Objectives: Interest in the psychology of bipolar disorder has led to a shift away from solely biological accounts, towards integrative biopsychosocial models. Three such models formed the basis for the current study. These were: the behavioural activation model (Depue & Iacono, 1989), the circadian rhythm instability and appraisal model (Jones, 2001), and the integrative cognitive model (lCM), (Mansell et ai, 2007). The behavioural activation model proposes that behavioural activation system (BAS) hypersensitivity increases vulnerability towards developing bipolar disorder. Likewise, cognitive style, which is central to the circadian rhythm instability and appraisal model and the ICM, can also increase vulnerability. To date, few studies have explored these factors amongst bipolar individuals who are in episode. Furthermore, no comparisons have been made on these dimensions between bipolar individuals and individuals experiencing other psychiatric disorders. This was addressed in the current study. Methodology: Twenty inpatients with a diagnosis of bipolar disorder were compared to 20 inpatients with a diagnosis of schizophrenia on dimensions of behavioural activation and cognitive style. All individuals were recruited from psychiatric wards in Greater Manchester. Diagnostic status was confirmed using the SCID (all participants were experiencing an acute episode). BAS sensitivity was assessed using the BIS-BAS (Carver & White, 1994) whilst cognitive style was assessed using bipolar specific measures, namely the HIQ (Jones et ai, 2006) and the Brief-HAPPI (Mansell & Jones, 2006). Symptoms of mania and depression were also assessed using observer rated and self-report measures Results: As hypothesised, the bipolar group displayed significantly elevated levels of BAS sensitivity than the schizophrenia group. This was reflected across all three BAS subscales (fun seeking, drive and reward responsiveness). The bipolar group also displayed significantly elevated positive self-dispositional appraisals of hypomanic experiences than the schizophrenia group, as measured by the HIQ-H subscale. However, the groups only differed significantly on some of the dysfunctional beliefs outlined in the Brief-HAPP!. This was reflected in the significant group difference on Brief-HAPPI (forward items) but not on the Brief- HAPPI (reverse items). Despite the significant differences between the groups, a logistic regression revealed that there were no significant single predictors of diagnostic group membership, although HIQ-H was approaching significance. Conclusions: The current findings propose that BAS hypersensitivity and positive self-dispositional appraisals of hypomanic experiences are elevated amongst bipolar individuals who are in episode, as are certain dysfunctional beliefs. There is also evidence to suggest that these factors may be specific to bipolar individuals in the context of severe and enduring psychiatric disorders. Whilst BAS hypersensitivity and cognitive style may increase an individual's vulnerability towards experiencing extreme shifts in affect, prospective longitudinal studies are required that further explore this notion. The current findings, as well as providing support for the three biopsychosocial models mentioned above, also contribute towards the further advancement of psychological therapies for bipolar disorder, and in particular cognitive behavioural therapy (CBT).
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:492755 |
| Date | January 2008 |
| Creators | Franks, Mark |
| Publisher | University of Manchester |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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