Bipolar Disorder Flashcards
1
Q
List the 5 disorders in the bipolar spectrum
A
- Major depression
- Sub-syndromal depression
- Sub-syndromal elevated mood
- Hypomania
- Mania
2
Q
What disorders are included in Bipolar Disorder Type 1?
A
- Major depression
- Sub-syndromal depression
- Sub-syndromal elevated mood
- Hypomania
- Mania
3
Q
What disorders are included in Bipolar Disorder Type 2?
A
- Major depression
- Sub-syndromal depression
- Sub-syndromal elevated mood
- Hypomania
4
Q
What disorders are included in Cyclothymia?
A
- Sub-syndromal depression
- Sub-syndromal elevated mood
5
Q
How do we know if the symptoms of a disorder are ‘normal’ subjectively?
List 3 questions we would normally ask
A
- Have I had them?
- Have my friends had them?
- Do they seem ‘normal’?
6
Q
How do we know if the symptoms of a disorder are ‘normal’ objectively?
List 4 questions we would normally ask
A
- Are they on a continuum, i.e. part of a ‘normal’ distribution?
- Do people without a disorder experience them?
- Can a person experience them and function effectively?
- Can they be explained by within ‘normal’ accounts of cognitive functioning?
7
Q
Describe of Udachina & Mansell’s (2007) study on Self-reported History of Hypomanic Symptoms in a Student Population
List 2 points
A
- Mood Disorder Questionnaire is a self-report inventory that screens for a lifetime history of (hypo)manic experiences
- Study sample (n = 167 first-year psychology undergraduate students)
8
Q
What is a Mood Disorder Questionnaire?
A
A self-report inventory that screens for a lifetime history of (hypo)manic experiences
9
Q
A self-report inventory that screens for a lifetime history of (hypo)manic experiences
This is known as…?
A
Mood Disorder Questionnaire
10
Q
What are the 3 characterisations of mood episodes in bipolar disorder?
A
- The mood episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic
- The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
- The disturbance in mood and change in functioning is observable by others
11
Q
Mood episodes in bipolar disorder is associated with …?
A
An unequivocal change in functioning that is uncharacteristic of the person when not symptomatic
12
Q
What are the symptoms of major depression?
List 3 points
A
- At least 2 weeks of:
Depressed mood, most of the day, nearly every day
and/or
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
- Plus at least three symptoms:
- Significant change in appetite or weight
- Insomnia or hypersomnia
- Psychomotor agitation / retardation
- Fatigue or loss of energy
- Feelings of worthlessness and/or inappropriate guilt
- Diminished ability to think of concentrate
- Recurrent thoughts of death, suicidal ideation, suicide attempt, or a specific plan for committing suicide
13
Q
What are the symptoms of mania?
List 4 points
A
- At least 1 week of abnormally and persistently elevated, expansive or irritable mood
And
- Abnormally and persistently increased activity or energy
- Plus at least three or more of:
- Inflated self esteem / grandiosity
- Decreased need for sleep
- More talkative than usual, pressure of speech
- Flight of ideas, thoughts racing
- Distractibility
- Increased in goal-directed activity/physical agitation
- Excessive involvement in pleasurable activities that may have high potential for painful consequences
- Mania must lead to marked impairment in social or occupational functioning, hospitalisation, or psychosis
14
Q
Mania must lead to…?
List 3 things
A
- Impairment in social or occupational functioning
- Hospitalisation
- Psychosis
15
Q
Leads to:
- Impairment in social or occupational functioning
- Hospitalisation
- Psychosis
Which disorder does this apply to?
A
Mania
16
Q
What are the symptoms of hypomania?
List 3 points
A
- At least 4 days of abnormally and persistently elevated, expansive or irritable mood
And
- Abnormally and persistently increased activity or energy
- Plus at least three or more of:
- Inflated self esteem / grandiosity
- Decreased need for sleep
- More talkative than usual, pressure of speech
- Flight of ideas, thoughts racing
- Distractibility
- Increased in goal-directed activity/physical agitation
- Excessive involvement in pleasurable activities that may have high potential for painful consequences
17
Q
A milder version of mania that typically lasts for a shorter period
This is known as…?
