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Symptom-specific self-referential cognitive processes in bipolar disorder: a longitudinal analysis.

H Pavlickova¹, F Varese, O Turnbull

¹School of Psychology, Bangor University, UK.

Psychological Medicine

|December 1, 2012

Summary

In bipolar disorder, depression and mania are linked to distinct psychological processes, with self-esteem playing a key role. Low self-esteem predicts future depression, impacting therapeutic strategies.

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Area of Science:

Psychiatry
Clinical Psychology
Behavioral Science

Background:

Bipolar disorder symptoms, depression and mania, are often viewed as opposites but show weak positive correlation.
These symptoms vary independently over time, necessitating consideration of comorbidity and temporal changes in research.
Understanding psychological processes linked to specific bipolar disorder symptoms is crucial for effective treatment.

Purpose of the Study:

To investigate the relationship between psychological processes and specific symptoms in bipolar disorder.
To examine how self-esteem, dysfunctional attitudes, and attributional styles relate to depression and mania.
To explore prospective associations between psychological factors and symptom development over time.

Main Methods:

A longitudinal study involving 253 patients with bipolar disorder.
Data collected every 24 weeks for 18 months using validated scales for depression, mania, self-esteem, dysfunctional attitudes, and attributions.
Multilevel modeling was employed to analyze the nested data structure.

Main Results:

Mania and depression showed a weak but significant association, each linked to distinct psychological processes.
Self-esteem demonstrated the strongest association: low positive and high negative self-esteem with depression, and high positive self-esteem with mania.
Prospectively, low self-esteem was a significant predictor of future depressive episodes.

Conclusions:

Distinct self-referential thinking patterns are associated with different phases of bipolar disorder.
The presence of a negative self-concept in both depression and mania has significant implications for treatment.
Findings suggest new directions for research into the psychological underpinnings of bipolar disorder.