Cognitive Styles and Life Events in Subsyndromal Unipolar and Bipolar Disorders: Stability and Prospective Prediction of Depressive and Hypomanic Mood Swings

Abstract

We examined the interaction of cognitive styles and life events in predicting the depressive and hypomanic mood swings of 43 undergraduates meeting criteria for a subsyndromal mood disorder (i.e., cyclothymia, dysthymia, or hypomania) or no lifetime diagnosis. Participants completed symptom, cognitive style, and life events measures on three separate occasions as the different mood states characteristic of their subsyndromal disorder naturally occurred. Normal controls were assessed in three separate normal mood states at times yoked to participants in the three disorder groups. All groups’ attributional styles and dysfunctional attitudes remained stable across large changes in mood and symptomatology and cyclothymics’ cognitive styles were as negative as those of dysthymics. Moreover, hierarchical regression analyses indicated that participants’ attributional styles, as measured in a normal mood state (Time 1), in interaction with intervening life events predicted prospectively their depressive symptom changes at Times 2 and 3 and their hypomanic symptom changes at Time 2. These findings provide support for the cognitive vulnerability-stress hypothesis of the Hopelessness theory of depression (Abramson, Metalsky, & Alloy, 1989) and suggest that the logic of the Hopelessness theory’s vulnerability-stress hypothesis extends to the prediction of manic/hypomanic symptoms.

Cognitive-Behavioral Therapy for the Bipolar Disorder Patients

“…For example, in combination with negative life stressors, bipolar individuals with dysfunctional attitudes or depressogenic attributional styles are more likely to develop affective symptoms (Alloy et al, 1999). These findings support the rationale for utilizing cognitive-behavioral interventions aimed at modifying maladaptive cognitive styles and decreasing the impact of environmental stress.…”

Lifestyle regularity and cyclothymic symptomatology

“…The HMI (Alloy, Reilly-Harrington, Fresco, Whitehouse, & Zechmeister, 1999;Francis-Raniere et al, 2006) is a 28-item self-report inventory designed to measure the severity of current (hypo)manic symptoms and is administered and scored similarly to the BDI. The HMI assesses the presence and severity of affective, cognitive, motivational, and somatic symptoms of (hypo)mania.…”

Cognitive responses to failure and success relate uniquely to bipolar depression versus mania.

“…Similarly, Seligman et al (1988) found that self-blaming attributions for failure correlated with severity of depression in both unipolar and bipolar depression. Prospective studies have also shown that negative cognitive styles predict increases in bipolar depressive symptoms over time (Alloy, Reilly-Harrington, Fresco, Whitehouse, & Zechmeister, 1999;Johnson & Fingerhut, 2004). Thus it is important to acknowledge that a previous history of depression or current depressive symptoms may account for cognitive patterns observed among persons who also have a history of mania.…”