A
Hypomania
18
Q
What are the 4 predictors of relapse in bipolar disorder
A
- Stressful interpersonal life events
- High ‘Expressed Emotion’ (hostility, overprotectiveness, criticism) in family members
- Disrupted social rhythm events including sleep changes
- Goal-attainment Events *manic symptoms and not depression
19
Q
- Stressful interpersonal life events
- High ‘Expressed Emotion’ (hostility, overprotectiveness, criticism) in family members
- Disrupted social rhythm events including sleep changes
- Goal-attainment Events *manic symptoms and not depression
What do these predict?
A
Relapse in bipolar disorder
20
Q
What are the symptoms of cyclothymia?
List 3 points
A
- For at least 2 years:
numerous periods of hypomanic symptoms not meeting threshold for hypomanic episodes - Numerous periods of depressed mood / loss of interest that do not meet depression
- The symptoms cause clinically significant distress or impairment in:
- Social
- Occupational
- Or other important areas of functioning
21
Q
What are the symptoms of other specified bipolar disorder?
List 8 points
A
- Short-duration hypomanic like episodes (2-3 days) and major depressive episodes
- Hypomanic-like episodes with insufficient symptoms and major depressive episodes
- Hypomanic episodes without prior major depressive episode(s)
- Short-duration cyclothymia
- Short-duration manic-like episodes
- Unable to determine whether bipolar or related disorder is primary
- Other (describe)
- Unspecified
22
Q
What is the Bipolar At Risk (BAR) Criteria?
List 3 points
A
- Early detection of BD has focused on familial risk & identification of state-trait factors
- Standardised Bipolar At Risk (BAR) criteria developed by Bechdolf & colleagues (2010):
Youth (15-25) experiencing:
- Short duration (and/or less symptoms) high mood
- Short duration (and/or less symptoms) high & low mood
- First degree relative with BD plus low mood
- BAR criteria has predictive validity, can be reliably assessed in an NHS context, & holds clinical utility
23
Q
Early detection of BD has focused on ____ and ____
A
- Familial risk
- Identification of state-trait factors
24
Q
Early detection of ___ has focused on:
- Familial risk
- Identification of state-trait factors
A
Bipolar disorder
25
Who developed the Standardised Bipolar At Risk (BAR) criteria?
Bechdolf & colleagues (2010)
26
Describe the Standardised Bipolar At Risk (BAR) criteria developed by Bechdolf & colleagues (2010)
List 3 points
Youth (15-25) experiencing:
1. Short duration (and/or less symptoms) high mood
2. Short duration (and/or less symptoms) high & low mood
3. First degree relative with BD plus low mood
27
True or False?
Bipolar At Risk (BAR) Criteria does not have predictive validity
False
Bipolar At Risk (BAR) Criteria has predictive validity
It can be reliably assessed in an NHS context and holds clinical utility
28
Bipolar disorder affects __% of the population
a. 10-15%
b. 8-12%
c. 4-7%
d. 1-3%
d. 1-3%
29
What is the average duration of illness (DUI) for bipolar disorder?
6-10 years, or longer for onset in adolescence
30
Longer average duration of illness (DUI) for bipolar disorder is associated with ___ and ___
1. More mood episodes
2. Higher risks of suicide
31
What is associated with:
1. More mood episodes
2. Higher risks of suicide
Longer average duration of illness (DUI) for bipolar disorder
32
Which disorder has the average duration of illness (DUI) of 6-10 years?
Bipolar disorder
33
The economic impact of Bipolar Disorder in the UK is projected to be £____ by 2026
a. £8.2 billion
b. £4.9 million
c. £14.7 million
d. £5.1 billion
a. £8.2 billion
34
Economic impact of what disorder in the UK is projected to be £8.2 billion by 2026?
Bipolar disorder
35
What are the 3 biological factors contributing to bipolar disorder?
1. High heritability
2. Separate heritability of mania & depression
3. Genes for mania may involve reward pathways, i.e. dopamine function
36
1. High heritability
2. Separate heritability of mania & depression
3. Genes for mania may involve reward pathways, i.e. dopamine function
These are the biological factors of which disorder?
Bipolar disorder
37
According to the NICE guidelines, what 2 steps are involved in primary care of bipolar disorder?
