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Validity and Usage of the Seasonal Pattern Assessment Questionnaire (SPAQ) in a French Population of Patients with Depression, Bipolar Disorders and Controls. J Clin Med 2021; 10:jcm10091897. [PMID: 33925578 PMCID: PMC8123881 DOI: 10.3390/jcm10091897] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 12/04/2022] Open
Abstract
The Seasonal Pattern Assessment Questionnaire (SPAQ), by Rosenthal et al. (1984), is by far the most used questionnaire to evaluate seasonal effects on mood and behavior. It includes a general seasonality score (GSS), composed of 6 items, from which cutoffs have been established to screen for seasonal affective disorder (SAD). However, it has never been validated in French and associations with circadian rhythm and symptoms of depression and bipolarity remain unclear. In this study, including 165 subjects (95 controls and 70 patients with depression or bipolar disorder), we confirmed the validity of the French version of the SPAQ, with a two-factor structure (a psychological factor: energy, mood, social activity and sleep length; and a food factor: weight and appetite) and a good fit was observed by all indicators. Mood and social activity dimensions were significantly affected by seasons in the depressed/bipolar group and a stronger global seasonality score (GSS) was associated with more severe phenotypes of depression and mania. Subjects meeting SAD and subsyndromal-SAD criteria also showed a delayed circadian rhythm compared to controls. Simple tools, such as the SPAQ, can aid the identification of significant seasonal changes and have direct implications on therapeutics including the use of bright light therapy in order to enhance personalized treatments, but also to prevent adverse seasonal effects.
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Meyer TD, Crist N, La Rosa N, Ye B, Soares JC, Bauer IE. Are existing self-ratings of acute manic symptoms in adults reliable and valid?-A systematic review. Bipolar Disord 2020; 22:558-568. [PMID: 32232950 DOI: 10.1111/bdi.12906] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Depression research historically uses both self- and clinician ratings of symptoms with significant and substantial correlations. It is often assumed that manic patients lack insight and cannot accurately report their symptoms. This delayed the development of self-rating scales for mania, but several scales now exist and are used in research. Our objective is to systematically review the literature to identify existing self-ratings of symptoms of (hypo)mania and to evaluate their psychometric properties. METHODS PubMed, Web of Knowledge, and Ovid were searched up until June 2018 using the keywords: "(hypo)mania," "self-report," and "mood disorder" to identify papers which included data on the validity and reliability of self-rating scales for (hypo)mania in samples including patients with bipolar disorder. RESULTS We identified 55 papers reporting on 16 different self-rating scales claiming to assess (hypo)manic symptoms or states. This included single item scales, but also some with over 40 items. Three of the scales, the Internal State Scale (ISS), Altman Self-Rating Mania Scale (ASRM), and Self-Report Manic Inventory (SRMI), provided data about reliability and/or validity in more than three independent studies. Validity was mostly assessed by comparing group means from individuals in different mood states and sometimes by correlation to clinician ratings of mania. CONCLUSIONS ASRM, ISS, and SRMI are promising self-rating tools for (hypo)mania to be used in clinical contexts. Future studies are, however, needed to further validate these measures; for example, their associations between each other and sensitivity to change, especially if they are meant to be outcome measures in studies.
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Affiliation(s)
- Thomas D Meyer
- McGovern Medical School, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas HSC at Houston, Houston, TX, USA
| | - Nicholas Crist
- McGovern Medical School, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas HSC at Houston, Houston, TX, USA
| | - Nikki La Rosa
- McGovern Medical School, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas HSC at Houston, Houston, TX, USA.,Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Biyu Ye
- McGovern Medical School, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas HSC at Houston, Houston, TX, USA.,The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Jair C Soares
- McGovern Medical School, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas HSC at Houston, Houston, TX, USA
| | - Isabelle E Bauer
- McGovern Medical School, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas HSC at Houston, Houston, TX, USA
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3
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Radulescu A, Niv Y. State representation in mental illness. Curr Opin Neurobiol 2019; 55:160-166. [PMID: 31051434 DOI: 10.1016/j.conb.2019.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 03/10/2019] [Accepted: 03/25/2019] [Indexed: 10/26/2022]
Abstract
Reinforcement learning theory provides a powerful set of computational ideas for modeling human learning and decision making. Reinforcement learning algorithms rely on state representations that enable efficient behavior by focusing only on aspects relevant to the task at hand. Forming such representations often requires selective attention to the sensory environment, and recalling memories of relevant past experiences. A striking range of psychiatric disorders, including bipolar disorder and schizophrenia, involve changes in these cognitive processes. We review and discuss evidence that these changes can be cast as altered state representation, with the goal of providing a useful transdiagnostic dimension along which mental disorders can be understood and compared.
