Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-17T06:52:55.044Z Has data issue: false hasContentIssue false

Appraisals of Internal States and their Consequences: Relationship to Adolescent Analogue Bipolar Symptoms

Published online by Cambridge University Press:  01 April 2015

Rebecca E. Kelly*
Affiliation:
South London and Maudsley NHS Foundation Trust, and Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Patrick Smith
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Eleanor Leigh
Affiliation:
South London and Maudsley NHS Foundation Trust, and Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Warren Mansell
Affiliation:
University of Manchester, UK
*
Reprint requests to Rebecca Kelly, Psychological Interventions Clinic for outpatients with Psychosis (PICuP), Maudsley Psychology Centre, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK. E-mail: [email protected]

Abstract

Background: Extreme appraisals of internal states correlate with and prospectively predict mood symptoms in adults, and discriminate individuals with bipolar disorder from individuals with unipolar depression and non-clinical controls. Aims: These findings required replication in adolescents. This study sought to investigate the relationships between appraisals of internal states, mood symptoms and risk for bipolar disorder in an adolescent sample. Method: A non-clinical sample (n = 98) of adolescents completed measures of mood symptoms, appraisals, and mania risk, alongside covariates. Results: Appraisals of internal states were associated with analogue bipolar symptoms, independently of impulsivity and responses to positive affect. Positive appraisals of activated mood states were uniquely associated with hypomania, whilst negative appraisals were uniquely associated with depression and irritability symptoms. Individuals who appraised activated states as both extremely positive and extremely negative were more likely to score at high or moderate risk for future mania. Conclusions: This study is the first to demonstrate associations between appraisals of internal states, analogue mood symptoms and mania risk in adolescents. Clinical implications are discussed.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bauer, M. S., Crits-Christoph, P., Ball, W. A., Dewees, E., McAllister, T., Alahi, P., et al. (1991). Independent assessment of manic and depressive symptoms by self-rating: scale characteristics and implications for study of mania. Archives of General Psychiatry, 48, 807812.CrossRefGoogle ScholarPubMed
Bauer, M. S., Vojta, C., Kinosian, B., Altshuler, L. and Glick, H. (2000). The Internal State Scale: replication of its discriminating abilities in a multi-site, public sector sample. Bipolar Disorders, 2, 340346.Google Scholar
Bijttebier, P., Raes, F., Vasey, M. V. and Feldman, G. C. (2012). Responses to positive affect predict mood symptoms in children under conditions of stress: a prospective study. Journal of Abnormal Child Psychology, 40, 381389.CrossRefGoogle ScholarPubMed
Birmaher, B., Axelson, D., Strober, M., Gill, M. K., Valeri, S., Chiappetta, L., et al. (2006). Clinical course of children and adolescents with bipolar spectrum disorders. Archives of General Psychiatry, 63, 175183.Google Scholar
Carver, C. S. and White, T. L. (1994). Behavioural inhibition, behavioural activation, and affective responses to impending reward and punishment: the BIS/BAS scales. Journal of Personality and Social Psychology, 67, 319333.Google Scholar
Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24, 461470.CrossRefGoogle ScholarPubMed
Cooper, A., Gomez, R. and Aucote, H. (2007). The behavioural inhibition system and behavioural approach system (BIS/BAS) scales: measurement and structural invariance across adults and adolescents. Personality and Individual Differences, 43, 295305.Google Scholar
Dodd, A. L., Mansell, W., Morrison, A. P. and Tai, S. J. (2011). Extreme appraisals of internal states and bipolar symptoms: the Hypomanic Attitudes and Positive Predictions Inventory. Psychological Assessment, 23, 635645.Google Scholar
Dodd, A. L., Mansell, W., Sadhnani, V., Morrison, A. P. and Tai, S. (2010). Principal components analysis of the Hypomanic Attitudes and Positive Predictions Inventory and associations with measures of personality, cognitive style and analogue symptoms in a student sample. Behavioural and Cognitive Psychotherapy, 38, 1534.Google Scholar
