Mental imagery in bipolar affective disorder versus unipolar depression: Investigating cognitions at times of ‘positive’ mood

AbstractBackgroundCompared to unipolar depression (UD), depressed mood in bipolar disorder (BD) has been associated with amplified negative mental imagery of the future (‘flashforwards’). However, imagery characteristics during positive mood remain poorly explored. We hypothesise first, that unlike UD patients, the most significant positive images of BD patients will be ‘flashforwards’ (rather than past memories). Second, that BD patients will experience more frequent (and more ‘powerful’) positive imagery as compared to verbal thoughts and third, that behavioural activation scores will be predicted by imagery variables in the BD group.MethodsBD (n=26) and UD (n=26) patients completed clinical and trait imagery measures followed by an Imagery Interview and a measure of behavioural activation.ResultsCompared to UD, BD patients reported more ‘flashforwards’ compared to past memories and rated their ‘flashforwards’ as more vivid, exciting and pleasurable. Only the BD group found positive imagery more ‘powerful’, (preoccupying, ‘real’ and compelling) as compared to verbal thoughts. Imagery-associated pleasure predicted levels of drive and reward responsiveness in the BD group.LimitationsA limitation in the study was the retrospective design. Moreover pathological and non-pathological periods of “positive” mood were not distinguished in the BD sample.ConclusionsThis study reveals BD patients experience positive ‘flashforward’ imagery in positive mood, with more intense qualities than UD patients. This could contribute to the amplification of emotional states and goal directed behaviour leading into mania, and differentiate BD from UD

Considering a role for verbal thoughts and mental imagery in mania

Bipolar disorder is a difficult disorder which can significantly impact upon an individual's physical, psychological and functional wellbeing. The progress made in developing effective psychological interventions for other severe and enduring mental health conditions is yet to be matched by advances in the psychological treatment of bipolar disorder. Two areas of emerging research have show.n promise: the association between personal goals and risk of mania; and the identification of intrusive mental imagery during the mood states defining bipolar disorder. Gaining an increased understanding of the cognitive processes involved in mania could inform the development of new treatment models for bipolar disorder. The review paper critically evaluates the literature investigating the association between personal goals and risk of mania, plus evidence for a role of future cognition in anxiety, depression and bipolar disorder. The review concludes that future research should more specifically investigate the relevance of goals to a psychiatric population of individuals with bipolar disorder and that mental imagery appears to play a role in the maintenance of mood disorders. Future research endeavours should bridge the gap that is evident between these diverse fields of enquiry. The empirical paper investigates the experience of mental imagery during periods of positive mood among individuals with bipolar disorder or unipolar disorder. All participants (n=36) reported experiencing intrusive mental imagery during their last period of positive mood. The predicted differences between- and within- groups in the frequency and properties of their imagery and thoughts were not found, although trends were in the predicted direction. There was a significant difference between the groups on a measure of goal-striving. Content analysis of each participant's most significant image yielded a range of interesting findings. Despite its limitations, this study provides evidence of theoretical and clinical interest, thus further research with a larger sample size is warranted.EThOS - Electronic Theses Online ServiceGBUnited Kingdo