Emotion regulation in bipolar disorder: Are emotion  regulation abilities less compromised in euthymic bipolar disorder than unipolar depressive or anxiety disorders?

Kate Cruise,Darryl Bassett,Rodrigo Becerra,Sean Hood,Alfred Allan,Craig Harms,Greg Murray

doi:10.4236/ojpsych.2013.34a001

Abstract

Objective: This study investigated the profile of emotion dysregulation in Bipolar Disorder (BD) and compared it to Unipolar Depression, Anxiety, and Healthy control groups. Methods: 148 euthymic patients diagnosed with BD (n = 48), Unipolar Depressive disorder (n = 50), Anxiety disorder (n = 50), and a Healthy Control (HC) group (n = 48) were evaluated using the Difficulties in Emotion Regulation Scale (DERS). The DERS yields a total score in addition to scores on six subcomponents believed to encapsulate the emotion dysregulation construct. Results: Compared to the healthy control group, all clinical groups (BD, Unipolar Depression, and Anxiety) reported significantly greater overall difficulties in emotion regulation (Total DERS) and difficulties specific to the DERS subcomponent measures: Goals, Impulse, and Strategies. The profile of emotion dysregulation was virtually identical for the Unipolar Depression and Anxiety groups, with BD demonstrating emotion regulation difficulties intermediate between controls and the two clinical groups. Specifically, emotion regulation in the BD group was significantly less compromised in the domains of acceptance of emotions, emotional awareness, and emotional clarity compared to the depression and anxiety groups. Conclusions: Emotion regulation abilities among people with euthymic BD were significantly less compromised than Unipolar Depression and Anxiety groups with regards to emotional awareness, acceptance of emotions, and understanding of emotions. However, emotion regulation abilities pertaining to engagement in goal directed behaviour, impulse control, and access to emotion regulation strategies were similarly compromised across all three clinical groups. This profile might help enrich extant adjunct psychological interventions for BD by enlisting emotion regulation strategies with the aim of decreasing the relapse rate that characterises BD.

Highlights

Bipolar Disorder (BD) is a chronic psychiatric condition characterised by manic, depressive and mixed states (American Psychiatric Association, 2000)
No significant differences were demonstrated between groups with regards to age F (3179) = 0.836, p = 0.476 (HC: 41.36 ± 11.51; BD: 44.90 ± 11.65; Unipolar Depression: 44.12 ± 11.71; Anxiety: 43.73 ± 10.01) or gender composition χ2 (3) = 5.80, p = 0.122
The proportion of individuals completing secondary and tertiary education were higher among the Healthy Control (HC) and BD groups compared to the Unipolar Depression and Anxiety groups, with a higher proportion of HC participants completing tertiary education than all of the clinical groups

Summary

Introduction

Bipolar Disorder (BD) is a chronic psychiatric condition characterised by manic, depressive and mixed states (American Psychiatric Association, 2000). In spite of significant advances in its treatment, the course of BD is typically characterised by high rates of relapse and hospitalisation. A seminal longitudinal study found that 37% of patients taking mood stabilizing medications relapsed within one year, 60% in two years, and 73% in five or more years [1]. Psychosocial functioning and quality of life often remain impaired between mood episodes [2,3,4]. Several factors are recognised to trigger mood episodes including psychosocial challenges and their emotional consequences [6]. There is little research on the emotional strategies that people with BD use to deal with psychosocial challenges. Little is known about the emotion regulation (ER) profile associated with BD

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Conclusion