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    Rights statement: This is the author’s version of a work that was accepted for publication in Journal of Affective Disorders. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Affective Disorders, 246, 2019 DOI: 10.1016/j.jad.2018.12.026

    Accepted author manuscript, 369 KB, PDF document

    Embargo ends: 18/12/19

    Available under license: CC BY-NC-ND

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Emotion regulation strategies in bipolar disorder: A systematic and critical review

Research output: Contribution to journalJournal article

Published
<mark>Journal publication date</mark>1/03/2019
<mark>Journal</mark>Journal of Affective Disorders
Volume246
Number of pages23
Pages (from-to)262-284
Publication statusPublished
Early online date18/12/18
Original languageEnglish

Abstract

Background
Theoretical frameworks emphasise associations between interpretations and responses to affect and bipolar disorder (BD). This review (PROSPERO CRD42016043801) investigated which emotion regulation (ER) strategies have been applied to BD, are elevated in BD compared to clinical and non-clinical controls, and are associated with clinical and functional outcomes in BD

Methods
Search terms relating to emotion regulation, coping and bipolar disorder were entered into Embase, MedLine and PsycInfo. Quantitative studies investigating relationships between ER strategies and BD were eligible for this narrative synthesis

Results
A large volume of research (n = 47) investigated specific ER strategies in BD. Maladaptive strategies such as rumination and dampening were elevated in BD compared to controls and these particular strategies had a detrimental impact on outcomes such as mood symptoms. BD had a similar profile of ER strategies to unipolar depression, but there was limited comparison to other clinical groups. People with BD did not generally have deficits in using adaptive strategies, as evidenced by comparisons with controls and experimental studies

Limitations
Methodological heterogeneity and a lack of ecologically valid ER assessments

Conclusions
Empirical literature is critiqued in line with contemporary theories of BD and of emotion regulation more generally, in order to inform future research recommendations. This includes investigation of the importance of context in the impact of ER strategies, and discrepancies between trait and state use of ER strategies, particularly through experience sampling.

Bibliographic note

This is the author’s version of a work that was accepted for publication in Journal of Affective Disorders. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Affective Disorders, 246, 2019 DOI: 10.1016/j.jad.2018.12.026