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Dempsey RC, Eardley K, Dodd AL. The role of tenacious versus flexible goal pursuit in the vulnerability to bipolar disorder. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00748-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AbstractThe vulnerability to bipolar disorder is characterized by dysregulated goal-related behavior, the setting of ambitious and extreme goals, and increases in goal approach behaviors. To date, no studies have investigated the nature of goal pursuit behaviors amongst individuals at a behavioral risk for bipolar disorder in terms of whether goal pursuit is characterized by a tenacious active striving for goals or a more flexible changeable focus on goals. A non-clinical sample of 168 participants completed online measures of mood, bipolar-vulnerability, reward sensitivity, goal-related perfectionist tendencies, tenacious goal pursuit and flexible goal adjustment behaviors. Our findings demonstrate that bipolar-vulnerability is characterized by the tenacious, not flexible, pursuit of goals, in combination with low regulation of goal behavior, and tendencies towards narcissistic and self-critical perfectionism indicative of setting high ambitious standards and making overly harsh self-judgments when such standards are not met. These findings are similar to those from clinical bipolar samples where there is evidence of prolonged symptom recoveries after the experience of goal frustrations and failures. Reducing the tenacious, active striving for goals amongst at-risk individuals may be a potential avenue for early intervention.
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He D, Liu QQ, Jiang F. How is cybervictimization associated with Chinese adolescent suicidal ideation? A moderated mediation analysis. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03044-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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3
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Xu M, Wang J, Jin Z, Xia L, Lian Q, Huyang S, Wu D. The Behavioral Inhibition System/Behavioral Activation System Scales: Measurement Invariance Across Gender in Chinese University Students. Front Psychol 2021; 12:681753. [PMID: 34970177 PMCID: PMC8712760 DOI: 10.3389/fpsyg.2021.681753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 11/15/2021] [Indexed: 12/05/2022] Open
Abstract
Objectives: To identify the optimal factor structure of the behavioral inhibition system/behavioral activation system (BIS/BAS) scales and to examine measurement invariance (MI) of the scales across gender among a sample of Chinese undergraduate students. Methods: Convenience sampling was employed to recruit 1,085 subjects. Participants completed the Chinese version of the BIS/BAS scales. A confirmatory factor analysis (CFA) of competing models was conducted to determine the optimal factor model, followed by a test of MI across gender based on the optimal model. Results: A single-group CFA indicated that the modified four-factor structure fits best in the total sample. Multiple-group CFAs demonstrated that configural invariance, weak invariance, strong invariance, and strict invariance models of the four-factor structure of the BIS/BAS scales were all acceptable. Conclusion: The four-factor structure of the Chinese version of the BIS/BAS scales possesses MI across gender.
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Affiliation(s)
- Ming Xu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jinyu Wang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhishuai Jin
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Lu Xia
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qiaoping Lian
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Sizhu Huyang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Daxing Wu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Medical Psychological Institute, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
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Takahashi Y, Yamagata S, Ritchie SJ, Barker ED, Ando J. Etiological pathways of depressive and anxiety symptoms linked to personality traits: A genetically-informative longitudinal study. J Affect Disord 2021; 291:261-269. [PMID: 34052749 DOI: 10.1016/j.jad.2021.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/03/2021] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The comorbidity of depression and anxiety is associated with an increased risk of prolonged adverse mental health status. However, little is currently known about their genetic and environmental influences that help to explain both the comorbidity and distinctiveness. Using longitudinal twin data, the present study investigated both the overlapping and distinct relationships between depression and anxiety viewed from the perspective of Gray's Reinforcement Sensitivity Theory (RST): two personality traits of the Behavioral Inhibition and Activation Systems (BIS and BAS). METHODS A total of 422 twin pairs (298 monozygotic and 124 dizygotic pairs) participated by completing a personality questionnaire at wave 1, and mood symptoms questionnaires at wave 2. The waves were on average 2.23 years apart. RESULTS Multivariate Cholesky decomposition indicated that the genetic variance of the personality traits (BIS and BAS) explained all of the genetic variance in depressive and anxiety symptoms. Additionally, genetic factors related to the BIS positively explained depressive and anxiety symptoms, whereas genetic factors related to the BAS negatively explained only depressive symptoms. LIMITATIONS Limitations include shorter time interval and the reliance on self-reported data. CONCLUSIONS The present study provided evidence explaining the overlap and differentiation of depressive and anxiety symptoms by using data on personality traits in a longitudinal, genetically-informative design. The findings suggested the personality traits from Gray's RST model played an important role in the prediction, and clarified the description, of both depressive and anxiety symptoms.
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Affiliation(s)
| | - Shinji Yamagata
- Graduate School of Education and Human Development, Nagoya University, Japan
| | - Stuart J Ritchie
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Edward D Barker
- Department of Psychology, King's College London, United Kingdom
| | - Juko Ando
- Faculty of Letters, Keio University, Japan
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Mediation analysis of recovery-focused therapy for recent-onset bipolar disorder. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Mezes B, Lobban F, Costain D, Longson D, Jones SH. Psychological factors in personal and clinical recovery in bipolar disorder. J Affect Disord 2021; 280:326-337. [PMID: 33221719 DOI: 10.1016/j.jad.2020.11.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 09/18/2020] [Accepted: 11/07/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Research into bipolar disorder (BD) has primarily focused upon clinical recovery (CR), i.e. symptom reduction, and overlooked personally meaningful recovery outcomes emphasized by service users. Personal recovery (PR) has been a major focus in the formulation of mental health policies and guidelines, and yet, research into factors influencing PR in BD is in its infancy. METHODS This study compared psychological associates of concurrent PR and CR, and determined psychological factors in PR prospectively at 6 months. RESULTS 107 participants completed baseline assessments, of whom 84% completed follow-up at 6 months. Controlling for potential confounders, multiple linear and ordinal regression models showed that some psychological factors underpinned both CR and PR at baseline: worse PR and CR outcomes were associated with higher negative self-dispositional appraisals and dysfunctional attitudes. Better PR, but worse CR ([hypo]mania related) were associated with higher adaptive coping. Additionally, better PR (but not CR) was associated with higher concurrent risk taking at baseline and predicted at follow-up by higher levels of baseline rumination. Better CR ([hypo]mania related), but not PR, was associated with lower impulsivity, but higher BAS processes. LIMITATIONS Psychological and clinical factors were not measured at follow up and may have changed over time. Participants were a convenience sample. CONCLUSIONS Understanding psychological factors driving recovery in BD is essential for refining the conceptual framework of PR, and informing psychological models and related interventions for BD. The identified differences in psychological factors highlight the importance of more individualised, PR focused therapeutic approaches.
