The British Journal of Psychiatry (2009) 194: 146-151. doi: 10.1192/bjp.bp.107.047894
© 2009 The Royal College of Psychiatrists
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Psychological processes in bipolar affective disorder: negative cognitive style and reward processing

Emma Van der Gucht, MSc

Department of Clinical Psychology, University of Leeds

Richard Morriss, MD

Department of Psychiatry, University of Nottingham

Gill Lancaster, PhD

Postgraduate Statistics Centre, Department of Mathematics and Statistics, University of Lancaster

Peter Kinderman, PhD

Department of Clinical Psychology, University of Liverpool

Richard P. Bentall, PhD

School of Psychology, University of Bangor, Gwynedd, UK

Correspondence: Richard P. Bentall, School of Psychology, Adeilad Brigantia, University of Bangor, Gwynedd LL57 2AS, UK. Email: richard.bentall{at}bangor.ac.uk

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

Psychological processes in bipolar disorder are of both clinical and theoretical importance.

Aims

To examine depressogenic psychological processes and reward responsivity in relation to different mood episodes (mania, depression, remission) and bipolar symptomatology.

Method

One hundred and seven individuals with bipolar disorder (34 in a manic/hypomanic or mixed affective state; 30 in a depressed state and 43 who were euthymic) and 41 healthy controls were interviewed with Structured Clinical Interview for DSM–IV and completed a battery of self-rated and experimental measures assessing negative cognitive styles, coping response to negative affect, self-esteem stability and reward responsiveness.

Results

Individuals in all episodes differed from controls on most depression-related and reward responsivity measures. However, correlational analyses revealed clear relationships between negative cognitive styles and depressive symptoms, and reward responsivity and manic symptoms.

Conclusions

Separate psychological processes are implicated in depression and mania, but cognitive vulnerability to depression is evident even in patients who are euthymic.


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