1. Review treatment & care, including medication (e.g. antidepressant medication)
2. Offer choice of an evidence-based psychological intervention developed for BD (e.g. Cognitive Behavioural Therapy, Interpersonal Therapy, or Family Focused Therapy)
38
According to the NICE guidelines, what 2 steps are involved in secondary care of bipolar disorder?
1. Pharmacological interventions:
If mania or hypomania develops and the person is taking antidepressants, consider stopping the antidepressant and offer an antipsychotic
2. Offer evidence-based psychological intervention
39
According to the NICE guidelines, when should we implement secondary care for bipolar patients?
When the patient experiences deterioration in depressive symptoms, signs of hypomania, or mania (refer urgently)
40
When the patient experiences deterioration in depressive symptoms, signs of hypomania, or mania (refer urgently), what type of care is needed?
a. Primary care
b. Secondary care
c. None of the above
b. Secondary care
41
Offer choice of an evidence-based psychological intervention developed for BD (e.g. Cognitive Behavioural Therapy, Interpersonal Therapy, or Family Focused Therapy)
What type of care does this apply to?
a. Primary care
b. Secondary care
c. None of the above
a. Primary care
42
Pharmacological interventions
What type of care does this apply to?
a. Primary care
b. Secondary care
c. None of the above
b. Secondary care
43
If mania or hypomania develops and the person is taking antidepressants, consider stopping the antidepressant and offer an antipsychotic
What type of care does this apply to?
a. Primary care
b. Secondary care
c. None of the above
b. Secondary care
44
Review treatment & care, including medication (e.g. antidepressant
medication)
What type of care does this apply to?
a. Primary care
b. Secondary care
c. None of the above
a. Primary care
45
Offer evidence-based psychological intervention
What type of care does this apply to?
a. Primary care
b. Secondary care
c. None of the above
b. Secondary care
46
What are the 2 types of treatments for bipolar disorder?
1. Medication
2. Psychological treatments
47
What medication do patients of bipolar disorder typically receive?
List 3
1. Mood stabilisers (e.g. lithium)
2. Anti-depressants
3. Anti-psychotics
48
True or False?
Bipolar patients who receive adequate medication experience low relapse rates
False
Bipolar patients who receive adequate medication experience high relapse rates
49
What are the 3 types of psychological treatments for bipolar disorder?
1. Psychoeducation/ Relapse Prevention
2. Family Focused Therapy
3. Cognitive Behavioural Therapy
50
What are the 3 stages to Psychoeducation/ Relapse Prevention of bipolar disorder?
1. Provide
2. Identify
3. Work
51
What treatment for bipolar disorder involves these 3 stages:
1. Provide
2. Identify
3. Work
a. Psychoeducation/ Relapse Prevention
b. Family Focused Therapy
c. Cognitive Behavioural Therapy
a. Psychoeducation/ Relapse Prevention
52
In Psychoeducation/ Relapse Prevention of bipolar disorder, what happens in the 'Provide' stage?
The treatment provides information about bipolar disorder and how people with bipolar disorder learn to cope better
53
In Psychoeducation/ Relapse Prevention of bipolar disorder, what happens in the 'Identify' stage?
Identify warning signs – also called ‘prodromes’ or ‘relapse signature’
- Changes in thoughts, feelings, behaviours
- Quantified and grounded in personal experience
- Judge early, middle and late strategies
54
In Psychoeducation/ Relapse Prevention of bipolar disorder, what happens in the 'Work' stage?
Work collaboratively to identify effective coping strategies, e.g. relax, postpone behaviour, get feedback from family members
55
Psychoeducation/ Relapse Prevention of bipolar disorder identifies warning signs
These are also known as...?
List 2 points
‘Prodromes’
or
‘Relapse signature’
56
Psychoeducation/ Relapse Prevention of bipolar disorder identifies warning signs
List the 3 types of warning signs
1. Changes in thoughts, feelings, behaviours
2. Quantified and grounded in personal experience
3. Judge early, middle and late strategies
57
Which treatment for bipolar disorder provides information about bipolar disorder and how people with bipolar disorder learn to cope better?
