The portfolio has three parts. Part one is a systematic literature review, in which the empirical literature relating to the relationship between mental imagery and emotion is reviewed. Part two is an empirical paper which explores self-defining memories, mental imagery and emotion in individuals likely to develop bipolar disorder. Part three comprises the appendices.

The overarching aim of this thesis was to use an experimental psychopathology approach to investigate mood, stress and mental imagery in the Broad Bipolar Phenotype (BPP), defined by the experience of elevated lifetime hypomania. Daily mood reactions to stress have been well explored in psychosis, but the limited research in BD has produced mixed findings. Holmes, Geddes, Colom and Goodwin (2008) hypothesised that mental imagery in BD may amplify emotion and worsen day to day mood extremes. This thesis investigates volunteers ranging across the continuum ofthe BPP in relation to key variables from the Holmes et al (2008) model: mood, stress and mental imagery, and brings new methodology to this area. The Mood Disorder Questionnaire (MDQ; Hirschfeld et ai, 2000) was used to identify groups with high (N=50; ~ 7 symptoms) and low (N=60; :s 6 symptoms) rates of hypomanic experience i.e. high MDQ and low MDQ. A single investigation was conducted for this thesis (N=IIO) which is divided into four studies. Study I and 2 tested the hypothesis that high MDQ volunteers would report higher levels of mental imagery compared to low MDQ volunteers. Study I (N=61) found that high MDQ volunteers had higher levels of trait mental imagery and intrusive imagery of the future, replicating patient findings. Study 2 (N=49) extended these findings to additional imagery measures. In a laboratory study, study 3 tested the hypothesis that after an experimental stressor (a traumatic film) high MDQ volunteers would experience more image-based flashback memories to the film than low MDQ volunteers. Volunteers reported any flashback memories to the film via mobile phone Short Message Service (SMS) prompts for six days, plus convergent measures at follow-up. As predicted, compared to the low MDQ group, the high MDQ group experienced significantly more flashback memories to the stressor (on all measures). Study 4 used an Experience Sampling Method (ESM; momentary assessment sampling over time) to frequently monitor mood and its event-related stress context. Thus, in the context of daily life study 4 sought to explore the role of bipolarity in exacerbating mood reactions, in comparison to other hypothesised contributors: neuroticism and intrusive imagery of the future. SMS mobile-phone messages were sent 10 times a day for 6 days to capture event-related stress ratings and mood ratings. Higher bipolarity (MDQ), neuroticism (EPQN) and intrusive imagery of the future (IFES) were each associated with increased mood reactions over six days, compared to lower levels of these characteristics. In understanding which of these characteristics best accounted for mood reactions, bipolarity (MDQ) best accounted for elated mood reactions, neuroticism did not best account for any moods, intrusive imagery of the future (lFES) best accounted for sad, depressed and anxious mood reactions and both bipolarity and intrusive imagery of the future best accounted for fearful mood reactions. In summary, the aim of this thesis was to investigate volunteers ranging across the continuum of the BPP in relation to key variables from the Holmes et al (2008) model: mood, stress and mental imagery. As predicted, compared to low MDQ volunteers, the high MDQ group had higher levels of I) self-reported use of mental imagery, 2) negative flashback memory imagery after an experimental stressor and 3) daily life negative mood reactions to stress. Critically, repeatedly imaging future scenes (lFES), which flash to mind unbidden, was found to show the greatest impact on negative mood reactions in daily life. Mental imagery offers a psychological characteristic which is elevated in volunteers at the higher end of the BPP continuum and also has the potential to be a novel cognitive treatment target in clinical BD samples. For example, targeting flashback memories after a stressor or targeting intrusive imagery of the future may help regulate mood reactions in daily life. This warrants further investigation in patients with BD.

Bipolar mood disorder has been traditionally researched, explored, and explained from a modernistic, psychiatric perspective. The purpose of this study is to explicate an alternative description for bipolar mood disorder, from a postmodern perspective. The widely accepted psychiatric knowledge focuses on the signs and symptoms of the disorder, pharmacological treatments, and manualised psychotherapies. This thesis shifts the focus from an intrapsychic, deficit perspective towards one which is inclusive of surrounding discourses and patterned relationships. The social constructionist research approach is followed, utilising vignette and thematic analyses for textual deconstruction and reconstruction. In addition to these data analyses, discourses were analysed using the actual text of the co-researchers. This allowed for a thorough explication of the ways in which discourses shape the construct bipolar mood disorder. From these analyses, emergent themes were then distilled and compared to the existing body of literature in the bipolar mood spectrum field of study. Process models were generated to depict the various pertinent aspects of the social construction of bipolar mood disorder. This research has value for the treating professional, allowing for a broader, more inclusive discourse perspective to add to the already established medical model view. Further, this research gives credence to the voice of the person who has been diagnosed with the illness. This research may also contribute to the epistemological debates within modernist and postmodernist paradigms. Key words: Bipolar mood disorder, medical model, pharmacology, mania, depression, psychiatry, psychotherapy, titrating power relations, expert, problem determined systems, belonging, problems of therapy and therapeutic problems, vignette analysis, people as meaning generating beings, context, reflexivity, self-reflection, multiple realities, positivism, social constructionist epistemology, qualitative research, process model. / Psychology / D. Litt. et Phil. (Psychology)

