Understanding Bipolar Disorder Within a Biopsychosocial Emotion Dysregulation Framework

This is the author accepted manuscript. The final version is available on open access from Elsevier via the DOI in this recordBipolar disorder is characterized by extreme mood fluctuations and ongoing affective instability. Mechanisms involved in emotion regulation (ER) seem to be a contributing factor, however the nature and extent of these are not clear yet. The aim of the current review is to contribute to a comprehensive model that covers the full scope of the emotion regulation processes in BD, in order to understand the psychological mechanisms that could contribute to the onset of both manic and depressive states. To this end we review each stage (attentional, behavioural and cognitive processes) of the Process Model of Emotion Regulation in relation to the extant literature on mood or emotion-linked responses in BD. Additionally, potential vulnerability factors (e.g. biological, genetic, personality) for dysfunctional emotion regulation patterns are described. We conclude that on all levels of the emotion regulation model there are seemingly contradictory findings in BD, with evidence for a profile that is characterized by the tendency to upregulate positive affect, as well as a profile that tends to over-use downregulation strategies for both positive and negative affect. These profiles could be characterized by different emotion regulation mechanisms, personality profiles and biological and psychological vulnerability factors. Based on these findings we tentatively identify two emotion regulation profiles in BD (reflecting ‘approach’ and ‘avoidant’ behaviours respectively) and discuss clinical implications and different treatment approaches. To illustrate the latter, we present two clinical cases of both ER profiles and their different treatment approaches

Traumatic experiences, family functioning, and mood disorder development in bipolar offspring

Objectives. Studies in children of patients affected with bipolar disorder (BD; bipolar offspring) are at high risk to develop mood disorders. Our aim is to investigate how environmental factors such as childhood trauma and family functioning relate to the development of mood disorders in offspring at familial risk for BD. Design. The current study is part of a longitudinal prospective cohort study among offspring of parents with BD. Methods. The current study is part of the Dutch Bipolar Offspring Study, an ongoing prospective cohort study among adolescent offspring of a parent with BD. Bipolar offspring were psychiatrically evaluated at baseline and at 1-, 5-, and 12-year follow-up. Complete follow-up data over de 12-year follow-up were available for 102 offspring. Childhood trauma was measured with the Childhood Trauma Questionnaire (CTQ) and filled out by the offspring. Family functioning was reported by the mother with the 130- item Questionnaire for Family Problems (QFP). Results. Emotional maltreatment was significantly associated (HR = 1.82, CI 1.18–2.82, p = .007) with mood disorder onset in bipolar offspring. No association was found with the family functioning total score (HR = 1.04, CI 0.94–15, p = .085) nor its subscales. Conclusions. The current study suggests that emotional maltreatment is associated with mood disorder development in bipolar offspring. Remarkably, the association of offspring-reported emotional maltreatment and mood disorder onset was not reflected in parent-reported family functioning (e.g., support and communication, openness or involvement). Possible explanations are discussed and warrant further stud

The simulation of transport processes in cementitious materials with embedded healing systems

A new model for simulating the transport of healing agents in self-healing (SH) cementitious materials is presented. The model is applicable to autonomic SH material systems in which embedded channels, or vascular networks, are used to supply healing agents to damaged zones. The essential numerical components of the model are a crack flow model, based on the Navier-Stokes equations, which is coupled to the mass balance equation for simulating unsaturated matrix flow. The driving forces for the crack flow are the capillary meniscus force and the force derived from an external (or internal) pressure applied to the liquid healing agent. The crack flow model component applies to non-uniform cracks and allows for the dynamic variation of the meniscus contact angle, as well as accounting for inertial terms. Particular attention is paid to the effects of curing on the flow characteristics. In this regard, a kinetic reaction model is presented for simulating the curing of the healing agent and a set of relationships established for representing the variation of rheological properties with the degree of cure. Data obtained in a linked experimental programme of work is employed to justify the choice and form of the constitutive relationships, as well as to calibrate the model’s evolution functions. Finally, a series of validation examples are presented that include the analysis of a series of concrete beam specimens with an embedded vascular network. These examples demonstrate the ability of the model to capture the transport behaviour of this type of SH cementitious material system