TY - JOUR

T1 - Psychological mechanisms and the ups and downs of personal recovery in bipolar disorder

AU - Dodd, Alyson Lamont

AU - Mezes, Barbara

AU - Lobban, Anne Fiona

AU - Jones, Steven Huntley

N1 - This is the peer reviewed version of the following article Dodd, A. L., Mezes, B., Lobban, F. and Jones, S. H. (2017), Psychological mechanisms and the ups and downs of personal recovery in bipolar disorder. Br J Clin Psychol, 56: 310–328. doi:10.1111/bjc.12140 which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/BJC.12140/abstract This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.

PY - 2017/9

Y1 - 2017/9

N2 - BackgroundPersonal recovery is recognized as an important outcome for individuals with bipolar disorder (BD) and is distinct from symptomatic and functional recovery. Recovery-focused psychological therapies show promise. As with therapies aiming to delay relapse and improve symptoms, research on the psychological mechanisms underlying recovery is crucial to inform effective recovery-focused therapy. However, empirical work is limited. This study investigated whether negative beliefs about mood swings and self-referent appraisals of mood-related experiences were negatively associated with personal recovery.DesignCross-sectional online survey.MethodPeople with a verified research diagnosis of BD (n = 87), recruited via relevant voluntary sector organizations and social media, completed online measures. Pearson's correlations and multiple regression analysed associations between appraisals, beliefs, and recovery.ResultsNormalizing appraisals of mood changes were positively associated with personal recovery. Depression, negative self-appraisals of depression-relevant experiences, extreme positive and negative appraisals of activated states, and negative beliefs about mood swings had negative relationships with recovery. After controlling for current mood symptoms, negative illness models (relating to how controllable, long-term, concerning, and treatable mood swings are; β = −.38), being employed (β = .39), and both current (β = −.53) and recent experience of depression (β = .30) predicted recovery.LimitationsDue to the cross-sectional design, causality cannot be determined. Participants were a convenience sample primarily recruited online. Power was limited by the sample size.ConclusionsInterventions aiming to empower people to feel able to manage mood and catastrophize less about mood swings could facilitate personal recovery in people with BD, which might be achieved in recovery-focused therapy.Practitioner points•Personal recovery is an important outcome for people living with bipolar disorder•More positive illness models are associated with better personal recovery in bipolar disorder, over and above mood symptoms•Recovery-focused therapy should focus on developing positive illness models•Recovery-focused therapy should address personally meaningful goals such as gaining employment

AB - BackgroundPersonal recovery is recognized as an important outcome for individuals with bipolar disorder (BD) and is distinct from symptomatic and functional recovery. Recovery-focused psychological therapies show promise. As with therapies aiming to delay relapse and improve symptoms, research on the psychological mechanisms underlying recovery is crucial to inform effective recovery-focused therapy. However, empirical work is limited. This study investigated whether negative beliefs about mood swings and self-referent appraisals of mood-related experiences were negatively associated with personal recovery.DesignCross-sectional online survey.MethodPeople with a verified research diagnosis of BD (n = 87), recruited via relevant voluntary sector organizations and social media, completed online measures. Pearson's correlations and multiple regression analysed associations between appraisals, beliefs, and recovery.ResultsNormalizing appraisals of mood changes were positively associated with personal recovery. Depression, negative self-appraisals of depression-relevant experiences, extreme positive and negative appraisals of activated states, and negative beliefs about mood swings had negative relationships with recovery. After controlling for current mood symptoms, negative illness models (relating to how controllable, long-term, concerning, and treatable mood swings are; β = −.38), being employed (β = .39), and both current (β = −.53) and recent experience of depression (β = .30) predicted recovery.LimitationsDue to the cross-sectional design, causality cannot be determined. Participants were a convenience sample primarily recruited online. Power was limited by the sample size.ConclusionsInterventions aiming to empower people to feel able to manage mood and catastrophize less about mood swings could facilitate personal recovery in people with BD, which might be achieved in recovery-focused therapy.Practitioner points•Personal recovery is an important outcome for people living with bipolar disorder•More positive illness models are associated with better personal recovery in bipolar disorder, over and above mood symptoms•Recovery-focused therapy should focus on developing positive illness models•Recovery-focused therapy should address personally meaningful goals such as gaining employment

KW - appraisals

KW - bipolar disorder

KW - depression

KW - illness perceptions

KW - mania

KW - psychological processes

KW - recovery

U2 - 10.1111/bjc.12140

DO - 10.1111/bjc.12140

M3 - Journal article

VL - 56

SP - 310

EP - 328

JO - British Journal of Clinical Psychology

JF - British Journal of Clinical Psychology

SN - 0144-6657

IS - 3

ER -