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Affiliation(s)
| | - Yael Niv
- Psychology Department, Princeton University, United States; Princeton Neuroscience Institute, Princeton University, United States
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Glazer JE, Kelley NJ, Pornpattananangkul N, Nusslock R. Hypomania and depression associated with distinct neural activity for immediate and future rewards. Psychophysiology 2018; 56:e13301. [PMID: 30443957 DOI: 10.1111/psyp.13301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/03/2018] [Accepted: 10/07/2018] [Indexed: 01/20/2023]
Abstract
Bipolar spectrum and unipolar depressive disorders have been associated with distinct and opposite profiles of reward-related neural activity. These opposite profiles may reflect a differential preexisting vulnerability for both types of disorders. In support, recent ERP studies find that, following reward feedback, a larger reward positivity (RewP) is associated with greater vulnerability for bipolar spectrum disorders, whereas a smaller RewP is associated with greater vulnerability for depression. However, prior studies have investigated only immediate rewards and have not examined dimensions of both bipolar disorder and unipolar depression within the same sample. The present study is the first to investigate feedback-related ERP correlates of proneness to hypomania and unipolar depressive tendencies within the same sample and to expand our scope to include future rewards. Participants completed a modified time estimation task where the same monetary reward was available immediately or at one of five different future dates. Results revealed proneness to hypomania and unipolar depressive tendencies were related to an elevated and blunted RewP, respectively, but only following immediate rewards (i.e., today). Following rewards in the distant future (e.g., 8 months), proneness to hypomania and depressive tendencies were associated with elevated and blunted amplitudes for the P3, respectively, a subsequent ERP component reflecting motivational salience during extended feedback processing. Furthermore, these opposing profiles were independent of, and significantly different from, one another. These results suggest that feedback-related ERPs following immediate and future rewards are candidate biomarkers that can physiologically separate vulnerability for bipolar spectrum from unipolar depressive disorders.
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Affiliation(s)
- James E Glazer
- Department of Psychology, Northwestern University, Evanston, Illinois
| | - Nicholas J Kelley
- Department of Psychology, Northwestern University, Evanston, Illinois
| | | | - Robin Nusslock
- Department of Psychology, Northwestern University, Evanston, Illinois
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Alloy LB, Nusslock R. Reward-related cognitive vulnerability to bipolar spectrum disorders. World Psychiatry 2018; 17:102-103. [PMID: 29352559 PMCID: PMC5775116 DOI: 10.1002/wps.20494] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Kim BN, Kwon SM, Meyer TD. Reward Sensitivity and Affect After Success: Role of Positive Attribution Bias in Korean Individuals at Risk for Bipolar Disorder. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2017. [DOI: 10.1521/jscp.2017.36.7.607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Bin-Na Kim
- Seoul National University, Seoul, South Korea
| | | | - Thomas D. Meyer
- McGovern Medical School, University of Texas Health Science Center, Houston, TX
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Ng TH, Freed RD, Titone MK, Stange JP, Weiss RB, Abramson LY, Alloy LB. Aggression Protects Against the Onset of Major Depressive Episodes in Individuals With Bipolar Spectrum Disorder. Behav Ther 2017; 48:311-321. [PMID: 28390495 PMCID: PMC5385844 DOI: 10.1016/j.beth.2016.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 08/05/2016] [Accepted: 08/20/2016] [Indexed: 12/11/2022]
Abstract
A growing body of research suggests that bipolar spectrum disorders (BSDs) are associated with high aggression. However, little research has prospectively examined how aggression may affect time to onset of hypomanic/manic versus major depressive episodes. In a longitudinal study, we tested the hypothesis that aggression would prospectively predict a shorter time to the onset of hypomanic/manic episodes and a longer time to the onset of major depressive episodes, based on the behavioral approach system theory of BSDs. Young adults (N = 120) diagnosed with cyclothymia, bipolar II disorder, or bipolar disorder not otherwise specified were followed every 4 months for an average of 3.55 years. Participants completed measures of depressive and manic symptoms, family history of mood disorder, impulsivity, and aggression at baseline and were followed prospectively with semistructured diagnostic interview assessments of hypomanic/manic and major depressive episodes and treatment seeking for mood problems. Cox proportional hazard regression analyses indicated that overall, physical, and verbal aggression predicted a longer time to major depressive episode onset, even after controlling for baseline depressive and manic symptoms, family history of mood disorder, treatment seeking for mood problems, and impulsivity. Aggression, however, did not significantly predict time to onset of hypomanic/manic episodes, controlling for the same covariates. The findings suggest that approach-related behaviors may be utilized to delay the onset of major depressive episodes among people with BSDs.
