, 364–374. [Google Scholar] [CrossRef]
- Zhang, J.W.; Howell, R.T. Do time perspectives predict unique variance in life satisfaction beyond personality traits? Pers. Individ Differ. 2011, 50, 1261–1266. [Google Scholar] [CrossRef]
- Shores, K.; Scott, D. The relationship of individual time perspective and recreation experience preferences. J. Leis Res. 2007, 39, 28–59. [Google Scholar] [CrossRef]
- Oyanadel, C.; Buela-Casal, G. Time perception and psychopathology: Influence of time perspective on quality of life of severe mental illness. Actas Esp. Psiquiatr. 2014, 42, 99–107. [Google Scholar] [PubMed]
- Sircova, A.; Van De Vijver, F.J.R.; Osin, E.; Milfont, T.L.; Fieulaine, N.; Kislali-Erginbilgic, A.; Zimbardo, P.G.; Djarallah, S.; Chorfi, M.S.; Do Rego Leite, U.; et al. A global look at time: A 24-country study of the equivalence of the Zimbardo time perspective inventory. SAGE Open 2014, 4, 1–12. [Google Scholar] [CrossRef]
- Giglio, L.M.F.; Magalhães, P.V.S.; Andersen, M.L.; Walz, J.C.; Jakobson, L.; Kapczinski, F. Circadian preference in bipolar disorder. Sleep Breath. 2010, 14, 153–155. [Google Scholar] [CrossRef]
- Lemoine, P.; Zawieja, P.; Ohayon, M.M. Associations between morningness/eveningness and psychopathology: An epidemiological survey in three in-patient psychiatric clinics. J. Psychiatr. Res. 2013, 47, 1095–1098. [Google Scholar] [CrossRef]
- Vilhauer, J.S.; Young, S.; Kealoha, C.; Borrmann, J.; Ishak, W.W.; Rapaport, M.H.; Hartoonian, N.; Mirocha, J.; Jennice Vilhauer, C. Treating major depression by creating positive expectations for the future: A pilot study for the effectiveness of future-directed therapy (FDT) on symptom severity and quality of life. CNS Neurosci. Ther. 2012, 18, 102–109. [Google Scholar] [CrossRef]
- Van Beek, W.; Kerkhof, A.; Beekman, A. Future oriented group training for suicidal patients: A randomized clinical trial. BMC Psychiatry 2009, 9, 65. [Google Scholar] [CrossRef]
- Sword, R.M.; Sword, R.K.M.; Brunskill, S.R. Time Perspective Therapy: Transforming Zimbardo’s Temporal Theory into Clinical Practice. In Time Perspective Theory; Review, Research and Application; Stolarski, M., Fieulaine, N., van Beek, W., Eds.; Springer: Cham, Switzerland, 2015; pp. 481–498. [Google Scholar]
Patients (n = 150) | Control (n = 84) | p | |
---|---|---|---|
Age † | 42.3 ± 12.1 | 43.2 ± 11.5 | |
§ | 43.0 [22.0–65.0] | 41.0 [22.0–67.0] | 0.841 |
Gender ‡ | |||
Male | 71 (47.3) | 47 (56.0) | 0.259 |
Female | 79 (52.7) | 37 (44.0) | |
Education ‡ | |||
Primary School | 36 (24.0) | 26 (31.0) | 0.276 |
Secondary School | 77 (51.3) | 44 (52.4) | |
University | 37 (24.7) | 14 (16.7) | |
Marital Status ‡ | |||
Single | 86 (57.3) | 40 (47.6) | 0.196 |
Married | 64 (42.7) | 44 (52.4) | |
Employment Status ‡ | |||
Employed | 43 (28.7) | 40 (47.6) | 0.006 |
Unemployed | 107 (71.3) | 44 (52.4) | Cramer’s V = 0.190 |
Residence ‡ | |||
Urban | 77 (51.3) | 46 (54.8) | 0.713 |
Rural | 73 (48.7) | 38 (45.2) | |
Smoking, presence ‡ | 72 (48.0) | 31 (36.9) | 0.133 |
Alcohol use, presence ‡ | 42 (28.0) | 25 (29.8) | 0.892 |
Social Support, presence ‡ | 148 (98.7) | 83 (98.8) | 0.999 |
Patients (n = 150) | Control (n = 84) | p | |
---|---|---|---|
Number of depressive episodes § | 2.0 [0.0–10.0] | - | - |
Number of manic episodes § | 1.0 [1.0–6.0] | - | - |
Predominant polarity ‡ | |||
Manic | 60 (40.0) | - | - |
Depressive | 90 (60.0) | - | |
Number of hospitalizations § | 2.0 [0.0–8.0] | - | - |
Substance use, presence ‡ | 0 (0) | - | - |
History of physical illness, presence ‡ | 60 (40.0) | 22 (26.2) | 0.048 Cramer’s V = 0.139 |
Family history of psychiatric disorder, presence ‡ | 85 (56.7) | 23 (27.4) | <0.001 Cramer’s V = 0.282 |
Duration of disorder (year) § | 8.0 [1.0–30.0] | - | - |
Patients (n = 150) | Control (n = 84) | Effect Size * | p | |
---|---|---|---|---|