Psychoeducation/ Relapse Prevention
58
Which treatment for bipolar disorder identifies warning signs – also called ‘prodromes’ or ‘relapse signature’?
Psychoeducation/ Relapse Prevention
59
Which treatment for bipolar disorder encourages patients to work collaboratively to identify effective coping strategies?
Psychoeducation/ Relapse Prevention
60
Describe the results of Perry et al.'s (1999) study on the efficacy of Psychoeducation/ Relapse Prevention
List 2 points
1. 7-12 sessions of individual relapse prevention vs. treatment as usual
2. Over 18 months, longer time to relapse with mania but no effects
on time to relapse with depression
61
According to Perry et al. (1999), Psychoeducation/ Relapse Prevention resulted in longer time to relapse with ...?
Mania
62
According to Perry et al. (1999), Psychoeducation/ Relapse Prevention had no effects in time to relapse with...?
Depression
63
Describe the results of Colom et al.'s (2003) study on the efficacy of Psychoeducation/ Relapse Prevention
List 2 points
1. 21 sessions of group psychoeducation versus treatment as usual
2. Reduced rates of relapse of mania and depression over 2 years
64
According to Colom et al. (2003), Psychoeducation/ Relapse Prevention resulted in reduced rates of relapse of ____ and ____ over 2 years
Mania and Depression
65
“You have been excited and restless constantly for two days”
Is this a warning sign of mania?
Is it ‘normal’?
What are the potentials possibilities & pitfalls of identifying these warning signs?
How could this be improved?
What type of treatment for bipolar disorder is this?
Psychoeducation/ Relapse Prevention
66
What are the 3 stages to Family Focused Therapy (FFT) for bipolar disorder?
1. Work
2. Provide
3. Identify
67
What treatment for bipolar disorder involves these 3 stages:
1. Work
2. Provide
3. Identify
a. Psychoeducation/ Relapse Prevention
b. Family Focused Therapy
c. Cognitive Behavioural Therapy
b. Family Focused Therapy
68
In Family Focused Therapy (FFT) for bipolar disorder, what happens in the 'Work' stage?
Work with families or groups of families
69
In Family Focused Therapy (FFT) for bipolar disorder, what happens in the 'Provide' stage?
Provide psychoeducation to improve their understanding of bipolar – non-blaming
70
In Family Focused Therapy (FFT) for bipolar disorder, what happens in the 'Identify' stage?
Identify hostility, criticism and overprotectiveness & help build up more collaborative, positive communication
71
What does Family Focused Therapy (FFT) for bipolar disorder identify?
List 3 points
1. Hostility
2. Criticism
3. Overprotectiveness
72
What does Family Focused Therapy (FFT) for bipolar disorder help individuals build up?
More collaborative, positive communication
73
What treatment for bipolar disorder works with families or groups of families?
Family Focused Therapy (FFT)
73
What treatment for bipolar disorder provides psychoeducation to improve their understanding of bipolar?
Family Focused Therapy (FFT)
74
What treatment for bipolar disorder is non-blaming?
Family Focused Therapy (FFT)
75
What treatment for bipolar disorder identifies hostility, criticism and overprotectiveness & helps build up more collaborative, positive communication?
Family Focused Therapy (FFT)
75
Describe the results of Miklowitz et al.'s (2003) study on the efficacy of Family Focused Therapy (FFT)
List 2 points
1. 21 sessions of family-focused psychoeducation and behavioural intervention vs crisis management
2. Reduced relapse rates and mood symptoms over 2 years
76
According to Miklowitz et al. (2003), Family Focused Therapy (FFT) results in reduced relapse rates and mood symptoms over ___ years
2 years
77
Describe the results of Rea et al.'s (2003) study on the efficacy of Family Focused Therapy (FFT)
List 2 points
1. Compared FFT to individual psychoeducation
2. Lower rates of rehospitalisation
78
According to Rea et al. (2003), Family Focused Therapy (FFT) results in lower rates of ____ compared to individual psychoeducation
Rehospitalisation
79
What does Cognitive Behavioural Therapy (CBT) for bipolar disorder do?
It develops a problem list with the client
80
Develops a problem list with the client
Which treatment for bipolar disorder does this apply to?
