“…Even if all internal factors that predict lower functioning were identified and successfully treated, people with BD may still not achieve functional recovery due to environmental influences that include level of expressed emotion (i.e., criticism or stigmatization of person with BD) in families (Elgie & Morselli, 2007;McMurrich & Johnson, 2009), stigma (Michalak et al, 2011;Perlick et www.intechopen.com al., 2001;Vazquez et al, 2011), discrimination Elgie & Morselli, 2007;Michalak et al, 2007;Tse & Yeats, 2002), and lack of social support (Elgie & Morselli, 2007;Michalak, Yatham, Kolesar, & Lam, 2006;Michalak et al, 2011). This notion is consistent with qualitative studies showing people with BD describing stigma, discrimination, reduction in social (especially family) support, shame and identity loss as the greatest challenges they face in dealing with their illness and functional recovery (Elgie & Morselli, 2007;Michalak et al, 2006;Michalak et al, 2007;Michalak et al, 2011;Proudfoot et al, 2009). People with BD describe social validation and support as the most important components that determine their quality of life (QOL; Michalak et al, 2006;Michalak et al, 2007;Michalak et al, 2011).…”