1. Etiological
Factors

2. Etiological Factors
 Hereditary Factors
 Biochemical Hypothesis
 Stressful Life Events
 Cognitive Styles as Vulnerabilities

3. Hereditary Factors
 1stdegree relatives have significantly
higher rates
 Twinand adoption studies indicate
genetic vulnerability
 May reflect environmental factors

4. Biochemical Hypothesis
 Deficiency in norepinephrine
 Dopamineimplicated in the study of
mania and psychotic symptoms
 Serotonin
levels have also been
implicated

5. Stressful Life Events
 Linkage between significant life events
and affective abnormalities
 Negative, traumatic life events trigger
mania
 Low social support, low self-esteem trigger
depressive

6. Family Environment
 Expressed Emotion may be an important
factor-families with high expressed
emotion have poor coping skills
 Families with high levels of EE are linked to
greater levels of symptom relapse and
poor treatment outcome, as compared
to clients in families with low levels of EE

7. Cognitive Styles as Vulnerability
Factors
 Individuals
with negative attributional styles
combined with stressful life events can predict
hypomanic, manic and depressive mood
shifts
 Mania and depression are related to an
ongoing sense of low self-worth