Bipolar risk and mental imagery susceptibility in a representative sample of Chinese adults residing in the community

Abstract

Background:We need to better understand the cognitive factors associated with risk for bipolar disorders. Recent research suggests that increased susceptibility to mental imagery may be one such factor. However, since this research was primarily conducted with Western students and at a single time-point, it is not known whether the relationship between imagery susceptibility and bipolar symptoms exists across cultures or within the general community, or whether this relationship remains stable over time.Aim:This study evaluated whether Chinese adults identified as being at high (HR) versus low (LR) risk of developing bipolar disorders showed greater mental imagery susceptibility. We aimed to test whether such a relationship was stable over time by measuring imagery characteristics at baseline and at the 7-week follow-up.Method:This prospective study recruited a community sample of N = 80 Chinese adults screened for the absence of neurotic and psychotic disorders. The sample was split into HR (n = 18) and LR (n = 62) groups at baseline based on a criterion cut-off score on a measure of hypomania, the Mood Disorder Questionnaire (MDQ). Participants completed measures of imagery susceptibility and its impact: the Spontaneous Use of Imagery Scale (SUIS) and the Impact of Future Events Scale (IFES), at baseline and 7 weeks later.Results:HR group reported greater tendency to use imagery in daily life (SUIS) and greater emotional impact of prospective imagery (IFES) than LR group at baseline. These results remained stable at follow-up.Conclusion:This study provides preliminary evidence for increased susceptibility to mental imagery in individuals at high risk of bipolar disorders recruited from a community sample of Chinese adults. This extends previous research in Western student samples suggesting that imagery (both levels of use and its emotional impact) may be a cognitive factor with cross-cultural relevance that is stable over time.

An investigation of mental imagery in bipolar disorder: Exploring “the mind's eye”

“…Our results on the association between BD phenotype and affective lability traits, and greater imagery frequency and emotionality, are in keeping with previous findings that individuals with a BD phenotype are more susceptible to intrusive imagery and to spontaneous use of imagery . Interestingly, better performance in imagery maintenance via visual short‐term memory was also associated with affective lability.…”

Emotional Mental Imagery Abnormalities in Monozygotic Twins With, at High-Risk of, and Without Affective Disorders: Present in Affected Twins in Remission but Absent in High-Risk Twins

“…Our data are more consistent with the notion that imagery-based abnormalities reflect (neuro)cognitive markers of the disorder itself—abnormalities that are likely to play a role in increasing future relapse given their persistence in remitted states. We note that previous research has shown altered emotional mental imagery in individuals with phenotypic (rather than genetic/familial) risk for BD, mainly based on the presence of hypomanic-like experiences (32, 43, 69, 79). However, our study was the first to focus instead on genetic-based risk using a twin design enabled by the unique Danish registers (49).…”

“…However, our study was the first to focus instead on genetic-based risk using a twin design enabled by the unique Danish registers (49). As a potential explanation for this discrepancy, maladaptive prospective emotional imagery may be associated with phenotypic characteristics of affective disorders that lie on the same dimension of clinical symptoms, such as the actual presence of dysphoric mood (47, 62) or hypomanic-like experiences (32, 43, 69, 79), but we did not measure such features in our high-risk twins. Another potential explanation is that our high-risk twins had an average higher age compared to at-risk groups from previous research.…”

Mental imagery and bipolar disorders: Introducing scope for psychological treatment development?

“…In another study, patients with bipolar disorders reported experiencing more vivid, exciting and pleasurable 'flash-forwards' (future images) at times of positive mood compared to patients with unipolar depression (Ivins, Di Simplicio, Close, Goodwin, & Holmes, 2014). Higher imagery susceptibility was also found in people with high hypomanic experiences (measured on the Mood Disorders Questionnaire; Malik, Goodwin, Hoppitt, & Holmes, 2014;Ng, Burnett Heyes, McManus, Kennerley, & Holmes, 2015), something we are following up in a familial risk study. Thus, there is to date some preliminary support that people with a bipolar phenotype are more likely to visualise their thoughts and also report stronger emotional arousal to their own visual images than people without a bipolar phenotype.…”