Extreme Appraisals of Internal States in Bipolar I Disorder: A Multiple Control Group Study

Mansell, Warren; Paszek, G.; Seal, Karen H.; Pedley, Rebecca; Jones, Sarah Amelia; Thomas, Nia; Mannion, Helena; Saatsi, Sari; Dodd, Alyson

doi:10.1007/s10608-009-9287-1

Cited by 41 publications

(48 citation statements)

References 44 publications

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“…These results were consistent across extreme pessimistic and extreme optimistic attributions, suggesting that the tendency to make extreme attributions in general might be more important in understanding course of illness than the valence of the attributions themselves. These studies have been broadly consistent with theoretical work and empirical studies of BSDs that suggest that individuals with BSDs make extreme appraisals about the meaning of internal mood states (Jones et al, 2006; Kelly et al, 2011; Mansell et al, 2007, 2011), and that these appraisals are associated with increases in symptoms of mood elevation and depression (Dodd et al, 2011). Notably, although studies among samples with unipolar depression also have found that extreme dysfunctional attitudes predict a poorer course of depression (Beevers et al, 2003; Forand & DeRubeis, 2014; Petersen et al, 2007; Teasdale et al, 2001), no study to date has evaluated this question in BSDs.…”

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confidence: 80%

Extreme Cognitions in Bipolar Spectrum Disorders: Associations With Personality Disorder Characteristics and Risk for Episode Recurrence

et al. 2015

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Bipolar spectrum disorders (BSDs) are often characterized by cognitive inflexibility and affective extremities, including “extreme” or polarized thoughts and beliefs, which have been shown to predict a more severe course of illness. However, little research has evaluated factors that may be associated with extreme cognitions, such as personality disorders, which are often characterized by extreme, inflexible beliefs and also are associated with poor illness course in BSDs. The present study evaluated associations between BSDs, personality disorder characteristics, and extreme cognitions (polarized responses made on measures of attributional style and dysfunctional attitudes), as well as links between extreme cognitions and the occurrence of mood episodes, among euthymic young adults with BSDs (n = 83) and demographically-matched healthy controls (n = 89) followed prospectively for three years. The relationship between personality disorder characteristics and negative and positive extreme cognitions was stronger among BSD participants than among healthy controls, even after statistically accounting for general cognitive styles. Furthermore, extreme negative cognitions predicted the prospective onset of major depressive and hypomanic episodes. These results suggest that extreme cognitive styles are most common in individuals with BSDs and personality disorder characteristics, and they provide further evidence that extreme negative cognitions may confer risk for mood dysregulation.

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confidence: 80%

Extreme Cognitions in Bipolar Spectrum Disorders: Associations With Personality Disorder Characteristics and Risk for Episode Recurrence

et al. 2015

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“…The Hypomanic and Positive Predictions Inventory (HAPPI; Mansell, 2006) was constructed to measure key appraisals of the model. The HAPPI has been shown to distinguish bipolar groups from non-clinical controls (Mansell, 2006;Mansell & Jones, 2006) and from people with remitted unipolar depression (Alatiq, Crane, Williams, & Goodwin, 2010;Mansell et al, 2011) and to prospectively predict symptoms of bipolar disorder over one month when controlling for clinical variables (Dodd, Mansell, Morrison, & Tai, 2011). The model is also consistent with experimental (Mansell & Lam, 2006) and qualitative studies of bipolar disorder.…”

Section: Introductionmentioning

confidence: 57%

Think Effectively About Mood Swings (TEAMS): A case series of cognitive–behavioural therapy for bipolar disorders

Searson

Mansell

Lowens

et al. 2012

Journal of Behavior Therapy and Experimental Psychiatry

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“…Consistent with this hypothesis, individuals with bipolar disorder have been demonstrated to have high levels of extreme (conflicting positive and negative) appraisals of internal mood states compared to individuals with major depressive disorder and healthy controls (Kelly et al, 2011; Jones, Mansell & Waller, 2006; Mansell et al, 2011). Furthermore, these appraisals predicted increases in symptoms of mood elevation and depression (Dodd et al, 2011).…”

Section: Introductionmentioning

confidence: 85%

Extreme attributions predict transition from depression to mania or hypomania in bipolar disorder

Stange

Sylvia

Magalhães

et al. 2013

Journal of Psychiatric Research

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Background Relatively little is known about psychological predictors of the onset of mania among individuals with bipolar disorder, particularly during episodes of depression. In the present study we investigated attributional style as a predictor of onset of hypomanic, manic or mixed episodes among bipolar adults receiving psychosocial treatment for depression. We hypothesized that “extreme” (i.e., excessively pessimistic or optimistic) attributions would predict a greater likelihood of developing an episode of mood elevation. Method Outpatients with DSM-IV bipolar I or II disorder (N=105) enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) were randomly allocated to one of three types of intensive psychotherapy for depression or a brief psychoeducational intervention. Patients completed a measure of attributional style at baseline and were followed prospectively for up to one year. All analyses were by intent to treat. Results Logistic regressions and Cox proportional hazards models indicated that extreme (both positively- and negatively-valenced) attributions predicted a higher likelihood of (and shorter time until) transition from depression to a (hypo)manic or mixed episode (ps < .04), independent of the effects of manic or depressive symptom severity at baseline. Extreme attributions were also retrospectively associated with more lifetime episodes of (hypo)mania and depression (ps < .05). Conclusions Evaluating extreme attributions may help clinicians to identify patients who are at risk for experiencing a more severe course of bipolar illness, and who may benefit from treatments that introduce greater cognitive flexibility.

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Extreme Appraisals of Internal States in Bipolar I Disorder: A Multiple Control Group Study

Cited by 41 publications

References 44 publications

Extreme Cognitions in Bipolar Spectrum Disorders: Associations With Personality Disorder Characteristics and Risk for Episode Recurrence

Extreme Cognitions in Bipolar Spectrum Disorders: Associations With Personality Disorder Characteristics and Risk for Episode Recurrence

Think Effectively About Mood Swings (TEAMS): A case series of cognitive–behavioural therapy for bipolar disorders

Extreme attributions predict transition from depression to mania or hypomania in bipolar disorder

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