Extreme cognitions are associated with diminished ability to use disconfirming evidence

Objectives An Integrative Cognitive Model of mood swings and bipolar disorder proposes that cognitive styles characterised by extreme self-referent appraisals of internal states (e.g., ‘If I have a bad night’s sleep it means that I am about to have a breakdown’) interfere with mood regulation. The aim of this study is to determine whether strong endorsement of such appraisals is predicted by a diminished ability to access disconfirming counterexamples. Design We examined whether the ability to access two different categories of counterexample (known as Disabling Conditions and Alternative Causes) would predict endorsement of extreme appraisals (measured by the Hypomanic Attitudes and Positive Predictions Inventory; HAPPI) and mania risk (measured by the Hypomanic Personality Scale; HPS). Method A non-clinical sample of 150 students completed the HAPPI, the HPS and a conditional reasoning task that indexed the ability to access Disabling Conditions and Alternative Causes. Current mood was controlled for using the Internal States Scale. Results The ability to make use of disabling counterexamples during the reasoning task was inversely related with scores on the HAPPI (r= -.19, p<.05); participants that were less able to make use of disabling counterexamples endorsed extreme self-referent appraisals to a greater extent. There was no association between the use of alternative cause counterexamples and the HAPPI, and no association between either measure of counterexample generation and the HPS. Conclusions A diminished ability to use disconfirming evidence when reasoning about the world may reinforce problematic cognitive styles such as extreme, personalised appraisals of experience, which can interfere with mood regulation

Diagnostic efficiency of the SDQ for parents to identify ADHD in the UK:a ROC analysis

BackgroundEarly, accurate identification of ADHD would improve outcomes while avoiding unnecessary medication exposure for non-ADHD youths, but is challenging, especially in primary care.The aim of this paper is to test the Strengths and Difficulties Questionnaire (SDQ) using a nationally representative sample to develop scoring weights for clinical use. MethodThe British Child and Adolescent Mental Health Survey (N=18,232 youths 5 to 15 years old) included semi-structured interview DSM-IV diagnoses and parent-rated SDQ scores. ResultsAreas Under the Curve (AUCs) for SDQ subscales were good (0.81) to excellent (0.96) across sex and age groups. Hyperactive/Impulsive scores of 10+ increased odds of ADHD by 21.3x. For discriminating ADHD from other diagnoses, accuracy was fair (<0.70) to good (0.88); Hyperactive/Impulsive scores of 10+ increased odds of ADHD by 4.47x. ConclusionsThe SDQ is free, easy to score, and provides clinically meaningful changes in odds of ADHD that can guide clinical decision-making in an evidence based medicine framework

Psychological mechanisms and the ups and downs of personal recovery in bipolar disorder

Background Personal recovery is recognized as an important outcome for individuals with bipolar disorder (BD) and is distinct from symptomatic and functional recovery. Recovery-focused psychological therapies show promise. As with therapies aiming to delay relapse and improve symptoms, research on the psychological mechanisms underlying recovery is crucial to inform effective recovery-focused therapy. However, empirical work is limited. This study investigated whether negative beliefs about mood swings and self-referent appraisals of mood-related experiences were negatively associated with personal recovery. Design Cross-sectional online survey. Method People with a verified research diagnosis of BD (n = 87), recruited via relevant voluntary sector organizations and social media, completed online measures. Pearson's correlations and multiple regression analysed associations between appraisals, beliefs, and recovery. Results Normalizing appraisals of mood changes were positively associated with personal recovery. Depression, negative self-appraisals of depression-relevant experiences, extreme positive and negative appraisals of activated states, and negative beliefs about mood swings had negative relationships with recovery. After controlling for current mood symptoms, negative illness models (relating to how controllable, long-term, concerning, and treatable mood swings are; β = −.38), being employed (β = .39), and both current (β = −.53) and recent experience of depression (β = .30) predicted recovery. Limitations Due to the cross-sectional design, causality cannot be determined. Participants were a convenience sample primarily recruited online. Power was limited by the sample size. Conclusions Interventions aiming to empower people to feel able to manage mood and catastrophize less about mood swings could facilitate personal recovery in people with BD, which might be achieved in recovery-focused therapy. Practitioner points •Personal recovery is an important outcome for people living with bipolar disorder •More positive illness models are associated with better personal recovery in bipolar disorder, over and above mood symptoms •Recovery-focused therapy should focus on developing positive illness models •Recovery-focused therapy should address personally meaningful goals such as gaining employmen

How Can the University Environment Support Student Quality of Life? A Novel Conceptual Model

During emerging adulthood (18–25 years), university students have taken steps towards independent living and learning. However, they are also in a liminal phase before the ‘stable roles’ of adulthood. This developmental context distinguishes them from both adolescents and peers who are not attending university. In order to support student well-being, their unique priorities and concerns need to be taken into consideration. This qualitative study explored what life domains were important to students, and what influenced Quality of Life (QoL) within these, in order to build a novel conceptual model of student QoL. Individual interviews (n = 18) were conducted with undergraduate students (aged 18–25 years). The themes derived via Template Analysis were Supportive and Rewarding University Studies, Personal Growth, Social Support, Concerns about Finances and Financial Independence, Physical Environment, Physical and Mental Well-being, and Maintaining Balance. As well as conceptualising QoL in students, this model has practical value for operationalising student QoL. It is a framework to help universities to understand the needs and priorities of students and provide well-being initiatives in line with these needs