A behavioural high risk paradigm was used to investigate cognitive vulnerability to bipolar disorder in a group of individuals at high risk of developing symptoms, and similar measures were administered to a group of bipolar patients whose symptoms were currently in remission. High risk was defined as a combination of elevated scores on both the Hypomanic Personality Questionnaire and the Dysfunctional Attitudes Scale. The research addressed several psychological models of bipolar disorder including response styles, behavioural engagement, circadian rhythm disruption, self-esteem instability and the manic defence, as well as cognitive reactivity to musical mood induction and the impact of mood on emotion recognition. In the initial analogue study, hypothetically low-, medium- and high-risk participants were compared on measures of the models listed. High-risk participants displayed a uniquely dysfunctional combination of rumination and risk-taking coping behaviours, high behavioural inhibition and activation scores, irregular and unrestful sleep, highly unstable self-esteem, heightened sensitivity to positive and negative mood induction, and a moodcongruent bias in their perception of ambiguous facial expressions relative to the low-risk participants. They had also experienced significant levels of affective symptomatology consistent with their high-risk status. The subsequent clinical study compared remitted bipolar patients to remitted unipolar depressed patients and healthy controls. The bipolar group displayed more ruminative coping, high behavioural inhibition, disrupted and inefficient sleep, unstable selfesteem, and a clear manic defence when compared to the controls. The remitted bipolar patients also reported greater shifts in mood and self-esteem following both mood induction procedures than the controls. The remitted bipolar patients were therefore very similar to both the unipolar depressed group and the high-risk analogue participants in cognitive terms. Taken together, the results support the use of behavioural high-risk paradigms in investigations of bipolar disorder, and confirm the involvement of the presently examined cognitive and psychosocial factors in conferring vulnerability to bipolar symptomatology.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:488262 |
| Date | January 2004 |
| Creators | Knowles, Rebecca Elizabeth |
| Publisher | University of Manchester |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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