Bipolar mood disorder has been traditionally researched, explored, and explained from a modernistic, psychiatric perspective. The purpose of this study is to explicate an alternative description for bipolar mood disorder, from a postmodern perspective. The widely accepted psychiatric knowledge focuses on the signs and symptoms of the disorder, pharmacological treatments, and manualised psychotherapies. This thesis shifts the focus from an intrapsychic, deficit perspective towards one which is inclusive of surrounding discourses and patterned relationships. The social constructionist research approach is followed, utilising vignette and thematic analyses for textual deconstruction and reconstruction. In addition to these data analyses, discourses were analysed using the actual text of the co-researchers. This allowed for a thorough explication of the ways in which discourses shape the construct bipolar mood disorder. From these analyses, emergent themes were then distilled and compared to the existing body of literature in the bipolar mood spectrum field of study. Process models were generated to depict the various pertinent aspects of the social construction of bipolar mood disorder. This research has value for the treating professional, allowing for a broader, more inclusive discourse perspective to add to the already established medical model view. Further, this research gives credence to the voice of the person who has been diagnosed with the illness. This research may also contribute to the epistemological debates within modernist and postmodernist paradigms. Key words: Bipolar mood disorder, medical model, pharmacology, mania, depression, psychiatry, psychotherapy, titrating power relations, expert, problem determined systems, belonging, problems of therapy and therapeutic problems, vignette analysis, people as meaning generating beings, context, reflexivity, self-reflection, multiple realities, positivism, social constructionist epistemology, qualitative research, process model. / Psychology / D. Litt. et Phil. (Psychology)

