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How is affective instability defined and measured? A systematic review.
1Division of Mental Health and Wellbeing, Warwick Medical School,University of Warwick,Coventry,UK.
Psychological Medicine
|October 1, 2013
Summary
Affective instability (AI) lacks a clear definition and consistent measurement in clinical research. This review proposes a definition and highlights the need for a new, validated AI assessment tool.
Area of Science:
- Psychiatry and Clinical Psychology
- Affective Science
- Mental Health Research
Background:
- Affective instability (AI) is a clinically significant but poorly defined construct.
- Existing research lacks consensus on the precise definition and measurement of AI.
Purpose of the Study:
- To systematically review and analyze the definitions and measures of affective instability used in clinical populations.
- To identify gaps in current understanding and propose a refined definition and assessment strategy for AI.
Main Methods:
- A systematic review adhering to PRISMA guidelines was conducted.
- Searches included major databases (MEDLINE, Embase, PsycINFO, etc.) and hand searches of key journals.
- Data from 37 selected empirical studies were narratively synthesized after quality appraisal.
Main Results:
- Seven distinct definitions of AI were identified, alongside numerous related terms with overlapping features.
- Twenty-four different measures were found, assessing facets like oscillation, intensity, regulation ability, and environmental triggers.
- Significant overlap and lack of definitional clarity were observed across studies.
Conclusions:
- A precise definition of AI is crucial for advancing clinical research and practice.
- The proposed definition for AI is 'rapid oscillations of intense affect, with a difficulty in regulating these oscillations or their behavioural consequences'.
- Current measures are insufficient; a combination is needed, alongside development of a new, validated short AI assessment tool.
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