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Alloy LB, Olino T, Freed RD, Nusslock R. Role of Reward Sensitivity and Processing in Major Depressive and Bipolar Spectrum Disorders. Behav Ther 2016; 47:600-621. [PMID: 27816074 PMCID: PMC5119651 DOI: 10.1016/j.beth.2016.02.014] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 02/25/2016] [Accepted: 02/27/2016] [Indexed: 12/11/2022]
Abstract
Since Costello's (1972) seminal Behavior Therapy article on loss of reinforcers or reinforcer effectiveness in depression, the role of reward sensitivity and processing in both depression and bipolar disorder has become a central area of investigation. In this article, we review the evidence for a model of reward sensitivity in mood disorders, with unipolar depression characterized by reward hyposensitivity and bipolar disorders by reward hypersensitivity. We address whether aberrant reward sensitivity and processing are correlates of, mood-independent traits of, vulnerabilities for, and/or predictors of the course of depression and bipolar spectrum disorders, covering evidence from self-report, behavioral, neurophysiological, and neural levels of analysis. We conclude that substantial evidence documents that blunted reward sensitivity and processing are involved in unipolar depression and heightened reward sensitivity and processing are characteristic of hypomania/mania. We further conclude that aberrant reward sensitivity has a trait component, but more research is needed to clearly demonstrate that reward hyposensitivity and hypersensitivity are vulnerabilities for depression and bipolar disorder, respectively. Moreover, additional research is needed to determine whether bipolar depression is similar to unipolar depression and characterized by reward hyposensitivity, or whether like bipolar hypomania/mania, it involves reward hypersensitivity.
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Ng TH, Stange JP, Black CL, Titone MK, Weiss RB, Abramson LY, Alloy LB. Impulsivity predicts the onset of DSM-IV-TR or RDC hypomanic and manic episodes in adolescents and young adults with high or moderate reward sensitivity. J Affect Disord 2016; 198:88-95. [PMID: 27011364 PMCID: PMC4844858 DOI: 10.1016/j.jad.2016.03.045] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 01/13/2016] [Accepted: 03/09/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND A growing body of research suggests that bipolar disorders (BD) are associated with high impulsivity. Using a multi-method approach, the current study provided the first examination of the hypothesis that impulsivity would prospectively predict shorter time to onset of DSM-IV-TR or RDC hypomanic or manic episodes in a sample selected based on reward sensitivity, a biobehavioral trait shown to predict onset and course of BD. METHODS 163 participants with high reward sensitivity and 114 participants with moderate reward sensitivity were followed every six months for an average of 2.68 years. Participants completed the Barratt Impulsiveness Scale - Version 11 (BIS-11), Balloon Analog Risk Task (BART), Beck Depression Inventory, Altman Self-Rating Mania Scale, and an expanded Schedule for Affective Disorders and Schizophrenia (exp-SADS) - Lifetime Version at baseline and were followed prospectively with the exp-SADS - Change Version to assess onset of hypomanic or manic episodes and treatment seeking for mood problems. RESULTS Cox proportional hazard regression analyses indicated that impulsivity as measured by a behavioral task (BART; OR=1.04, p=.03) and a self-report measure (BIS-11 Attentional Impulsiveness subscale; OR=1.16, p=.01) predicted shorter time to hypomania/mania onset, after controlling for baseline depressive and manic symptoms, family history of mood disorder, treatment seeking for mood problems, and reward sensitivity. LIMITATIONS The study was limited by non-comprehensive assessment of impulsivity and unknown generalizability to clinical samples. CONCLUSIONS Impulsivity confers vulnerability to hypomania or mania. Future studies would benefit from considering how impulsivity can be integrated into existing biopsychosocial models of BD.