Beck Scale for Suicidal Ideation § | 1.0 [0.0–15.0] | - | - | |
Zimbardo Time Perspective Inventory § | ||||
Past negative | 17.5 [13.0–43.0] | 16.0 [13.0–19.0] | 0.428 | <0.001 |
Past positive | 28.0 [15.0–37.0] | 27.0 [17.0–34.0] | 0.204 | |
Present fatalistic | 18.0 [11.0–43.0] | 25.0 [15.0–42.0] | 0.364 | <0.001 |
Present hedonistic | 41.0 [19.0–54.0] | 43.0 [26.0–55.0] | 0.324 | |
Future | 40.5 [27.0–51.0] | 39.5 [28.0–48.0] | 0.169 | 0.010 |
MEQ total score § | 56.0 [19.0–85.0] | 52.0 [19.0–73.0] | 0.152 | 0.020 |
MEQ classification ‡ | ||||
Eveningness | 27 (18.0) | 6 (7.1) | 0.304 | <0.001 |
İntermediate | 58 (38.7) | 59 (70.2) | ||
Morningness | 65 (43.3) | 19 (22.6) |
Beta [%95 CI] | Adj. Beta [%95 CI] | p-Value | |
---|---|---|---|
Past negative TP | 0.362 [0.314–0.411] | 0.803 [0.696–0.911] | <0.001 |
Past positive TP | 0.031 [−0.081–0.143] | 0.040 [−0.104–0.183] | 0.587 |
Present hedonistic TP | −0.005 [−0.070–0.061] | −0.010 [−0.150–0.130] | 0.892 |
Future TP | −0.068 [−0.153–0.017] | −0.093 [−0.210–0.024] | 0.017 |
MEQ total score | 0.043 [0.012–0.075] | 0.139 [0.037–0.240] | 0.008 |
Age | −0.002 [−0.029–0.025] | −0.005 [−0.090–0.079] | 0.901 |
Male | 0.287 [−0.356–0.930] | 0.038 [−0.047–0.123] | 0.380 |
Primary School | 0.126 [−0.815–1.067] | 0.015 [−0.095–0.124] | 0.792 |
Secondary School | 0.029 [−0.787–0.845] | 0.004 [−0.104–0.111] | 0.944 |
Single | −0.206 [−0.860–0.447] | −0.027 [−0.113–0.059] | 0.535 |
Beck Scale for Suicidal Ideation (BSSI) | ||
---|---|---|
r | p | |
Zimbardo Time Perspective Inventory (ZTPI) | ||
Past negative | 0.540 | <0.001 |
Past positive | −0.360 | <0.001 |
Present fatalistic | 0.433 | <0.001 |
Present hedonistic | −0.337 | <0.001 |
Future | −0.371 | <0.001 |
MEQ total score | −0.228 | 0.005 |
Model | Pathway | Std. Path Coefficient (β) | Std Error (Sβ) | p-Value | |
---|---|---|---|---|---|
Basic model (without ZTPI) | Chronotype → BSSI | −0.287 | 0.091 | 0.002 | |
Model I. Mediation Analysis (Past negative mediator) | Direct effect | Chronotype → BSSI | 0.115 | 0.071 | 0.104 |
Indirect effect | Chronotype → Past negative → BSSI | −0.402 | 0.065 | <0.001 | |
Model II. Mediation Analysis (Past positive mediator) | Direct effect | Chronotype → BSSI | 0.045 | 0.093 | 0.628 |
Indirect effect | Chronotype → Past positive → BSSI | −0.332 | 0.063 | <0.001 | |
Model III. Mediation Analysis (Present hedonistic mediator) | Direct effect | Chronotype → BSSI | 0.002 | 0.093 | 0.982 |
Indirect effect | Chronotype → Present hedonistic → BSSI | −0.289 | 0.063 | <0.001 | |
Model IV. Mediation Analysis (Present fatalistic mediator) | Direct effect | Chronotype → BSSI | 0.182 | 0.075 | 0.015 |
Indirect effect | Chronotype → Present fatalistic → BSSI | −0.469 | 0.070 | <0.001 | |
Model V. Mediation Analysis (Future mediator) | Direct effect | Chronotype → BSSI | −0.035 | 0.089 | 0.694 |
Indirect effect | Chronotype → Future → BSSI | −0.252 | 0.052 | <0.001 |
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Karaytuğ, M.O.; Tamam, L.; Demirkol, M.E.; Namlı, Z.; Gürbüz, M.; Yeşiloğlu, C.; Eriş Davut, Ö. The Mediating Role of Time Perspective in the Relationship between Chronotype and Suicide in Bipolar Disorder. Behav. Sci. 2022, 12, 492. https://doi.org/10.3390/bs12120492
Karaytuğ MO, Tamam L, Demirkol ME, Namlı Z, Gürbüz M, Yeşiloğlu C, Eriş Davut Ö. The Mediating Role of Time Perspective in the Relationship between Chronotype and Suicide in Bipolar Disorder. Behavioral Sciences. 2022; 12(12):492. https://doi.org/10.3390/bs12120492
Chicago/Turabian StyleKaraytuğ, Mahmut Onur, Lut Tamam, Mehmet Emin Demirkol, Zeynep Namlı, Mahmut Gürbüz, Caner Yeşiloğlu, and Özge Eriş Davut. 2022. "The Mediating Role of Time Perspective in the Relationship between Chronotype and Suicide in Bipolar Disorder" Behavioral Sciences 12, no. 12: 492. https://doi.org/10.3390/bs12120492