Abstract
Psychological models of bipolar disorder (BD), such as the self‐regulation model (SRM; Leventhal, Nerenz, & Steele, 1984), highlight the crucial role of beliefs about mood in relapse vulnerability. To date, no studies have directly compared these beliefs between people with and without BD. Based on the SRM, the current research examined beliefs about mood in people with and without BD and explored the impact of current affect on these beliefs. Fifty euthymic people with a diagnosis of BD and 50 controls were recruited through an online screening study, clinical services, and support organizations. Experience sampling methodology (ESM) was used to assess beliefs (according to the Brief Illness Perceptions Questionnaire; Broadbent, Petrie, Main, & Weinman, 2006) across a typical week of everyday life. Data were analysed using multilevel modelling. Forty‐two people with a diagnosis of BD and 50 controls were included in the analyses. Results indicated that the BD group reported less control over mood, a shorter duration of mood, and less understanding of mood and were more likely to report the cause of depressive symptoms as something internal, compared with controls. When controlling for current affect, the BD group also reported more positive consequences, made more internal attributions for hypomanic symptoms, and reported less concern about mood, compared with controls. Findings suggest important differences in beliefs about mood between people with and without BD that are not the result of current affect. These beliefs may be particularly important in understanding underlying vulnerability to future relapse into depression and/or mania.
Highlights
Beliefs about the cause of current mood were assessed using single items from the Hypomanic Interpretations Questionnaire (HIQ) (Jones et al, 2006; Item “If I felt in high spirits and full of energy, I would probably think it was because I'm a talented person with lots to offer”) and the Interpretations of Depression Questionnaire (IDQ) (Jones & Day, 2008; “If I felt down on myself, I would probably think it was because I am a bad person, even towards myself”) to allow multilevel modelling analysis
Less understanding of mood, and more likely to attribute the cause of depressive symptoms to something internal compared with controls
When current affect was controlled for, the bipolar disorder (BD) group still reported less control over mood, a shorter expected duration of mood, less understanding of mood and were more likely to attribute the cause of depressive symptoms to something internal compared with controls
Summary
This study was conducted in line with the Declaration of Helsinki. The study was approved by a UK local National Health Service (NHS) ethics committee (REC ref: 10/H1015/76), and independently peer reviewed and adopted by the Mental Health Research Network in England (MHRN ref: 59258). Beliefs about the cause of current mood were assessed using single items from the HIQ (Jones et al, 2006; Item “If I felt in high spirits and full of energy, I would probably think it was because I'm a talented person with lots to offer”) and the IDQ (Jones & Day, 2008; “If I felt down on myself, I would probably think it was because I am a bad person, even towards myself”) to allow multilevel modelling analysis These were selected based on the items with the highest loading in principal components analyses of these positive and negative appraisal measures
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