Real-world emotion? An experience-sampling approach to emotion experience and regulation in bipolar I disorder

Laboratory studies suggest that bipolar disorder is characterized by emotion dysregulation, yet emotion disturbance has not been systematically described using more ecologically valid methods. Using an experience-sampling approach, we therefore sought to investigate positive and negative emotionality, emotion regulation strategies, and functioning among remitted individuals with bipolar I disorder (BD; n = 31) compared with both healthy controls (CTL; n = 32) and remitted individuals with major depressive disorder (MDD; n = 21). Hierarchical linear modeling analyses of self-report data spanning a 6-day consecutive period revealed that the BD group aligned with the CTL group in reporting greater positive emotionality than the MDD group, but aligned with the MDD group in reporting greater negative emotionality than the CTL group. Furthermore, the BD and MDD groups reported greater general use of emotion regulation strategies than the CTL group. These findings suggest that BD is characterized by amplified emotionality as well as increased efforts to regulate emotions in everyday life. Discussion focuses on implications for BD, as well as identification of unique (disorder-specific) and shared (transdiagnostic) features of emotion disturbance.