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Affiliation(s)
- Barbara Mezes
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Bailrigg, Lancaster LA1 4YW, United Kingdom;.
| | - Fiona Lobban
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Bailrigg, Lancaster LA1 4YW, United Kingdom
| | - Deborah Costain
- Department of Mathematics and Statistics, Lancaster University, Bailrigg, Lancaster LA1 4YW, United Kingdom
| | - Damien Longson
- Greater Manchester Mental Health NHS Foundation Trust, Bury New Road, Prestwich, Manchester M25 3BL, United Kingdom
| | - Steven H Jones
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Bailrigg, Lancaster LA1 4YW, United Kingdom
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Koenders M, Dodd A, Karl A, Green M, Elzinga B, Wright K. Understanding bipolar disorder within a biopsychosocial emotion dysregulation framework. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2020. [DOI: 10.1016/j.jadr.2020.100031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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8
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The dual-system theory of bipolar spectrum disorders: A meta-analysis. Clin Psychol Rev 2020; 83:101945. [PMID: 33217713 DOI: 10.1016/j.cpr.2020.101945] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 10/15/2020] [Accepted: 11/02/2020] [Indexed: 01/05/2023]
Abstract
Bipolar spectrum disorders are characterized by alternating intervals of extreme positive and negative affect. We performed a meta-analysis to test the hypothesis that such disorders would be related to dysregulated reinforcement sensitivity. First, we reviewed 23 studies that reported the correlation between self-report measures of (hypo)manic personality and measures of reinforcement sensitivity. A large relationship was found between (hypo)manic personality and BAS sensitivity (g = .74), but not with BIS sensitivity (g = -.08). This stands in contrast to self-reported depression which has a small, negative relationship with BAS sensitivity and a large positive one with BIS sensitivity (Katz et al., 2020). Next, we reviewed 33 studies that compared reinforcement sensitivity between euthymic, bipolar participants and healthy controls. There, bipolar disorder had a small, positive relationship with BAS sensitivity (g = .20) and a medium, positive relationship with BIS sensitivity (g = .64). These findings support a dualsystem theory of bipolar disorders, wherein BAS sensitivity is more closely related to mania and BIS sensitivity more closely to bipolar depression. Bipolar disorders show diatheses for both states with euthymic participants being BAS- and BIS- hypersensitive. Implications for further theory and research practice are expounded upon in the discussion.
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Dempsey R, Gooding P, Jones S. A prospective study of bipolar disorder vulnerability in relation to behavioural activation, behavioural inhibition and dysregulation of the Behavioural Activation System. Eur Psychiatry 2020; 44:24-29. [DOI: 10.1016/j.eurpsy.2017.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 03/08/2017] [Accepted: 03/17/2017] [Indexed: 02/02/2023] Open
Abstract
AbstractBackground:The weak regulation, or “dysregulation”, of the Behavioural Activation System (BAS) is implicated in the development and recurrence of bipolar disorder. However, there has been a lack of prospective studies investigating the predictive role of BAS dysregulation in relation to bipolar-vulnerability. Furthermore, no studies have tested the prospective predictive utility of the DYS self-report measure of BAS dysregulation in an analogue sample. The goal of the current study was to redress this gap.Methods:Participants (n = 127) completed baseline self-report measures of mood symptoms (Internal States Scale [ISS]), the Hypomanic Personality Scale (HPS), behavioural activation, inhibition and dysregulation of BAS (BIS/BAS and DYS), and at six months, the Mood Disorders Questionnaire (MDQ).Results:Linear regression analysis indicated a significant main effect of BAS Dysregulation, and a significant interaction between BIS and BAS Fun Seeking, on prospective MDQ scores whilst controlling for baseline mood symptoms and HPS scores. The interaction effect indicated that the relationship between high BAS Fun Seeking and follow-up MDQ scores was strongest when BIS scores were high, whilst the lowest MDQ scores were observed for a combination of low BAS Fun Seeking and high BIS. However, DYS scores were the stronger predictor of MDQ scores compared to the BAS Fun Seeking and BIS interaction.Conclusions:Bipolar-vulnerability is prospectively associated with heightened BAS Dysregulation, as measured by the DYS subscale, similar to prior findings in clinical samples. Further research investigating the longer-term associations between BAS Dysregulation with the development of clinically significant bipolar mood symptoms is required.