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Affiliation(s)
- Tommy H Ng
- Department of Psychology, Temple University, United States
| | | | | | | | - Rachel B Weiss
- Department of Psychiatry, McLean Hospital/Harvard Medical School, Unites States
| | - Lyn Y Abramson
- Department of Psychology, University of Wisconsin-Madison, Unites States
| | - Lauren B Alloy
- Department of Psychology, Temple University, United States.
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Distinct Roles of Emotion Reactivity and Regulation in Depressive and Manic Symptoms Among Euthymic Patients. COGNITIVE THERAPY AND RESEARCH 2015. [DOI: 10.1007/s10608-015-9738-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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11
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Tharp JA, Johnson SL, Sinclair S, Kumar S. Goals in bipolar I disorder: Big dreams predict more mania. MOTIVATION AND EMOTION 2015. [DOI: 10.1007/s11031-015-9519-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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12
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Shapero BG, Stange JP, Goldstein KE, Black CL, Molz AR, Hamlat EJ, Black SK, Boccia AS, Abramson LY, Alloy LB. Cognitive Styles in Mood Disorders: Discriminative Ability of Unipolar and Bipolar Cognitive Profiles. Int J Cogn Ther 2015; 8:35-60. [PMID: 25893033 DOI: 10.1521/ijct.2015.8.1.35] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Although previous research has identified cognitive styles that distinguish individuals with bipolar disorder (BD), individuals with major depressive disorder (MDD), and individuals without mood disorders from one another, findings have been inconsistent. The current study included 381 participants classified into a BD group, a MDD group, and a no mood disorder group. To differentiate between these groups, this study evaluated cognitive styles with a battery of traditional and more recently-developed measures. Receiver operating characteristics (ROC) analyses were used to determine the discriminate ability of variables with significant between group differences. Results supported that BD and MDD may be characterized by distinct cognitive styles. Given work showing that interventions for MDD may not be effective at treating BD, it is important to directly compare individuals with these disorders. By clarifying the overlapping and divergent cognitive styles characterizing BD and MDD, research can not only improve diagnostic validity, but also provide more efficacious and effective interventions.
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Alloy LB, Nusslock R, Boland EM. The development and course of bipolar spectrum disorders: an integrated reward and circadian rhythm dysregulation model. Annu Rev Clin Psychol 2015; 11:213-50. [PMID: 25581235 PMCID: PMC4380533 DOI: 10.1146/annurev-clinpsy-032814-112902] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In this article, we present and review the evidence for two major biopsychosocial theories of the onset and course of bipolar spectrum disorders (BSDs) that integrate behavioral, environmental, and neurobiological mechanisms: the reward hypersensitivity and the social/circadian rhythm disruption models. We describe the clinical features, spectrum, age of onset, and course of BSDs. We then discuss research designs relevant to demonstrating whether a hypothesized mechanism represents a correlate, vulnerability, or predictor of the course of BSDs, as well as important methodological issues. We next present the reward hypersensitivity model of BSD, followed by the social/circadian rhythm disruption model of BSD. For each model, we review evidence regarding whether the proposed underlying mechanism is associated with BSDs, provides vulnerability to the onset of BSDs, and predicts the course of BSDs. We then present a new integrated reward/circadian rhythm (RCR) dysregulation model of BSD and discuss how the RCR model explains the symptoms, onset, and course of BSDs. We end with recommendations for future research directions.
