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.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:573476 |
| Date | January 2012 |
| Creators | Malik, Aiysha |
| Contributors | Holmes, Emily A. ; Goodwin, Guy M. |
| Publisher | University of Oxford |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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