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10
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Reinforcement sensitivity, depression and anxiety: A meta-analysis and meta-analytic structural equation model. Clin Psychol Rev 2020; 77:101842. [PMID: 32179341 DOI: 10.1016/j.cpr.2020.101842] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 02/06/2020] [Accepted: 03/04/2020] [Indexed: 12/21/2022]
Abstract
Reinforcement Sensitivity Theory (RST) posits that individual differences in reward and punishment processing predict differences in cognition, behavior, and psychopathology. We performed a quantitative review of the relationships between reinforcement sensitivity, depression and anxiety, in two separate sets of analyses. First, we reviewed 204 studies that reported either correlations between reinforcement sensitivity and self-reported symptom severity or differences in reinforcement sensitivity between diagnosed and healthy participants, yielding 483 effect sizes. Both depression (Hedges' g = .99) and anxiety (g = 1.21) were found to be high on punishment sensitivity. Reward sensitivity negatively predicted only depressive disorders (g = -.21). More severe clinical states (e.g., acute vs remission) predicted larger effect sizes for depression but not anxiety. Next, we reviewed an additional 39 studies that reported correlations between reinforcement sensitivity and both depression and anxiety, yielding 156 effect sizes. We then performed meta-analytic structural equation modeling to simultaneously estimate all covariances and control for comorbidity. Again we found punishment sensitivity to predict depression (β = .37) and anxiety (β = .35), with reward sensitivity only predicting depression (β = -.07). The transdiagnostic role of punishment sensitivity and the discriminatory role of reward sensitivity support a hierarchical approach to RST and psychopathology.
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Robinson H, Jones S, Fanshawe T, Lobban F. Differences in beliefs about mood between people with and without bipolar disorder. Clin Psychol Psychother 2019; 26:684-694. [PMID: 31343092 PMCID: PMC6916314 DOI: 10.1002/cpp.2391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/28/2019] [Accepted: 07/19/2019] [Indexed: 11/08/2022]
Abstract
Psychological models of bipolar disorder (BD), such as the self-regulation model (SRM; Leventhal, Nerenz, & Steele, 1984), highlight the crucial role of beliefs about mood in relapse vulnerability. To date, no studies have directly compared these beliefs between people with and without BD. Based on the SRM, the current research examined beliefs about mood in people with and without BD and explored the impact of current affect on these beliefs. Fifty euthymic people with a diagnosis of BD and 50 controls were recruited through an online screening study, clinical services, and support organizations. Experience sampling methodology (ESM) was used to assess beliefs (according to the Brief Illness Perceptions Questionnaire; Broadbent, Petrie, Main, & Weinman, 2006) across a typical week of everyday life. Data were analysed using multilevel modelling. Forty-two people with a diagnosis of BD and 50 controls were included in the analyses. Results indicated that the BD group reported less control over mood, a shorter duration of mood, and less understanding of mood and were more likely to report the cause of depressive symptoms as something internal, compared with controls. When controlling for current affect, the BD group also reported more positive consequences, made more internal attributions for hypomanic symptoms, and reported less concern about mood, compared with controls. Findings suggest important differences in beliefs about mood between people with and without BD that are not the result of current affect. These beliefs may be particularly important in understanding underlying vulnerability to future relapse into depression and/or mania.
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Affiliation(s)
- Heather Robinson
- Spectrum Centre for Mental Health Research, Department of Health Research, Lancaster University, Lancaster, UK
| | - Steven Jones
- Spectrum Centre for Mental Health Research, Department of Health Research, Lancaster University, Lancaster, UK
| | - Thomas Fanshawe
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Fiona Lobban
- Spectrum Centre for Mental Health Research, Department of Health Research, Lancaster University, Lancaster, UK
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12
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Ironside ML, Johnson SL, Carver CS. Identity in bipolar disorder: Self-worth and achievement. J Pers 2019; 88:45-58. [PMID: 30714166 DOI: 10.1111/jopy.12461] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 12/10/2018] [Accepted: 01/27/2019] [Indexed: 12/17/2022]
Abstract
This article considers self and self-concept in bipolar disorder. Bipolar disorder, defined on the basis of manic symptoms, is a highly debilitating psychopathology. It is heavily grounded in biology but symptom course is still very responsive to psychological and social forces in the lives of persons who have the disorder. This review assumes an overall view of the self that is typical of personality psychology: self as traits, self as goals and aspirations, and ongoing efforts to attain those goals. In this review, we will discuss two different facets of self and identity in bipolar disorder. First, we review a body of goal pursuit literature suggesting that persons with bipolar disorder endorse heightened ambitions for attaining goals and recognition from others. Second, we will review multiple findings which suggest that among persons with bipolar disorder, self-worth depends on measurable success in an extreme way. We will consider how the intersection of these two themes may lead to unique identity challenges for people with bipolar disorder, drawing from self-report, behavioral, and neuroscience findings to critically examine this viewpoint.
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Affiliation(s)
- Manon L Ironside
- Department of Psychology, University of California, Berkeley, Berkeley, California
| | - Sheri L Johnson
- Department of Psychology, University of California, Berkeley, Berkeley, California
| | - Charles S Carver
- Department of Psychology, University of Miami, Coral Gables, Florida
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Struijs SY, Lamers F, Rinck M, Roelofs K, Spinhoven P, Penninx BWJH. The predictive value of Approach and Avoidance tendencies on the onset and course of depression and anxiety disorders. Depress Anxiety 2018; 35:551-559. [PMID: 29689597 PMCID: PMC6032866 DOI: 10.1002/da.22760] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 02/13/2018] [Accepted: 03/08/2018] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Trait and automatic approach-avoidance (AA) tendencies are central concepts in research on affective disorders. We longitudinally examined the associations of trait and automatic AA tendencies with the risk of onset and chronicity of anxiety and depressive disorders. METHODS Participants were subdivided into those with (n = 766) versus without (n = 1,636) a current anxiety or depression diagnosis at baseline. Clinical diagnoses were reassessed after 2-year follow-up. Automatic AA tendencies in reaction to facial expressions were assessed using the Approach-Avoidance Task, whereas self-reported trait AA tendencies were assessed using the Behavioral Inhibition System and the Behavioral Activation System scales. Analyses were adjusted for socio-demographics (basic adjustment) and for severity and history of psychopathology (full adjustment). RESULTS Stronger trait avoidance tendencies predicted both increased risk of onset and increased risk of a chronic course of anxiety disorders after full adjustment (Odds ratioonset = 1.55, P < .001, and Odds ratiochronicity = 1.31, P = .03). The associations between stronger trait avoidance tendencies and increased risk of onset and chronicity of depressive disorders were no longer significant after full adjustment. In contrast, trait approach tendencies and automatic AA tendencies were not related to onset or chronicity of disorders. CONCLUSIONS Increased trait avoidance tendencies are a risk factor for affective disorders in general, with possibly a slightly more pronounced role in anxiety than depressive disorders. This underlines the importance of addressing trait avoidance tendencies in both the treatment and aftercare of affective disorders.