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Affiliation(s)
- Lauren B Alloy
- Department of Psychology, Temple University, Philadelphia, Pennsylvania 19122; ,
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Stange JP, Sylvia LG, Magalhães PVDS, Frank E, Otto MW, Miklowitz DJ, Berk M, Nierenberg AA, Deckersbach T. Extreme attributions predict transition from depression to mania or hypomania in bipolar disorder. J Psychiatr Res 2013; 47:1329-36. [PMID: 23791456 PMCID: PMC3743936 DOI: 10.1016/j.jpsychires.2013.05.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Revised: 05/11/2013] [Accepted: 05/16/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Relatively little is known about psychological predictors of the onset of mania among individuals with bipolar disorder, particularly during episodes of depression. In the present study we investigated attributional style as a predictor of onset of hypomanic, manic or mixed episodes among bipolar adults receiving psychosocial treatment for depression. We hypothesized that "extreme" (i.e., excessively pessimistic or optimistic) attributions would predict a greater likelihood of developing an episode of mood elevation. METHOD Outpatients with DSM-IV bipolar I or II disorder (N = 105) enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) were randomly allocated to one of three types of intensive psychotherapy for depression or a brief psychoeducational intervention. Patients completed a measure of attributional style at baseline and were followed prospectively for up to one year. All analyses were by intent to treat. RESULTS Logistic regressions and Cox proportional hazards models indicated that extreme (both positively- and negatively-valenced) attributions predicted a higher likelihood of (and shorter time until) transition from depression to a (hypo)manic or mixed episode (ps < .04), independent of the effects of manic or depressive symptom severity at baseline. Extreme attributions were also retrospectively associated with more lifetime episodes of (hypo)mania and depression (ps < .05). CONCLUSIONS Evaluating extreme attributions may help clinicians to identify patients who are at risk for experiencing a more severe course of bipolar illness, and who may benefit from treatments that introduce greater cognitive flexibility.
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Affiliation(s)
- Jonathan P. Stange
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Louisa G. Sylvia
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Pedro Vieira da Silva Magalhães
- National Institute for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil
| | - Ellen Frank
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Michael W. Otto
- Department of Psychology, Boston University, Boston, Massachusetts, USA
| | - David J. Miklowitz
- Division of Child and Adolescent Psychiatry, UCLA School of Medicine, Los Angeles, California, USA
| | - Michael Berk
- Deakin University, School of Medicine, Geelong, Australia,Orygen Youth Health Research Centre, the Centre of Youth Mental Health, the Florey Institute for Neuroscience and Mental Health, and the Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Andrew A. Nierenberg
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Carl JR, Soskin DP, Kerns C, Barlow DH. Positive emotion regulation in emotional disorders: a theoretical review. Clin Psychol Rev 2013; 33:343-60. [PMID: 23399829 DOI: 10.1016/j.cpr.2013.01.003] [Citation(s) in RCA: 200] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 12/27/2012] [Accepted: 01/03/2013] [Indexed: 01/31/2023]
Abstract
Conceptualizations of emotion regulation have led to the identification of cognitive and behavioral regulatory abnormalities that contribute to the development and maintenance of emotional disorders. However, existing research on emotion regulation in anxiety and mood disorders has primarily focused on the regulation of negative emotions rather than positive emotions. Recent findings indicate that disturbances in positive emotion regulation occur across emotional disorders, and may be a generative target for treatment research. The aims of this paper are to: 1. Present a transdiagnostic model of positive emotion disturbances in emotional disorders; 2. Review evidence for disturbances in positive emotion regulation in emotional disorders across categories of emotion regulation; and 3. Propose treatment strategies that may address these disturbances.
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Affiliation(s)
- Jenna R Carl
- Center for Anxiety and Related Disorders, Department of Psychology, Boston University, Boston, MA, USA.
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Stange JP, Shapero BG, Jager-Hyman S, Grant DA, Abramson LY, Alloy LB. Behavioral Approach System (BAS)-Relevant Cognitive Styles in Individuals with High vs. Moderate BAS Sensitivity: A Behavioral High-Risk Design. COGNITIVE THERAPY AND RESEARCH 2012; 37:139-149. [PMID: 23459574 DOI: 10.1007/s10608-012-9443-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This study used a behavioral high-risk design to evaluate cognitive styles relevant to the Behavioral Approach System (BAS) among individuals at high (n = 171) versus low (n = 119) risk of first onset of bipolar disorder based on BAS sensitivity, a known risk factor for bipolar disorder. Cognitive styles in high-BAS participants paralleled those implicated in bipolar disorder. Linear regressions indicated that individuals with high BAS sensitivity exhibited greater levels of goal striving, positive overgeneralization, rumination on positive affect, depressive brooding, perfectionism, and hypomanic personality. Furthermore, of the cognitive styles, emotion-focused rumination on positive affect mediated the association between BAS sensitivity and current levels of hypomanic symptoms. These results provide evidence that individuals at risk for the development of bipolar disorder have higher levels of BAS-relevant cognitive styles and hypomanic personality than do individuals with lower risk, indicating that these styles are not simply markers of prior (hypo)manic episodes.
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