Cognitive Behavioural Therapy (CBT)
81
What does Cognitive Behavioural Therapy (CBT) for bipolar disorder identify when patients are experiencing depression?
‘Negative automatic thoughts’ and challenge; activity scheduling
82
What does Cognitive Behavioural Therapy (CBT) for bipolar disorder identify when patients are experiencing hypomania?
Coping strategies
83
What does Cognitive Behavioural Therapy (CBT) for bipolar disorder do when patients are experiencing remission?
Help them engage in relapse prevention
84
Cognitive Behavioural Therapy (CBT) for bipolar disorder identifies ‘negative automatic thoughts’ & challenge; activity scheduling during...?
Depression
85
Cognitive Behavioural Therapy (CBT) for bipolar disorder identifies coping strategies during...?
Hypomania
86
Cognitive Behavioural Therapy (CBT) for bipolar disorder helps patients engage in relapse prevention during...?
Remission
87
During depression, identify ‘negative automatic thoughts’ & challenge; activity scheduling
Which treatment for bipolar disorder does this apply to?
a. Psychoeducation/ Relapse Prevention
b. Family Focused Therapy
c. Cognitive Behavioural Therapy
c. Cognitive Behavioural Therapy
88
During hypomania, identify coping strategies
Which treatment for bipolar disorder does this apply to?
a. Psychoeducation/ Relapse Prevention
b. Family Focused Therapy
c. Cognitive Behavioural Therapy
c. Cognitive Behavioural Therapy
89
During remission, engage in relapse prevention
Which treatment for bipolar disorder does this apply to?
a. Psychoeducation/ Relapse Prevention
b. Family Focused Therapy
c. Cognitive Behavioural Therapy
c. Cognitive Behavioural Therapy
90
Cognitive Behavioural Therapy may develop a personalised formulation of client’s ‘schemas’
What does this involve? List 2 points
1. Problematic personal rules
2. Test with behavioural experiments
91
E.g. ‘I must be a complete success or my life is worthless’ – experiment with ‘less than perfect’ work
Which treatment for bipolar disorder does this apply to?
Cognitive Behavioural Therapy
92
Describe the results of Lam et al.'s (2003, 2005) study on the efficacy of Cognitive Behavioural Therapy (CBT)
List 2 points
1. 20 sessions Individual CBT vs treatment as usual
2. Reduced symptoms of depression, longer time to relapse over 2 years, improved functioning
93
According to Lam et al.(2003, 2005), Cognitive Behavioural Therapy (CBT) results in reduced symptoms of...?
Depression
94
According to Lam et al.(2003, 2005), Cognitive Behavioural Therapy (CBT) results in longer time to...?
Relapse over 2 years
95
According to Lam et al.(2003, 2005), Cognitive Behavioural Therapy (CBT) results in improved...?
Functioning
96
Describe the STEP trial – Systematic Treatment Enhancement Programme (Miklowitz et al., 2007)
List 3 points
1. 15 sites across USA
2. Equal efficacy of 30 sessions of FFT, interpersonal therapy and CBT vs. minimal care
3. Intensive psychological therapies are all effective in community settings
97
1. 15 sites across USA
2. Equal efficacy of 30 sessions of FFT, interpersonal therapy and CBT vs. minimal care
3. Intensive psychological therapies are all effective in community settings
This is known as...?
STEP trial – Systematic Treatment Enhancement Programme (Miklowitz et al., 2007)
98
What were the results of the STEP trial – Systematic Treatment Enhancement Programme (Miklowitz et al., 2007)?
List 2 points
1. Effect sizes are modest
2. Focus is on prevention of relapse rather than current symptoms and recovery
99
True or False?
The STEP trial – Systematic Treatment Enhancement Programme's focus is on current symptoms and recovery rather than prevention of relapse
False
The STEP trial – Systematic Treatment Enhancement Programme's focus is on prevention of relapse rather than current symptoms and recovery
100
Focus is on prevention of relapse rather than current symptoms and recovery
What treatment does this apply to?
STEP trial – Systematic Treatment Enhancement Programme
101
Mood swings are a consequence of multiple, conflicted, extreme...?
Personal appraisals of changes in internal state
102
A consequence of multiple, conflicted, extreme, personal appraisals of changes in internal state
This is known as...?