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Affiliation(s)
- Sascha Y. Struijs
- Department of Psychiatry and Amsterdam Public Health Research InstituteVU University Medical CentreAmsterdamthe Netherlands
| | - Femke Lamers
- Department of Psychiatry and Amsterdam Public Health Research InstituteVU University Medical CentreAmsterdamthe Netherlands
| | - Mike Rinck
- Behavioural Science InstituteRadboud University NijmegenNijmegenthe Netherlands
| | - Karin Roelofs
- Behavioural Science InstituteRadboud University NijmegenNijmegenthe Netherlands
| | - Philip Spinhoven
- Institute of PsychologyLeiden UniversityLeidenthe Netherlands,Department of PsychiatryLeiden University Medical CentreLeidenthe Netherlands
| | - Brenda W. J. H. Penninx
- Department of Psychiatry and Amsterdam Public Health Research InstituteVU University Medical CentreAmsterdamthe Netherlands
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Schönfelder S, Langer J, Schneider EE, Wessa M. Mania risk is characterized by an aberrant optimistic update bias for positive life events. J Affect Disord 2017; 218:313-321. [PMID: 28482278 DOI: 10.1016/j.jad.2017.04.073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 04/24/2017] [Accepted: 04/28/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Early cognitive models of mania posit that a cognitive triad consisting of unrealistically optimistic beliefs about the self, world and future may predispose vulnerable individuals to develop manic symptoms. Hypomanic personality traits (HYP) pose such a vulnerability factor in the etiopathogenesis of mania. METHODS To test the cognitive tenet of overly optimistic views of the future, 24 individuals with high-HYP and 24 age- and sex-matched controls (low-HYP) performed a belief update paradigm, during which they estimated their personal chances to experience future positive and negative life events. Afterwards, they were presented with the statistical likelihood of each event occurring to a peer living in the same socio-cultural environment and given the chance to adjust their initial estimates. RESULTS High-HYP individuals exhibited an asymmetric belief revision for positive events, reflected by an exaggerated incorporation of better-than-expected and an impaired integration of worse-than-expected information, relative to their low-HYP control counterparts. The strength of this optimistic update bias was linked to the trait sensitivity of the behavioral approach system. Furthermore, high-HYP individuals demonstrated a more optimistic initial prediction bias, characterized by greater overestimations of their likelihood to experience positive events, and reported enhanced trait optimism. LIMITATIONS The cross-sectional study relied on an extreme-group design to define mania risk. CONCLUSIONS Due to the crucial role of future-oriented beliefs in guiding decision-making and goal-directed behavior, this optimistic update bias for positive events may cognitively underpin the mania-typical engagement in highly pleasurable activities despite warnings for harmful consequences.
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Affiliation(s)
- Sandra Schönfelder
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany.
| | - Johanna Langer
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany; Section for Pediatric Oncology, Haematology and Haemostaseology, University Medicine Mainz, Germany
| | - Eva Elisa Schneider
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Michèle Wessa
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany
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Kelly RE, Dodd AL, Mansell W. "When my Moods Drive Upward There Is Nothing I Can Do about It": A Review of Extreme Appraisals of Internal States and the Bipolar Spectrum. Front Psychol 2017; 8:1235. [PMID: 28824476 PMCID: PMC5543079 DOI: 10.3389/fpsyg.2017.01235] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 07/06/2017] [Indexed: 11/15/2022] Open
Abstract
The integrative cognitive model provides a comprehensive account of bipolar disorder (BD) that, if empirically supported, has important potential implications for psychological therapies. This article is the first to review the evidence for this model. We evaluate the evidence (up to 2017) for four hypotheses derived uniquely from the model: extreme positive and negative appraisals of internal states are associated with (1) risk of developing BD; (2) BD diagnosis; (3) relevant clinical and functional outcomes including hypomanic and depressive mood symptoms; and (4) outcomes over time. Research involving individuals with diagnosed mood disorders as well as non-clinical populations is reviewed. The hypotheses were broadly supported and several consistent findings were not accounted for by alternative psychological models of BD. The evidence base is limited by a relative paucity of prospective studies; only 6 of the 31 studies identified. Implications for theory, research and clinical practice are discussed.
