An Investigation on Predictors of Occupational Functioning in Individuals with Bipolar Disorder.

[摘要] The goal of this research was to identify predictors of poor occupational functioning (OF) in individuals with bipolar disorder (BD).This investigation involved three distinct, but related studies.The first study investigated the effects of clinical, demographic and neurocognitive features on OF in individuals with BD.Previous work found that as depression and neurocognitive deficits increased, OF decreased.However, few studies have examined these features over time using distinct aspects of work functioning.This study employed multilevel modeling (MLM) to determine which demographic, clinical and neurocognitive characteristics influence 4 aspects of work functioning over 5 years:attendance, conflict, enjoyment, performance.Those with higher levels of depression were more likely to experience difficulties in all work domains that persisted over the entire 5 years. The second study investigated the influence of interpersonal features of individuals with BD on OF. Prior work has typically investigated traditional features of BD (e.g., clinical, neurocognitive) overlooking interpersonal characteristics.This study employed MLM to determine which demographic, clinical and interpersonal characteristics (i.e., personality, impulsivity, hostility, social anxiety) of individuals with BD affect work functioning across 5 years. Those with higher levels of depression were more likely to experience impairments related to work attendance, conflict with coworkers and supervisors, quality of work and enjoyment from work.At baseline, higher levels of mania were associated with improved attendance at work.Yet over time, mania negatively affected overall work functioning, attendance at work, and work performance. Prior work on OF focuses mainly on the individual’s features of BD neglecting the environment. The third study took a novel approach and evaluated the relationship between social aspects of the work environment and work outcomes among individuals with BD. This study employed regressions in order to determine which demographics, mood symptoms and aspects of the work environment (i.e., conflict, exclusion, social support, stigma) predict work status and work functioning for individuals with BD.Exclusion and stigma at work predicted unemployment, whereas depressive symptoms and conflict at work predicted poorer work functioning.Taken together, this dissertation aims to inform approaches to remediating poor OF ultimately improving the overall functioning of individuals with BD.

[发布机构] University of Michigan

[效力级别] Psychology

[关键词] An Investigation on Predictors of Occupational Functioning in Individuals with Bipolar Disorder;Psychology;Social Work;Social Sciences;Social Work and Psychology