Mood swings
103
Positive feelings of high energy is a consequence of...?
a. safe, relaxing
b. failure, boring
c. imminent success
d. mental breakdown
c. imminent success
104
Negative feelings of high energy is a consequence of...?
a. safe, relaxing
b. failure, boring
c. imminent success
d. mental breakdown
d. mental breakdown
105
Positive feelings of low energy is a consequence of...?
a. safe, relaxing
b. failure, boring
c. imminent success
d. mental breakdown
a. safe, relaxing
106
Negative feelings of low energy is a consequence of...?
a. safe, relaxing
b. failure, boring
c. imminent success
d. mental breakdown
b. failure, boring
107
Mood swings lead to ...?
Internal struggle trying to exert extreme control over internal states rather than active, successful ways of pursuing goals
108
Leads to internal struggle trying to exert extreme control over internal states rather than active, successful ways of pursuing goals
This is known as...?
Mood swings
109
Describe the Integrative
Cognitive Model of
Bipolar Disorder
List 6 points
1. Triggering event
2. Change in internal state
3. Appraised as having extreme personal meaning
4. Descent Behaviours
and/or
Ascent Behaviours
5. Life Experiences (including current environment & reactions of others)
6. Beliefs about self, world and others (including procedural beliefs about affect and control)
110
According to the Integrative
Cognitive Model of
Bipolar Disorder, what contributes to being appraised as having extreme personal meaning?
List 4
- Change in internal state
- Descent behaviours
- Ascent behaviours
- Beliefs about self, world and others (including procedural beliefs about affect and control)
111
According to the Integrative
Cognitive Model of
Bipolar Disorder, what contributes to descent and ascent behaviours?
List 2
- Appraised as having extreme personal meaning
- Beliefs about self, world and others (including procedural beliefs about affect and control)
112
According to the Integrative
Cognitive Model of
Bipolar Disorder, what contributes to life Experiences (including current environment & reactions of others)?
List 2
- Ascent behaviours
- Descent behaviours
113
According to the Integrative
Cognitive Model of
Bipolar Disorder, what contributes to change in internal state?
List 4
- Triggering event
- Ascent behaviours
- Descent behaviours
- Life Experiences (including current environment & reactions of others)
114
According to the Integrative
Cognitive Model of
Bipolar Disorder, what contributes to beliefs about self, world and others (including procedural beliefs about affect and control)?
Life Experiences (including current environment & reactions of others)
115
What 6 behaviours do hypomanic patients engage in?
1. Social Self Criticism
2. Increasing Activation To Avoid Failure
3. Success Activation and Triumph Over Fear
4. Loss of control
5. Grandiose Appraisals of Ideation
6. Regaining Autonomy
116
Hypomanic patients engage in social self criticism
What does this mean?
Reflecting self-critical beliefs and beliefs that others were critical, particularly in a social context
117
Hypomanic patients engage in Increasing Activation To Avoid Failure
What does this mean?
Beliefs about needing to remain ‘on the go’ and active in order to avert failure provide another predisposing factor for striving to experience highly activated states
118
Hypomanic patients engage in Success Activation and Triumph Over Fear
What does this mean?
Beliefs about extreme optimism and self-confidence, invincibility and desirability
119
Hypomanic patients engage in Loss of control
What does this mean?
Includes items pertaining to losing control of moods and thoughts
120
Hypomanic patients engage in Grandiose Appraisals of Ideation
What does this mean?
Extreme social aspirations and positive appraisals of idea generation reflected a cognitive style consistent with an ‘achievement striving’ personality
121
Hypomanic patients engage in regaining autonomy
What does this mean?