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Affiliation(s)
- Rebecca E Kelly
- Psychological Interventions Clinic for Outpatients with Psychosis, Maudsley Psychology Centre, South London and Maudsley NHS Foundation TrustLondon, United Kingdom
| | - Alyson L Dodd
- Department of Psychology, Northumbria UniversityNewcastle-upon-Tyne, United Kingdom
| | - Warren Mansell
- School of Psychological Sciences, Faculty of Medical and Human Sciences, University of ManchesterManchester, United Kingdom
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Dodd AL, Mezes B, Lobban F, Jones SH. Psychological mechanisms and the ups and downs of personal recovery in bipolar disorder. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2017; 56:310-328. [DOI: 10.1111/bjc.12140] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 04/12/2017] [Indexed: 01/22/2023]
Affiliation(s)
- Alyson L. Dodd
- Department of Psychology; Faculty of Health & Life Sciences; Northumbria University; Newcastle-upon-Tyne UK
- Spectrum Centre for Mental Health Research; Division of Health Research; Faculty of Health & Medicine; Lancaster University; UK
| | - Barbara Mezes
- Spectrum Centre for Mental Health Research; Division of Health Research; Faculty of Health & Medicine; Lancaster University; UK
| | - Fiona Lobban
- Spectrum Centre for Mental Health Research; Division of Health Research; Faculty of Health & Medicine; Lancaster University; UK
| | - Steven H. Jones
- Spectrum Centre for Mental Health Research; Division of Health Research; Faculty of Health & Medicine; Lancaster University; UK
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Banks FD, Lobban F, Fanshawe TR, Jones SH. Associations between circadian rhythm instability, appraisal style and mood in bipolar disorder. J Affect Disord 2016; 203:166-175. [PMID: 27295373 DOI: 10.1016/j.jad.2016.05.075] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 05/30/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Internal appraisal styles, in addition to circadian and social rhythm instability, have been implicated in the development of mood experiences in bipolar disorder (BD), yet potential interactions between these variables remain under researched. METHODS This study used online questionnaires to examine relationships between social and circadian rhythm instability, appraisal style and mood within populations at varying vulnerability for BD. RESULTS Participants with BD (n=51), and those at behavioural high-risk (BHR; n=77), exhibited poor sleep quality and a stronger tendency to form internal appraisals of both positive and negative experiences compared to non-clinical controls (n=498) and participants with fibromyalgia (n=80). Participants with BD also exhibited a stronger tendency to adopt an internal, negative appraisal style compared to individuals at BHR. Sleep disturbance and internal appraisal styles were significantly associated with low mood in BD. LIMITATIONS Sleep quality and social rhythm stability were assessed using self-report measures only, which may differ from objective measures. Causal relationships between constructs could not be examined due to the cross-sectional design. CONCLUSIONS The findings suggest the importance of attending to internal appraisal styles and sleep quality when working therapeutically with individuals diagnosed with BD. Potential differences in the effect of appraisal style at the state and trait level warrant further exploration.
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Affiliation(s)
- Faye D Banks
- School of Psychology, Newcastle University, United Kingdom.
| | - Fiona Lobban
- Spectrum Centre for Mental Health Research, Lancaster University, United Kingdom
| | - Thomas R Fanshawe
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - Steven H Jones
- Spectrum Centre for Mental Health Research, Lancaster University, United Kingdom
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Li Y, Xu Y, Chen Z. Effects of the behavioral inhibition system (BIS), behavioral activation system (BAS), and emotion regulation on depression: A one-year follow-up study in Chinese adolescents. Psychiatry Res 2015; 230:287-93. [PMID: 26386601 DOI: 10.1016/j.psychres.2015.09.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 07/26/2015] [Accepted: 09/06/2015] [Indexed: 11/29/2022]
Abstract
Depression is a worldwide mental health problem among adolescents. The current study aimed to examine the roles of the behavioral inhibition system (BIS), behavioral activation system (BAS), and emotion regulation on adolescent depression. A total of 330 Chinese adolescents were recruited to complete initial assessments of BIS/BAS, emotion regulation, and depression, with a follow-up after one year. Depression on these two occasions was positively correlated with gender, age, initial scores of BIS/BAS activity, and with Cognitive Emotion Regulation Questionnaire scores for self-blame, rumination, putting into perspective, catastrophizing, and blaming others, and negatively correlated with initial positive reappraisal scores. Structural equation modeling demonstrated that higher BIS activity, catastrophizing, rumination, and lower positive reappraisal predicted depression after one year. However, after controlling for initial depression, these variables were indirectly related to subsequent depression. Implications are discussed for assessments of depression and interventions targeted at the BIS, BAS, and emotion regulation.
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Affiliation(s)
- Yanzhang Li
- Sichuan Institute of Applied Psychology, Chengdu Medical College, Chengdu, Sichuan Province, China.
| | - Yun Xu
- Sichuan Institute of Applied Psychology, Chengdu Medical College, Chengdu, Sichuan Province, China
| | - Zi Chen
- Sichuan Institute of Applied Psychology, Chengdu Medical College, Chengdu, Sichuan Province, China
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Fisk C, Dodd AL, Collins A. Response styles, bipolar risk, and mood in students: The Behaviours Checklist. Psychol Psychother 2015; 88:412-26. [PMID: 25572903 DOI: 10.1111/papt.12052] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 11/07/2014] [Indexed: 01/09/2023]
Abstract
OBJECTIVES An Integrative Cognitive Model of mood swings and bipolar disorder proposes that extreme positive and negative appraisals about internal states trigger ascent and descent behaviours, contributing to the onset and maintenance of mood swings. This study investigated the reliability and validity of a new inventory, the Behaviours Checklist (BC), by measuring associations with appraisals, response styles to positive and negative affect, bipolar risk, mania, and depression. DESIGN Correlational analogue study. METHODS Students (N = 134) completed the BC alongside measures of appraisals, response styles to positive and negative mood, mania, depression, and hypomanic personality (bipolar risk). RESULTS The BC was of adequate reliability and showed good validity. Ascent behaviours and appraisals predicted bipolar risk, whereas descent behaviours and appraisals were associated with depression. CONCLUSIONS Appraisals, ascent, and descent behaviours may play an important role in the development and maintenance of mood swings. Limitations and research recommendations are outlined. PRACTITIONER POINTS Extreme positive and negative appraisals of internal states, and subsequent behavioural responses (ascent and descent behaviours), are associated with bipolar risk and bipolar mood symptoms in a student sample. These processes are involved with mood dysregulation in clinical populations as well as bipolar risk in students, with implications for mood management.
