Exploring emotion related attention & mindfulness in Bipolar Disorder
Research type
Research Study
Full title
Exploring emotion related attention and mindfulness in people with bipolar disorder
IRAS ID
133548
Contact name
Peter Gallagher
Contact email
Research summary
Bipolar disorder (BD) is a mood disorder characterized by manic or hypomanic episodes which mostly alternate with depressive episodes. Historically, BD has been understood as a biological-genetic disorder and the lack of strong psychological models has impeded the development of effective psychological therapies (Jones & Tarrier, 2005) However, there has been a shift in recent years towards a more psychological understanding of BD (BPS, 2010).
One of the first psychological theories of bipolar disorder (and in particular the manic episode) is the ‘manic-defence hypothesis’. This was adapted in to a cognitive model that suggests that negative cognitive processes related to the self can precede mania (Markus 1977). Thus ‘negative bias’ (i.e. higher sensitivity towards negative information) at unconscious levels can instigate mania. This has been coined a “cognitive defence mechanism” and suggests that perception and awareness of emotion may be fundamentally altered in BD and therefore observable even when people are not experiencing mood symptoms.
Part 1 of this study aims to explore this theory within a neuropsychological paradigm called the ‘Attentional Blink’ test. The paradigm uses facial expressions as stimuli displaying different emotions (e.g. neutral or anger). The aim is to see whether patients with BD attend to these faces differently, compared to healthy control participants. In other words, are patients with BD more able to detect angry faces because of a fundamental ‘negative bias’?
Having additional knowledge of differences in emotional attention in BD may, in the future, impact on interventions e.g. the potential of ‘mindful-attention training’ to reduce distressing responses to particular emotional stimuli.
In order to further explore attention in bipolar disorder part 2 of this study addresses the concept of “mindfulness” towards emotions in people with BD. NICE guidelines recommend the use of psychological therapies in the long-term management of BD, in particular Cognitive Behaviour Therapy (CBT), one of the forms of talking therapies with a good evidence base (NICE, 2006). As CBT developed over time, new interventions which try to increase mindfulness as a specific coping strategy are more frequently used during such treatments (here, mindfulness refers to an individual’s awareness of their own emotions, being conscious of them and being able to regulate them in a more helpful manner).
Part 2 of this study aims to increase our understanding of mindfulness in people with BD in order to help tailor mindfulness interventions for this group in the future. Prior research has shown that Individuals with BD score lower on tests of trait mindfulness than the general population when mood and comorbid anxiety disorders are not accounted for (e.g. Perich et al., 2011). This study aims to replicate and extend this by exploring the effect of high, low and ‘normal’ mood on mindfulness in the two groups (patients with BD, healthy controls) using questionnaires and a calendar based assessment of mood. The reason for taking into account mood is that Perich et al (2011) found some evidence that mood could play a role to what extent patients with BD differ in being mindful and attentive to emotions.REC name
North East - Tyne & Wear South Research Ethics Committee
REC reference
13/NE/0209
Date of REC Opinion
8 Aug 2013
REC opinion
Further Information Favourable Opinion