Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Symptom-specific self-referential cognitive processes in bipolar disorder
T2 - a longitudinal analysis
AU - Pavlickova, H.
AU - Varese, F.
AU - Turnbull, O.
AU - Scott, J.
AU - Morriss, R.
AU - Kinderman, P.
AU - Paykel, E.
AU - Bentall, R. P.
PY - 2013/9
Y1 - 2013/9
N2 - Background. Although depression and mania are often assumed to be polar opposites, studies have shown that, in patients with bipolar disorder, they are weakly positively correlated and vary somewhat independently over time. Thus, when investigating relationships between specific psychological processes and specific symptoms (mania and depression), co-morbidity between the symptoms and changes over time must be taken into account.Method. A total of 253 bipolar disorder patients were assessed every 24 weeks for 18 months using the Hamilton Rating Scale for Depression (HAMD), the Bech-Rafaelsen Mania Assessment Scale (MAS), the Rosenberg Self-Esteem Questionnaire (RSEQ), the Dysfunctional Attitudes Scale (DAS), the Internal, Personal and Situational Attributions Questionnaire (IPSAQ) and the Personal Qualities Questionnaire (PQQ). We calculated multilevel models using the XTREG module of Stata 9.1, with psychological and clinical measures nested within each participant.Results. Mania and depression were weakly, yet significantly, associated; each was related to distinct psychological processes. Cross-sectionally, self-esteem showed the most robust associations with depression and mania: depression was associated with low positive and high negative self-esteem, and mania with high positive self-esteem. Depression was significantly associated with most of the other self-referential measures, whereas mania was weakly associated only with the externalizing bias of the IPSAQ and the achievement scale of the DAS. Prospectively, low self-esteem predicted future depression.Conclusions. The associations between different self-referential thinking processes and different phases of bipolar disorder, and the presence of the negative self-concept in both depression and mania, have implications for therapeutic management, and also for future directions of research.
AB - Background. Although depression and mania are often assumed to be polar opposites, studies have shown that, in patients with bipolar disorder, they are weakly positively correlated and vary somewhat independently over time. Thus, when investigating relationships between specific psychological processes and specific symptoms (mania and depression), co-morbidity between the symptoms and changes over time must be taken into account.Method. A total of 253 bipolar disorder patients were assessed every 24 weeks for 18 months using the Hamilton Rating Scale for Depression (HAMD), the Bech-Rafaelsen Mania Assessment Scale (MAS), the Rosenberg Self-Esteem Questionnaire (RSEQ), the Dysfunctional Attitudes Scale (DAS), the Internal, Personal and Situational Attributions Questionnaire (IPSAQ) and the Personal Qualities Questionnaire (PQQ). We calculated multilevel models using the XTREG module of Stata 9.1, with psychological and clinical measures nested within each participant.Results. Mania and depression were weakly, yet significantly, associated; each was related to distinct psychological processes. Cross-sectionally, self-esteem showed the most robust associations with depression and mania: depression was associated with low positive and high negative self-esteem, and mania with high positive self-esteem. Depression was significantly associated with most of the other self-referential measures, whereas mania was weakly associated only with the externalizing bias of the IPSAQ and the achievement scale of the DAS. Prospectively, low self-esteem predicted future depression.Conclusions. The associations between different self-referential thinking processes and different phases of bipolar disorder, and the presence of the negative self-concept in both depression and mania, have implications for therapeutic management, and also for future directions of research.
KW - Bipolar disorder
KW - longitudinal analysis
KW - self-esteem
KW - self-referential processes
KW - symptoms
KW - RAFAELSEN MANIA SCALE
KW - PSYCHOLOGICAL PROCESSES
KW - ATTRIBUTIONAL STYLE
KW - RECOVERED BIPOLAR
KW - DEPRESSION
KW - ESTEEM
KW - DISCREPANCIES
KW - QUESTIONNAIRE
KW - VULNERABILITY
KW - VALIDATION
U2 - 10.1017/S0033291712002711
DO - 10.1017/S0033291712002711
M3 - Journal article
VL - 43
SP - 1895
EP - 1907
JO - Psychological Medicine
JF - Psychological Medicine
SN - 0033-2917
IS - 9
ER -