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Affiliation(s)
- Claire Fisk
- Department of Psychology, Lancaster University, UK
| | - Alyson L Dodd
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, UK
| | - Alan Collins
- Department of Psychology, Lancaster University, UK
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Dempsey RC, Gooding PA, Jones SH. Assessing the specificity of autobiographical memory in individuals at a trait-based vulnerability to bipolar disorder using a sentence completion task. Memory 2014; 22:222-31. [DOI: 10.1080/09658211.2013.778289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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21
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Jones S, Dodd A, Gruber J. Development and validation of a new multidimensional measure of inspiration: associations with risk for bipolar disorder. PLoS One 2014; 9:e91669. [PMID: 24670894 PMCID: PMC3966762 DOI: 10.1371/journal.pone.0091669] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 02/13/2014] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Individuals at risk for, and diagnosed with, bipolar disorder (BD) appear to have heightened levels of creativity. Although inspiration is creativity, the ways in which individuals appraise and respond emotionally to inspiration in BD remain unexplored. METHOD The present study reports on a new measure of inspiration (External and Internal Sources of Inspiration Scale--EISI). The reliability and validity of EISI were explored along with associations between EISI and BD risk. RESULTS Among a cross-national student sample (N = 708) 5 inspiration factors were derived from EISI (self, other, achievement, prosocial and external inspiration). Reliability, concurrent validity and convergent/divergent validity were good. Total EISI and all subscales were associated with increased positive rumination, and total EISI and the achievement EISI subscale were associated with impulsivity. Total EISI, self and prosocial EISI subscales were independently associated with BD risk and current mania symptoms. CONCLUSION This new measure of inspiration is multidimensional, reliable and valid. Findings suggest that self and prosocial focused inspiration are particularly associated with risk for BD after controlling for current manic symptoms. Future studies in clinical populations may illuminate the relationships between inspiration and creativity in BD.
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Affiliation(s)
- Steven Jones
- Spectrum Centre for Mental Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, United Kingdom
| | - Alyson Dodd
- Spectrum Centre for Mental Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, United Kingdom
| | - June Gruber
- Department of Psychology, Yale University, New Haven, Connecticut, United States of America
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22
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Self Appraisals of Internal States and Risk of Analogue Bipolar Symptoms in Student Samples: Evidence from Standardised Behavioural Observations and a Diary Study. COGNITIVE THERAPY AND RESEARCH 2013. [DOI: 10.1007/s10608-013-9541-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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23
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Revised Reinforcement Sensitivity Theory: Implications for psychopathology and psychological health. PERSONALITY AND INDIVIDUAL DIFFERENCES 2013. [DOI: 10.1016/j.paid.2012.10.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Jones S, Mulligan LD, Law H, Dunn G, Welford M, Smith G, Morrison AP. A randomised controlled trial of recovery focused CBT for individuals with early bipolar disorder. BMC Psychiatry 2012; 12:204. [PMID: 23171304 PMCID: PMC3533930 DOI: 10.1186/1471-244x-12-204] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 10/19/2012] [Indexed: 01/11/2023] Open
Abstract
UNLABELLED BACKGROUND There is increasing evidence for the effectiveness of structured psychological therapies for bipolar disorder. To date however there have been no psychological interventions specifically designed for individuals with early bipolar disorder. The primary objective of this trial is to establish the acceptability and feasibility of a new CBT based intervention (Recovery focused CBT; RfCBT) designed in collaboration with individuals with early bipolar disorder intended to improve clinical and personal recovery outcomes. METHODS AND DESIGN This article describes a single blind randomised controlled trial to assess the feasibility and acceptability of RfCBT compared with treatment as usual. Participants will be recruited from across the North West of England from specialist mental health services and through primary care and self referral. The primary outcome of the study is the feasibility and acceptability of RfCBT as indicated by recruitment to target and retention to follow-up as well as absence of untoward incidents associated with RfCBT. We also intend to estimate the effect size of the impact of the intervention on recovery and mood outcomes and explore potential process measures (self appraisal, stigma, hope and self esteem). DISCUSSION This is the first trial of recovery informed CBT for early bipolar disorder and will therefore be of interest to researchers in this area as well as indicating the wider potential for evaluating approaches to the recovery informed treatment of recent onset severe mental illness in general. TRIAL REGISTRATION NUMBER ISRCTN43062149.
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Affiliation(s)
- Steven Jones
- Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YT, UK
| | - Lee D Mulligan
- Spectrum Centre for Mental Health Research, School of Health and Medicine, Lancaster University & Greater Manchester West Foundation Trust, Lancaster, UK
| | - Heather Law
- Greater Manchester West Foundation Trust, Manchester, UK
| | - Graham Dunn
- School of Medicine, University of Manchester, Manchester, UK
| | - Mary Welford
- Greater Manchester West Foundation Trust, Manchester, UK
| | - Gina Smith
- Spectrum Centre for Mental Health Research, School of Health and Medicine, Lancaster University & Greater Manchester West Foundation Trust, Lancaster, UK
| | - Anthony P Morrison
- School of Psychological Sciences, University of Manchester, Manchester, UK
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Kelly RE, Mansell W, Sadhnani V, Wood AM. Positive and negative appraisals of the consequences of activated states uniquely relate to symptoms of hypomania and depression. Cogn Emot 2012; 26:899-906. [DOI: 10.1080/02699931.2011.613918] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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26
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An online randomised controlled trial to assess the feasibility, acceptability and potential effectiveness of ‘Living with Bipolar’: A web-based self-management intervention for Bipolar Disorder. Contemp Clin Trials 2012; 33:679-88. [DOI: 10.1016/j.cct.2012.02.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 01/19/2012] [Accepted: 02/17/2012] [Indexed: 02/02/2023]
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Johnson SL, Fulford D, Carver CS. The double-edged sword of goal engagement: consequences of goal pursuit in bipolar disorder. Clin Psychol Psychother 2012; 19:352-62. [PMID: 22610999 DOI: 10.1002/cpp.1801] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A series of studies suggest that bipolar disorder is related to high sensitivity to incentives and that incentive sensitivity (or sensitivity of the approach system) can predict the course of mania. Incentive sensitivity in bipolar disorder seems to be related to two processes: a tendency to invest in difficult-to-attain goals and an over-reactivity to cues of goal progress versus thwarting. Both of those processes appear relevant to symptom generation. Hence, bipolar disorder seems related to a greater emphasis on reaching goals and also a problematic reactivity to reaching those highly desired goals. We suggest directions for treatment development focused on these issues in goal regulation.
