Extreme attributions predict transition from depression to mania or hypomania in bipolar disorder

Stange, Jonathan P., Sylvia, Louisa G., Magalhães, Pedro Vieira da Silva, Frank, Ellen, Otto, Michael W., Miklowitz, David J., Berk, Michael, Nierenberg, Andrew A. and Deckersbach, Thilo 2013, Extreme attributions predict transition from depression to mania or hypomania in bipolar disorder, Journal of psychiatric research, vol. 47, no. 10, pp. 1329-1336, doi: 10.1016/j.jpsychires.2013.05.016.

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Title Extreme attributions predict transition from depression to mania or hypomania in bipolar disorder
Author(s) Stange, Jonathan P.
Sylvia, Louisa G.
Magalhães, Pedro Vieira da Silva
Frank, Ellen
Otto, Michael W.
Miklowitz, David J.
Berk, MichaelORCID iD for Berk, Michael orcid.org/0000-0002-5554-6946
Nierenberg, Andrew A.
Deckersbach, Thilo
Journal name Journal of psychiatric research
Volume number 47
Issue number 10
Start page 1329
End page 1336
Total pages 8
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2013-10
ISSN 1879-1379
Keyword(s) Attributional style
Cognitive style
Cognitive vulnerability
Manic switch
Bipolar Disorder
Diagnostic and Statistical Manual of Mental Disorders
Disease Progression
Middle Aged
Proportional Hazards Models
Psychiatric Status Rating Scales
Surveys and Questionnaires
Young Adult
Science & Technology
Life Sciences & Biomedicine
Summary BACKGROUND: Relatively little is known about psychological predictors of the onset of mania among individuals with bipolar disorder, particularly during episodes of depression. In the present study we investigated attributional style as a predictor of onset of hypomanic, manic or mixed episodes among bipolar adults receiving psychosocial treatment for depression. We hypothesized that "extreme" (i.e., excessively pessimistic or optimistic) attributions would predict a greater likelihood of developing an episode of mood elevation.
METHOD: Outpatients with DSM-IV bipolar I or II disorder (N = 105) enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) were randomly allocated to one of three types of intensive psychotherapy for depression or a brief psychoeducational intervention. Patients completed a measure of attributional style at baseline and were followed prospectively for up to one year. All analyses were by intent to treat.
RESULTS: Logistic regressions and Cox proportional hazards models indicated that extreme (both positively- and negatively-valenced) attributions predicted a higher likelihood of (and shorter time until) transition from depression to a (hypo)manic or mixed episode (ps < .04), independent of the effects of manic or depressive symptom severity at baseline. Extreme attributions were also retrospectively associated with more lifetime episodes of (hypo)mania and depression (ps < .05).
CONCLUSIONS: Evaluating extreme attributions may help clinicians to identify patients who are at risk for experiencing a more severe course of bipolar illness, and who may benefit from treatments that introduce greater cognitive flexibility.
Language eng
DOI 10.1016/j.jpsychires.2013.05.016
Field of Research 110904 Neurology and Neuromuscular Diseases
110319 Psychiatry (incl Psychotherapy)
111714 Mental Health
Socio Economic Objective 920410 Mental Health
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2013, Elsevier Ltd.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30067216

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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