Feldman, G. C., Joormann, J. and Johnson, S. L. (2008). Responses to positive affect: a self-report measure of rumination and dampening. Cognitive Therapy and Research, 32, 507525.Google Scholar
Fristad, M. A. and Algorta, G. P. (2013). Future directions for research on youth with bipolar spectrum disorders. Journal of Clinical Child and Adolescent Psychology, 42, 734747.Google Scholar
Giovanelli, A., Hoerger, M., Johnson, S. L. and Gruber, J. (2013). Impulsive responses to positive mood and reward are related to mania risk. Cognition and Emotion, 27, 10911104.Google Scholar
Gruber, J., Eidelman, P., Johnson, S. L., Smith, B. and Harvey, A.G. (2012). Hooked on a feeling: rumination about positive and negative emotion in inter-episode bipolar disorder. Journal of Abnormal Psychology, 120, 956961.Google Scholar
Hirschfeld, R. M. A., Williams, J. B. W., Spitzer, R. L., Calabrese, J. R., Flynn, L., Keck, P. E. Jr., et al. (2000). Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. American Journal of Psychiatry, 157, 18731875.Google Scholar
Isometsae, E., Suominen, K., Mantere, O., Valtonen, H., Leppämäki, S., Pippingsköld, M., et al. (2003). The Mood Disorder Questionnaire improves recognition of bipolar disorder in psychiatric care. BMC Psychiatry, 3, 8.Google Scholar
Kelly, R. E., Mansell, W., Sadhnani, V. and Wood, A. M. (2012). Positive and negative appraisals of the consequences of activated states uniquely relate to symptoms of hypomania and depression. Cognition and Emotion, 26, 899906.Google Scholar
Kelly, R. E., Mansell, W., Wood, A. M., Alatiq, Y., Dodd, A. and Searson, R. (2011). Extreme positive and negative appraisals of activated states interact to discriminate bipolar disorder from unipolar depression and non-clinical controls. Journal of Affective Disorders, 134, 434443.Google Scholar
Mansell, W. (2006). The Hypomanic Attitudes and Positive Predictions Inventory (HAPPI): a pilot study to identify items that are elevated in individuals with bipolar affective disorder compared to non-clinical controls. Behavioural and Cognitive Psychotherapy, 34, 467476.Google Scholar
Mansell, W. (2007). An integrative formulation-based cognitive treatment of bipolar disorders: application and illustration. Journal of Clinical Psychology, 63, 447481.Google Scholar
Mansell, W. and Jones, S. H. (2006). The HAPPI: a questionnaire to assess cognitions that distinguish between individuals with a diagnosis of bipolar disorder and non-clinical controls. Journal of Affective Disorders, 93, 2934.Google Scholar
Mansell, W., Morrison, A. P., Reid, G., Lowens, I. and Tai, S. J. (2007). The interpretation of and responses to changes in internal states in bipolar disorder: an integrative cognitive model. Behavioural and Cognitive Psychotherapy, 35, 515539.Google Scholar
Meyer, B., Johnson, S. L. and Carver, C. S. (1999). Exploring behavioral activation and inhibition sensitivities among college students at risk for bipolar spectrum symptomatology. Journal of Psychopathology and Behavioral Assessment, 21, 275292.Google Scholar
National Institute for Clinical Excellence (NICE) (2006). CG038: the management of bipolar disorder in adults, children and adolescents, in primary and secondary care. London: National Institute for Health and Clinical Excellence.Google Scholar
Pavlickova, H., Turnbull, O. and Bentall, R. P. (2014). Cognitive vulnerability to bipolar disorder in offspring of parents with bipolar disorder. British Journal of Clinical Psychology, 53, 386401.Google Scholar
Ruggero, C. J., Bain, K. M., Smith, P. M. and Kilmer, J. N. (2013). Dysfunctional cognitions among offspring of individuals with bipolar disorder. Behavioural and Cognitive Psychotherapy, 5, 116.Google Scholar
Searson, R., Mansell, W., Lowens, I. and Tai, S. J. (2012). Think Effectively About Mood Swings (TEAMS): a case series of cognitive behavioural therapy for bipolar disorders. Journal of Behavior Therapy and Experimental Psychiatry, 43, 770779.Google Scholar
Stringaris, A., Goodman, R., Ferdinando, S., Razdan, V., Muhrer, E., Leibenluft, E., et al. (2012). The Affective Reactivity Index: a concise irritability scale for clinical and research settings. Journal of Child Psychology and Psychiatry, 53, 11091117.Google Scholar
Udachina, A. and Mansell, W. (2007). Cross-validation of the mood disorders questionnaire, the internal state scale, and the hypomanic personality scale. Personality and Individual Differences, 42, 15391549.Google Scholar
Submit a response

Comments

No Comments have been published for this article.