Bipolar Flashcards
CBT Based interventions - Scott et al (2006)
- conducted a large scale, multi-site trial of CBT for complex and severe presentations of BD
- over half of ppts experienced a relapse 12 months post CBT
- no beneficial effect of CBT over ‘treatment as usual’
Criticism?
Lam - (2006)
Jones and Burrell-Hodgson (2008)
More positive outcomes have been reported amongst those earlier in the course of BD or with less acute/severe symptoms
Jones (2004)
- still quality issues associated with CBT trials for BD
- lack of adequate control groups
- treatment adherence
- theoretical basis to therapy
What have other clinical trials focused on? (Specific issues/BD symptoms)
- Co-morbid alcohol use (jones et al. 2019)
- Co-morbid anxiety (jones et al 2018)
- Mindfulness (Murray et al. 2015)
Circadian rhythms
Physiological rhythms corresponding to the 24 hour daily cycle
Why are they important?
In regulating the physiological systems
- melatonin levels
- sleep awake cycles
- activity levels
What are they set by?
Zeitgebers
What are these?
Environmental events that set and regulate the internal body clock
What can they be disturbed by?
Air travel
Changes in routines
Seasons
Juahar and weller (1982), young (1995)
- air travel eastwards is associated with higher rates of manic symptoms than westwards travel
- eastward travel associated more with greater jet lag, greater sleep loss, greater circadian disruption
How are these changes important when determining bipolar symptoms?
When these disruptions are appraised in an extreme self-positive manner
- leads to formation of positive self schema, increases in behavioural activity and mood
Jones et al (2006)
- overly positive interpretations of changes in internal state and objective measures of circadian disruption bipolar individuals
Ankers and Jones (2009)
- high risk individuals for BD also have these overly positive appraisals and more variable bedtimes