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28
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Stange JP, Molz AR, Black CL, Shapero BG, Bacelli JM, Abramson LY, Alloy LB. Positive overgeneralization and Behavioral Approach System (BAS) sensitivity interact to predict prospective increases in hypomanic symptoms: a behavioral high-risk design. Behav Res Ther 2012; 50:231-9. [PMID: 22342167 PMCID: PMC3315156 DOI: 10.1016/j.brat.2012.01.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 01/08/2012] [Accepted: 01/17/2012] [Indexed: 11/30/2022]
Abstract
Recent work has identified Behavioral Approach System (BAS) sensitivity as a risk factor for the first onset and recurrence of mood episodes in bipolar disorder, but little work has evaluated risk factors for the prospective development of hypomanic symptoms in individuals at risk for, but without a history of, bipolar disorder. The present study used a prospective behavioral high-risk design to evaluate the impact of positive overgeneralization, a cognitive correlate of risk for hypomania, on hypomanic symptoms in individuals with high vs. moderate BAS sensitivity, but without a history of mood elevation. Hierarchical linear regressions indicated that upward positive overgeneralization and BAS sensitivity interacted to predict increased levels of hypomanic symptoms at follow-up, controlling for initial hypomanic symptoms. The pattern of this interaction was such that positive overgeneralization predicted higher levels of hypomanic symptoms among high-BAS, but not moderate-BAS, individuals. Thus, the self-reported tendency to experience grandiose increases in confidence following success may confer additional risk for mood elevation among individuals already at risk for developing bipolar disorder. Potential implications for prevention and treatment are discussed.
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Abstract
For over two decades, theorists have suggested that mania relates to heightened sensitivity of the behavioral activation system (BAS). In this article, we review a burgeoning empirical literature on this model, drawing on both cross-sectional and prospective studies. As evidence has emerged for this model, we argue that it is time to consider more specific aspects of BAS sensitivity in this disorder. We review evidence that bipolar disorder relates to an increased willingness to expend effort toward reward and to increases in energy and goal pursuit after an initial reward. We conclude by considering the strengths and weaknesses of this literature, with an eye toward future directions and implications for treatment.
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Affiliation(s)
- Sheri L Johnson
- Department of Psychology, University of California, Berkeley, Berkeley, California 94720, USA.
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30
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Kelly RE, Mansell W, Wood AM, Alatiq Y, Dodd A, Searson R. Extreme positive and negative appraisals of activated states interact to discriminate bipolar disorder from unipolar depression and non-clinical controls. J Affect Disord 2011; 134:438-43. [PMID: 21683449 DOI: 10.1016/j.jad.2011.05.042] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 05/05/2011] [Accepted: 05/23/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND This research aimed to test whether positive, negative, or conflicting appraisals about activated mood states (e.g., energetic and high states) predicted bipolar disorder. METHODS A sample of individuals from clinical and control groups (171 with bipolar disorder, 42 with unipolar depression, and 64 controls) completed a measure of appraisals of internal states. RESULTS High negative appraisals related to a higher likelihood of bipolar disorder irrespective of positive appraisals. High positive appraisals related to a higher likelihood of bipolar disorder only when negative appraisals were also high. Individuals were most likely to have bipolar disorder, as opposed to unipolar depression or no diagnosis, when they endorsed both extremely positive and extremely negative appraisals of the same, activated states. LIMITATIONS Appraisals of internal states were based on self-report. CONCLUSIONS The results indicate that individuals with bipolar disorder tend to appraise activated, energetic internal states in opposing or conflicting ways, interpreting these states as both extremely positive and extremely negative. This may lead to contradictory attempts to regulate these states, which may in turn contribute to mood swing symptoms. Psychological therapy for mood swings and bipolar disorder should address extreme and conflicting appraisals of mood states.
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31
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Dodd AL, Mansell W, Morrison AP, Tai S. Bipolar vulnerability and extreme appraisals of internal states: a computerized ratings study. Clin Psychol Psychother 2011; 18:387-96. [PMID: 21887812 DOI: 10.1002/cpp.779] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A recent integrative cognitive model proposed that multiple, extreme, personalized, positive and negative appraisals of internal states predispose to maintain and exacerbate bipolar symptoms. This study aimed to directly assess conviction in a range of positive and negative appraisals of internal states suggested by the model, by using a laboratory-based computerized task. In a student sample (n = 68), a history of hypomania was associated with more positive and less negative appraisals of internal states, and a history of depression was associated with more negative appraisals and less positive appraisals of internal states. The sample was then split into three groups for comparison: bipolar risk (n = 18), depression risk (n = 20) and controls (n = 30). Relative to controls, the bipolar risk group made more extreme ratings of catastrophic appraisals of low activation states and tended to make more extreme ratings of appraisals of high activation states. The depression risk group scored higher on a range of negative appraisals of low activation states. These findings provide tentative support for the role of both positive and negative, extreme, personalized appraisals of internal states in hypomania and depression.
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Affiliation(s)
- Alyson L Dodd
- All School of Psychological Sciences, University of Manchester, UK.
