The psychosocial context of bipolar disorder: Environmental, cognitive, and developmental risk factors

Lauren B. Alloy*, Lyn Y. Abramson, Snezana Urosevic, Patricia D. Walshaw, Robin Nusslock, Amy M. Neeren

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

137 Scopus citations


In this article, we review empirical research on the role of individuals' current environmental contexts, cognitive styles, and developmental histories as risk factors for the onset, course, and expression of bipolar spectrum disorders. Our review is focused on the following overarching question: Do psychosocial factors truly contribute risk to the onset, course, or expression of bipolar disorders? As a secondary issue, we also address whether the psychosocial risks for bipolar disorders are similar to those for unipolar depression. We begin by discussing the methodological requirements for demonstrating a psychosocial risk factor and the challenges posed by bipolar spectrum disorders for psychosocial risk research. Next, we review the extant studies on the role of recent life events and supportive and nonsupportive social interactions (current environment) in bipolar disorders, as well as psychosocial treatments designed to remediate these current environmental factors. We then review the role of cognitive styles featured as vulnerabilities in theories of unipolar depression as risk factors for bipolar disorder alone and in combination with life events, including studies of cognitive-behavioral therapies for bipolar disorder. Finally, we review studies of parenting and maltreatment histories in bipolar disorders. We conclude with an assessment of the state of the psychosocial risk factors literature in bipolar disorder with regard to our guiding questions.

Original languageEnglish (US)
Pages (from-to)1043-1075
Number of pages33
JournalClinical Psychology Review
Issue number8
StatePublished - Dec 2005


  • Bipolar disorder
  • Cognitive risk
  • Developmental risk
  • Environmental risk

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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