title: Validation of the bipolar disorder etiology scale based on psychological behaviorism theory and factors related to the onset of bipolar disorder.
abstract: OBJECTIVE
  The aim of this study was to identify psychosocial factors related to the onset of bipolar I disorder (BD). To do so, the Bipolar Disorder Etiology Scale (BDES), based on psychological behaviorism, was developed and validated. Using the BDES, common factors related to both major depressive disorder (MDD) and BD and specific factors related only to BD were investigated.
  
  
  METHODS
  The BDES, which measures 17 factors based on psychological behaviorism hypotheses, was developed and validated. This scale was administered to 113 non-clinical control subjects, 30 subjects with MDD, and 32 people with BD. ANOVA and post hoc analyses were conducted. Subscales on which MDD and BD groups scored higher than controls were classified as common factors, while those on which the BD group scored higher than MDD and control groups were classified as specific factors.
  
  
  RESULTS
  The BDES has acceptable reliability and validity. Twelve common factors influence both MDD and BD and one specific factor influences only BD. Common factors include the following: learning grandiose self-labeling, learning dangerous behavior, reinforcing impulsive behavior, exposure to irritability, punishment of negative emotional expression, lack of support, sleep problems, antidepressant problems, positive arousal to threat, lack of social skills, and pursuit of short-term pleasure. The specific factor is manic emotional response.
  
  
  CONCLUSIONS
  Manic emotional response was identified as a specific factor related to the onset of BD, while parents' grandiose labeling is a candidate for a specific factor. Many factors are related to the onset of both MDD and BD.
authors.affiliation: Department of General Counseling, Korea Counseling Graduate School, Seoul, South Korea.
authors.forename: Jae Woo
authors.initials: JW
authors.lastname: Park
authors.affiliation: Department of Psychology, The Catholic University of Korea, College of Social Science, Bucheon, South Korea.
authors.forename: Kee Hwan
authors.initials: KH
authors.lastname: Park
mesh_terms: D000328:Adult; D001527:Behaviorism; D001714:Bipolar Disorder / Q000209:etiology* / Q000523:psychology*; D003865:Major Depressive Disorder / Q000209:etiology* / Q000523:psychology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012307:Risk Factors; D055815:Young Adult