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32
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Schwannauer M, Noble A, Fraser G. Behavioural Risk of Bipolar Disorder in an Analogue Population: The Role of Cognitive, Developmental and Interpersonal Factors. Clin Psychol Psychother 2011; 18:411-7. [DOI: 10.1002/cpp.781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Gillian Fraser
- School of Health in Social Science; The University of Edinburgh; Edinburgh; UK
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33
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Trew JL. Exploring the roles of approach and avoidance in depression: an integrative model. Clin Psychol Rev 2011; 31:1156-68. [PMID: 21855826 DOI: 10.1016/j.cpr.2011.07.007] [Citation(s) in RCA: 178] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 07/19/2011] [Accepted: 07/20/2011] [Indexed: 12/27/2022]
Abstract
Human behavior can be organized around two fundamental motivational principles: the desire to approach positive outcomes and the desire to avoid negative outcomes. Both approach and avoidance motivation are relevant to a range of psychopathology, including depression. However, with some notable exceptions, avoidance processes have been underemphasized in the literature on motivational processes in depression. This review will examine the roles that approach and avoidance play in depression and will present an integrative model of approach and avoidance processes in depression. Both approach deficits and avoidance motivation are argued to play a role in limiting positive experiences and reinforcement for non-depressed behavior, contributing to the onset and maintenance of depression. In addition, avoidance processes are argued to play a role in negative information processing biases that may increase vulnerability to the onset and recurrence of depression. Lastly, avoidance processes and dysregulation in the connections between the approach and avoidance systems may contribute to depression by promoting inappropriate perseveration in the pursuit of unattainable approach goals. Theoretical rationales and empirical evidence for each of these roles are presented. Understanding the roles that both approach and avoidance play in depression may help to inform current conceptualizations of depression and improve treatment outcomes.
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Affiliation(s)
- Jennifer L Trew
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, Canada, V6T 1Z4.
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Dempsey RC, Gooding PA, Jones SH. Positive and negative cognitive style correlates of the vulnerability to hypomania. J Clin Psychol 2011; 67:673-90. [PMID: 21425259 DOI: 10.1002/jclp.20789] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Specific forms of ruminative cognitive styles and self-appraisals have been implicated in the development of bipolar symptomatology. This study investigated the associations between measures of positive and negative forms of appraisals and rumination with vulnerability to hypomania, and also investigated the conceptual overlap between these measures in terms of the responses to emotional experiences captured. Hypomania vulnerability was predicted by measures of positive cognitive styles, whilst current depressive symptoms were explained by scores on measures of negative cognitive styles in an analogue sample of 353 participants. A principal components analysis conducted upon the rumination and appraisal measures yielded three components representing positive and negative cognitive styles, and a normalizing of symptoms component. The implications of these results are discussed.
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Affiliation(s)
- Robert C Dempsey
- School of Psychological Sciences, University of Manchester, United Kingdom.
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35
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Factor structure of the Hypomanic Attitudes and Positive Predictions Inventory and associations with analogue bipolar symptoms in a student sample. PERSONALITY AND INDIVIDUAL DIFFERENCES 2011. [DOI: 10.1016/j.paid.2010.10.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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36
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Johnson SL, Jones S. Cognitive correlates of mania risk: are responses to success, positive moods, and manic symptoms distinct or overlapping? J Clin Psychol 2009; 65:891-905. [PMID: 19455611 DOI: 10.1002/jclp.20585] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Several measures of cognitive style have been shown to be elevated among persons diagnosed with bipolar disorder and those at risk for bipolar disorder. Several of these scales capture responses to positive affect, success, and hypomanic symptoms. We had two goals: (a) to use factor analyses to assess whether the constructs within these scales were statistically independent and (b) to examine whether the factors identified uniquely related to mania risk. A cross-national sample of 638 participants completed measures of cognitive style, including the Responses to Positive Affect scale, the Positive Overgeneralization Scale, and the Hypomanic Interpretations Questionnaire. To assess whether these measures might simply reflect more impulsive reactions to positive mood states, participants also completed the Barratt Impulsivity Scale. To measure risk of mania, participants completed the Hypomanic Personality Scale (HPS). Factor analyses suggested seven factors of cognitive style and impulsivity. Four factors uniquely correlated with HPS. That is, risk for mania related to higher scores on separable factors of acting before thinking, being overly positive in interpreting manic symptoms, being overly confident in response to success, and tendencies to dampen positive affect. Current findings suggest the need to consider multifaceted aspects of cognition in refining psychological treatments of bipolar disorder.
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Principal Components Analysis of the Hypomanic Attitudes and Positive Predictions Inventory and Associations with Measures of Personality, Cognitive Style and Analogue Symptoms in a Student Sample. Behav Cogn Psychother 2009; 38:15-33. [DOI: 10.1017/s1352465809990476] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background: An integrative cognitive model proposed that ascribing extreme personal appraisals to changes in internal state is key to the development of the symptoms of bipolar disorder. The Hypomanic Attitudes and Positive Predictions Inventory (HAPPI) was developed to measure these appraisals. Aims: The aim of the current study was to validate an expanded 61-item version of the HAPPI. Method: In a largely female student sample (N = 134), principal components analysis (PCA) was performed on the HAPPI. Associations between the HAPPI and analogue bipolar symptoms after 3 months were examined. Results: PCA of the HAPPI revealed six categories of belief: Self Activation, Self-and-Other Critical, Catastrophic, Extreme Appraisals of Social Approval, Appraisals of Extreme Agitation, and Loss of Control. The HAPPI predicted all analogue measures of hypomanic symptoms after 3 months when controlling for baseline symptoms. In a more stringent test incorporating other psychological measures, the HAPPI was independently associated only with activation (e.g. thoughts racing) at 3 months. Dependent dysfunctional attitudes predicted greater conflict (e.g. irritability), depression and reduced well-being, hypomanic personality predicted self-reported diagnostic bipolar symptoms, and behavioural dysregulation predicted depression. Conclusions: Extreme beliefs about internal states show a modest independent association with prospective analogue bipolar symptoms, alongside other psychological factors. Further work will be required to improve the factor structure of the HAPPI and study its validity in clinical samples.
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38
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Bijttebier P, Beck I, Claes L, Vandereycken W. Gray's Reinforcement Sensitivity Theory as a framework for research on personality–psychopathology associations. Clin Psychol Rev 2009; 29:421-30. [PMID: 19403216 DOI: 10.1016/j.cpr.2009.04.002] [Citation(s) in RCA: 296] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Revised: 03/18/2009] [Accepted: 04/02/2009] [Indexed: 10/20/2022]
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