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Cognitive Behavioural Therapy for Cyclothymia: Cognitive Regulatory Control as a Mediator of Mood Change

Published online by Cambridge University Press:  22 February 2012

Peter Totterdell ,
Stephen Kellett  and
Warren Mansell
Peter Totterdell*
Affiliation:
University of Sheffield, UK
Stephen Kellett
Affiliation:
University of Sheffield, UK
Warren Mansell
Affiliation:
University of Manchester, UK
*
Reprint requests to Peter Totterdell, Department of Psychology, University of Sheffield, Sheffield S10 2TN, UK. E-mail: [email protected]
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Abstract

Background: Regulatory control of cognition is implicated in the amplification of mood variability in cyclothymia. Aims: This study examined whether cognitive behavioural therapy (CBT) directed at enhanced awareness and mood change could change global functioning, mood variability and regulatory control. Method: Using a prospective single case experimental design, mood and cognitive control ratings were recorded every 4 hours for 51 weeks by a patient diagnosed with cyclothymia, including a 5-week baseline, a 35-week (19 session) CBT intervention period and an 11-week follow-up period. Results: Findings indicated that the patient experienced reduced mood variability and greater regulatory control, became happier and less anxious but felt less energetic. Following CBT, high energy became negatively associated with positive mood, and this change was mediated by an increase in control over thoughts. Conclusions: The results suggest that CBT directed at cognitive control and mindfulness skills may help in the treatment of cyclothymia.

Keywords

Cyclothymiamood regulationsingle case experimental designcognitive behavioural therapydiary study
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 40 , Issue 4 , July 2012 , pp. 412 - 424
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2012

