title: The prestige model of spectrum bipolarity.
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.
authors.affiliation: The University of Melbourne, Melbourne, Australia; Monash University, Melbourne, Australia; Peninsula Health, Melbourne, Australia. Electronic address: james.lebas@monash.edu.
authors.forename: James
authors.initials: J
authors.lastname: Le Bas
authors.affiliation: The University of Melbourne, Melbourne, Australia; Monash University, Melbourne, Australia; Austin Health, Melbourne, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Newton
authors.affiliation: Statistical Consulting Centre, University of Melbourne, Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Sore
authors.affiliation: The University of Melbourne, Melbourne, Australia; St Vincent's Health, Melbourne, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Castle
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000145:classification* / Q000175:diagnosis* / Q000209:etiology*; D016022:Case-Control Studies; D006801:Humans; D007857:Leadership; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation / Q000502:physiology*; D012044:Regression Analysis; D012649:Self Concept; D011795:Surveys and Questionnaires