Psychological vulnerability in bipolar disorder

• Main Author: Pavlickova, Hana
• Published: Bangor University 2013
• Subjects: 616.895
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.613636

Background: The current understanding of bipolar disorder attributes a causal role to abnorma1 psychological processes in its development. However, little research has so far adequately tested this assumption. Two approaches might be employed to do so: (i) longitudinal investigations of psychological processes in patients (with some limitations); (ii) examinations of such processes in high-risk individuals. Methods: Three cohorts of participants were examined: two different cohorts of adults with bipolar disorder (using secondary data, Chapter 2 and 3), and adolescent offspring of parents with bipolar disorder, in comparison to offspring of control parents (Chapters 4, 5, 6). In adults with bipolar disorder, the associations between self-referential processes and symptoms of depression and mania (Chapter 2), and the inter-relationship between self-esteem, mood and response styles (Chapter 3) were examined longitudinally. In adolescent children, longitudinal relationship between mood, self-esteem and coping style (Chapter 4), abnormal psychological processes (Chapter 5), and explicit and implicit self-esteem and their discrepancies (Chapter 6), were investigated. Results: In adults with bipolar disorder, symptoms of depression and mania were associated with distinct psychological processes, with self-esteem being the most robust predictor (Chapter 2). However, mood, rather than self-esteem, instigated, and was affected by, an engagement in coping strategies (Chapter 3). In adolescents, index adolescents showed compromised capacity to employ adaptive coping, and employed risktaking in response to low self-esteem (Chapter 4). Further, no differences in abnormal psychological processes were found, unless children have already met diagnostic criteria for psychiatric disorders (Chapter 5). Despite no differences in explicit and implicit self-esteem, index offspring reported marginally higher level of self-esteem discrepancies. In addition, damaged self-esteem (i.e. low explicit self-esteem and high implicit self-esteem) was related to symptoms of depression, whilst low implicit self-esteem to symptoms of mania. Conclusions: Early coping abnormalities are important markers of individuals at ultra high lisk of bipolar disorder. Further, the relevance of self-esteem in bipolar disorder has been suggested. Implications for future research and psychotherapy are discussed.