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References

Akiskal, H. S. (2001). Dysthymia and cyclothymia in psychiatric practice a century after Kraepelin. Journal of Affective Disorders, 62, 17–31.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th edn). Washington, DC: American Psychiatric Association.Google Scholar
Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J. and Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27–45.CrossRefGoogle ScholarPubMed
Barkham, M., Hardy, G. E. and Startup, M. (1996). The IIP-32: a short version of the Inventory of Interpersonal Problems. British Journal of Clinical Psychology, 35, 21–35.CrossRefGoogle Scholar
Basco, M. R. and Rush, A. J. (2005). Cognitive Behaviour Therapy for Bipolar Disorder (2nd edn). New York: Guilford Press.Google Scholar
Beck, A. T., Steer, R. A. and Brown, G. K. (1995). BDI-II Manual. San Antonio, US: The Psychological Corporation, Harcourt Brace and Co.Google Scholar
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., et al. (2004). Mindfulness: a proposed operational definition. Clinical Psychology: Science and Practice, 11, 232–241.Google Scholar
Bolger, N., Davis, A. and Rafaeli, E. (2003). Diary methods: capturing life as it is lived. Annual Review of Psychology, 54, 579–616.CrossRefGoogle ScholarPubMed
Brieger, P. F. and Marneros, A. (1998). Dysthymia and cyclothymia – serious consequences of rarely diagnosed disorders. Versicherungsmedizin, 50, 215–218.Google ScholarPubMed
Burt, C. D. (1994). Prospective and retrospective account-making in diary entries: a model of anxiety reduction and avoidance. Anxiety, Stress, and Coping, 6, 327–340.CrossRefGoogle Scholar
Derogatis, L. R. (1993). Brief Symptom Inventory (BSI): Administration, scoring and procedures manual (3rd edn). National Computer Systems, Inc.Google Scholar
Ehlers, C. L., Frank, E. and Kupfer, D. J. (1988). Social zeitgebers and biological rhythms. Archives of General Psychiatry, 45, 948–952.CrossRefGoogle ScholarPubMed
First, M. B., Spitzer, R. L, Gibbon, M. and Williams, J. B. W. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV). Washington, DC: American Psychiatric Press.Google Scholar
Frank, E., Swartz, H. A. and Kupfer, D. J. (2000). Interpersonal and social rhythm therapy: managing the chaos of bipolar disorder. Biological Psychiatry, 48, 593–604.CrossRefGoogle ScholarPubMed
Goodman, D. A. (1996). 20-year chronobiologic study of a middle-aged cyclothymic male patient. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 20, 1325–1339.CrossRefGoogle Scholar
Grandin, L. D., Alloy, L. B. and Abramson, L. Y. (2006). The social zeitgeber theory, circadian rhythms, and mood disorders: review and evaluation. Clinical Psychology Review, 26, 679–694.CrossRefGoogle ScholarPubMed
Hersen, M. and Barlow, D. H. (1976). Single Case Experimental Design: strategies for studying behavior change. New York: Pergamon Press.Google Scholar
Jacobsen, F. M. (1993). Low-dose valproate: a new treatment for cyclothymia, mild rapid cycling disorders, and premenstrual syndrome. Journal of Clinical Psychiatry, 54, 229–234Google ScholarPubMed
Jacobson, N. S. and Traux, P. (1991). Clinical significance: a statistical approach to defining change in psychotherapy research. Journal of Abnormal Psychology, 59, 12–19.Google ScholarPubMed
Jones, S. H. (2001). Circadian rhythms, multilevel models of emotion and bipolar disorder: an initial step towards integration? Clinical Psychology Review, 21, 1193–1209.CrossRefGoogle ScholarPubMed
Kellett, S. (2007). The time series evaluation of the treatment of histrionic personality disorder with cognitive analytic therapy. Psychology and Psychotherapy: Theory, Research and Practice, 80, 389–405.CrossRefGoogle ScholarPubMed
Kellett, S. and Beail, N. (1997). The treatment of chronic post-traumatic nightmares using psychodynamic-interpersonal psychotherapy: a single-case study. British Journal of Medical Psychology, 70, 35–49.CrossRefGoogle ScholarPubMed
Mansell, W. (2006). The Hypomanic Attitudes and Positive Predictions Inventory (HAPPI): a pilot study to select cognitions that are elevated in individuals with bipolar disorder compared to non-clinical controls. Behavioural and Cognitive Psychotherapy, 34, 467–476.CrossRefGoogle Scholar
Mansell, W. (2007). An integrative formulation-based cognitive treatment of bipolar disorders: application and illustration. Journal of Clinical Psychology: In Session, 63, 447–461.CrossRefGoogle ScholarPubMed
Mansell, W., Morrison, A. P., Reid, G., Lowens, I. and Tai, S. (2007). The interpretation of, and responses to, changes in internal states: an integrative cognitive model of mood swings and bipolar disorders. Behavioural and Cognitive Psychotherapy, 35, 515–539.Google Scholar
Mansell, W. and Padley, R. (2007). The ascent into mania: a review of the psychological processes associated with the development of manic symptoms. Clinical Psychology Review, 28, 494–520.CrossRefGoogle Scholar
Mansell, W., Rigby, Z., Tai, S. and Lowe, C. (2008). Do current beliefs predict hypomanic symptoms beyond personality style? Factor analysis of the hypomanic attitudes and positive predictions inventory (HAPPI) and its association with hypomanic symptoms in a student population. Journal of Clinical Psychology, 64, 450–465.CrossRefGoogle Scholar
Matthews, G., Jones, D. M. and Chamberlain, A. G. (1990). Refining the measurement of mood: the UWIST mood adjective checklist. British Journal of Psychology, 81, 17–42.CrossRefGoogle Scholar
Moore, P. (2007). Formulation diagrams: is there more than meets the eye? Clinical Psychology Forum, 174, 9–13.CrossRefGoogle Scholar
Muller, D., Judd, C. M. and Yzerbyt, V. Y. (2005). When mediation is moderated and moderation is mediated. Journal of Personality and Social Psychology, 89, 852–863.CrossRefGoogle ScholarPubMed
Shen, G. H., Sylvia, L. G., Alloy, L. B., Barrett, F., Kohner, M., Iacoviello, B. and Mills, A. (2008). Lifestyle regularity and cyclothymic symptomatology. Journal of Clinical Psychology, 64, 482–500.CrossRefGoogle ScholarPubMed
Stone, A. A., Kessler, R. C. and Haythornthwaite, J. A. (1991). Measuring daily events and experiences: decisions for the researcher. Journal of Personality, 59, 575–606.CrossRefGoogle ScholarPubMed
Totterdell, P. and Kellett, S. (2008). Restructuring mood in cyclothymia using cognitive behavioral therapy: an intensive time-sampling study. Journal of Clinical Psychology, 64, 501–518.CrossRefGoogle ScholarPubMed
West, S. G. and Hepworth, J. T. (1991). Statistical issues in the study of temporal data: daily experiences. Journal of Personality, 59, 609–662.CrossRefGoogle Scholar
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