L'objectif de cette thèse est d'explorer les corrélats électrophysiologiques du traitement des émotions à différents niveaux : la perception, la réactivité et la régulation émotionnelles, chez des patients bipolaires. La plupart des études portant sur le traitement des émotions dans cette population clinique se sont focalisées sur le traitement des émotions faciales. Ces études ont mis en évidence un dysfonctionnement des processus de réactivité et de régulation émotionnelles. Cependant, peu d'études se sont intéressées au traitement de la prosodie émotionnelle chez ces patients. Or, la prosodie émotionnelle joue un rôle central dans les interactions sociales. C'est pourquoi il apparaît important d'étudier les corrélats électrophysiologiques des processus mis en œuvre à un stade pré-attentionnel, au niveau de la détection de changements survenant dans notre environnement auditif et de l'orientation de l'attention, étapes précoces du traitement des émotions (Scherer, 2001). A notre connaissance, aucune étude ne s'y est intéressée chez les patients bipolaires. Par ailleurs, un grand nombre d'études montrent que ces patients présentent une hyperréactivité émotionnelle ainsi qu'un défaut de régulation émotionnelle, en lien avec des anomalies telles qu'une hyperactiviation amygdalienne et/ou une hypoactivation du cortex préfrontal. Cependant, les corrélats électrophysiologiques de la réactivité et de la régulation émotionnelles sont peu connus chez ces patients comme dans la population générale. L'objet de ce travail est de proposer deux expériences en électroencéphalographie afin d'étudier le décours temporel des processus de détection de la nouveauté et d'orientation non volontaire de l'attention et de processus de réactivité et de régulation émotionnelles à l'aide des potentiels évoqués. Dans la première expérience, nous utilisons un paradigme Oddball afin d'étudier la détection de la nouveauté et l'orientation non volontaire de l'attention : le matériel élaboré spécialement pour cette étude est constitué de voyelles (/a/, /i/, /u/) produites avec une prosodie de joie, de peur, de tristesse ou neutre. Dans la seconde expérience, nous avons repris le paradigme d'induction émotionnelle à l'aide d'images (Schönfelder et al., 2013), dans lequel les participants observent passivement les images ou utilisent une stratégie de régulation émotionnelle (distraction, réinterprétation cognitive). Les principaux résultats ce cette thèse montrent des anomalies de traitement des émotions chez les patients bipolaires, dès les étapes précoces de détection de la nouveauté et d'orientation non volontaire de l'attention. Si les participants contrôles présentent une MisMatch Negativity (négativité de discordance) plus ample pour certaines émotions (la peur) que pour d'autres (la joie), ce n'est pas le cas des patients. Par ailleurs, ces derniers ne présentent pas de modulation de la P3a par le changement d'émotions, ce qui indique une anomalie de l'orientation non volontaire de l'attention vers des stimuli émotionnels. Néanmoins, ils réagissent plus rapidement au changement d'émotions que les contrôles. À des étapes plus tardives, les patients bipolaires témoignent d'une réactivité émotionnelle importante pour les stimuli neutres, ce qui n'est pas le cas des contrôles. Enfin, les patients ne parviennent pas à réguler les émotions positives à l'aide d'une stratégie fondée sur le mécanisme de redéploiement attentionnel. Ces résultats suggèrent que les patients bipolaires présentent des anomalies de traitement des émotions dès les premiers processus perceptifs, n'impliquant pas de mécanismes d'attention volontaire, jusqu'à des niveaux de traitement plus contrôlés (réactivité et régulation émotionnelle volontaires). Cette thèse apporte de nouvelles données concernant la perception, la réactivité et la régulation émotionnelles et contribue à une meilleure connaissance des bases neurophysiologiques du traitement des émotions chez les patients bipolaire / This thesis investigates electrophysiological correlates of emotion processing from perception to reactivity and emotion regulation in adult with bipolar disorders. Most studies with such patients have focused on the processing of facial emotion. They showed impairment of facial recognition as well as emotional reactivity and regulation. However, few studies investigated the processing of emotional prosody and preattentive stage of processing in patient with bipolar disorders. Given that emotional prosody plays a crucial role in social interactions, it is important to better understand neurophysiological correlates of novelty detection and involuntary orientation of attention which constitute early stages of emotional processing (Scherer, 2001). To our knowledge, no study has yet addressed this issue in bipolar disorder. Moreover, patients with bipolar disorder have abnormal emotional reactivity and a deficit in emotion regulation along with hyperactivation of amygdala and hypoactivation of prefrontal cortex. Also, electrophysiological correlates of emotional reactivity and regulation are not well known in patients with bipolar disorders and in general population. For this purpose, two experiments were run in the present thesis in order to investigate the time course of novelty detection, involuntary orientation of attention, emotion reactivity and emotion regulation using evoked potentials responses. In the first experiment, an Oddball paradigm was used to assess novelty detection and orientation of attention. The linguistic material specifically designed for this study consists of French vowels (/a/, /i/, /u/) produced with happiness, fear, sadness or neutral prosodies. In the second experiment, an emotional induction paradigm (Schönfelder et al., 2013) was employed. Participants watched affective or neutral pictures or used an emotion regulation strategy (i.e., distraction or cognitive reappraisal). Taken together, the results of the present thesis indicate that patients with bipolar disorders show impairment in emotion processing even at preattentive stages such as novelty detection and involuntary orientation of attention. Healthy participants show a larger MisMatch Negativity in response to fear than to happiness, whereas patients did not. These patients did not show modulation of the P3a in response to emotion change, suggesting dysfunctioning of orientation of attention towards emotional stimuli. However, they were more sensible to emotion change than control as indicating by faster response in the case of such change. At a later stage, patients present greater emotional reactivity in response to neutral stimuli than controls. Moreover, they fail to regulate positive emotions using a regulation strategy based on attentional deployment (distraction). Overall, these results suggest that patient with bipolar disorder already show dysfunctioning at a perceptive level of emotional processing. A dysfunctioning was also attested at a more controlled processing (e.g. emotional reactivity and emotion regulation). Our work enriches the understanding on perception, reactivity and emotion regulation and contributes to a better understanding of neurophysiological bases of emotion processing in patients with bipolar disorder.

This study explored the Object Relations of a sample of 45 subjects who were using alcohol and were diagnosed with co-morbid Depressive or Bipolar disorders and/or Personality disorders. All subjects were receiving treatment at a government psychiatric hospital in South Africa. The similarities and differences in the Object Relations of these individuals were identified. A biographical questionnaire, the Alcohol Use Disorder Test (AUDIT), which was used as a screening measure, and the Bells Object Relations and Reality Testing Inventory (BORRTI) were administered to obtain information from a purposive sample. Descriptive and inferential statistics were used to analyse the results of the assessment measures. Analysis of the BORRTI data indicated a high rate of depressive and personality disorders within this sample. Results of the sub-sample (n=29) whose scores were included in the Pearson’s Correlation Coefficient analysis indicate that higher levels of alcohol consumption result in increased levels of hallucinations and delusions. Other correlations were identified between high levels of alcohol consumption and heightened levels of reality distortions and more uncertainty in the perceptions of these individuals. Significant differences in the scores of the male and female participants were identified. With the female participants, the higher the level of alcohol consumption, the lower the individuals scored in terms of pathological levels of egocentricity, uncertain perceptions, insecure attachments, alienation, social incompetence as well as hallucinations and delusions. Alternatively, in the male sample, higher levels of alcohol consumption result in increased hallucinations and delusions, reality distortions, uncertainty in perceptions, alienation, social incompetence and egocentricity. / Psychology / M.A. (Research Psychology)