Includes beliefs about ignoring advice from others and striving for autonomy
122
Includes beliefs about ignoring advice from others and striving for autonomy
a. Loss of control
b. Grandiose Appraisals of Ideation
c. Regaining Autonomy
d. Social Self Criticism
e. Increasing Activation To Avoid Failure
f. Success Activation and Triumph Over Fear
c. Regaining Autonomy
123
Extreme social aspirations and positive appraisals of idea generation reflected a cognitive style consistent with an ‘achievement striving’ personality
a. Loss of control
b. Grandiose Appraisals of Ideation
c. Regaining Autonomy
d. Social Self Criticism
e. Increasing Activation To Avoid Failure
f. Success Activation and Triumph Over Fear
b. Grandiose Appraisals of Ideation
124
Includes items pertaining to losing control of moods and thoughts
a. Loss of control
b. Grandiose Appraisals of Ideation
c. Regaining Autonomy
d. Social Self Criticism
e. Increasing Activation To Avoid Failure
f. Success Activation and Triumph Over Fear
a. Loss of control
125
Beliefs about extreme optimism and self-confidence, invincibility and desirability
a. Loss of control
b. Grandiose Appraisals of Ideation
c. Regaining Autonomy
d. Social Self Criticism
e. Increasing Activation To Avoid Failure
f. Success Activation and Triumph Over Fear
f. Success Activation and Triumph Over Fear
126
Beliefs about needing to remain ‘on the go’ and active in order to avert failure provide another predisposing factor for striving to experience highly activated states
a. Loss of control
b. Grandiose Appraisals of Ideation
c. Regaining Autonomy
d. Social Self Criticism
e. Increasing Activation To Avoid Failure
f. Success Activation and Triumph Over Fear
e. Increasing Activation To Avoid Failure
127
Reflecting self-critical beliefs and beliefs that others were critical, particularly in a social context
a. Loss of control
b. Grandiose Appraisals of Ideation
c. Regaining Autonomy
d. Social Self Criticism
e. Increasing Activation To Avoid Failure
f. Success Activation and Triumph Over Fear
d. Social Self Criticism
128
When I am more active than usual, other people dislike me
a. Loss of control
b. Grandiose Appraisals of Ideation
c. Regaining Autonomy
d. Social Self Criticism
e. Increasing Activation To Avoid Failure
f. Success Activation and Triumph Over Fear
d. Social Self Criticism
129
When I feel good, I must keep “on the go” all the time or things will fall apart around me
a. Loss of control
b. Grandiose Appraisals of Ideation
c. Regaining Autonomy
d. Social Self Criticism
e. Increasing Activation To Avoid Failure
f. Success Activation and Triumph Over Fear
e. Increasing Activation To Avoid Failure
130
When I feel more active I realise that I am a very important person
a. Loss of control
b. Grandiose Appraisals of Ideation
c. Regaining Autonomy
d. Social Self Criticism
e. Increasing Activation To Avoid Failure
f. Success Activation and Triumph Over Fear
f. Success Activation and Triumph Over Fear
131
When I get very agitated about something, I have no control over my behaviour
a. Loss of control
b. Grandiose Appraisals of Ideation
c. Regaining Autonomy
d. Social Self Criticism
e. Increasing Activation To Avoid Failure
f. Success Activation and Triumph Over Fear
a. Loss of control
132
When I feel I am right, I must keep on generating lots more ideas and solutions
a. Loss of control
b. Grandiose Appraisals of Ideation
c. Regaining Autonomy
d. Social Self Criticism
e. Increasing Activation To Avoid Failure
f. Success Activation and Triumph Over Fear
b. Grandiose Appraisals of Ideation
133
WhenI feel restless, what happens to me is more important than what happens to other people
a. Loss of control
b. Grandiose Appraisals of Ideation
c. Regaining Autonomy
d. Social Self Criticism
e. Increasing Activation To Avoid Failure
f. Success Activation and Triumph Over Fear
c. Regaining Autonomy
134
Beliefs about internal states within the Integrative
Cognitive Model of
Bipolar Disorder is assessed by ...?
The HAPPI scale
135
The Integrative
Cognitive Model of
Bipolar Disorder clearly differentiates ___ from ___ and health controls
Bipolar from Unipolar depression
136
The Integrative
Cognitive Model of
Bipolar Disorder predicts ___ symptoms over one month in 50 patients
Bipolar symptoms
137
The Integrative
Cognitive Model of
Bipolar Disorder resulted in ____ after successful CBT
Reduced conviction in beliefs
138
Key research on the Integrative
Cognitive Model of
Bipolar Disorder involved 3 types of studies
What are they?
1. Diary studies
2. Experimental studies
3. Qualitative interview studies
139
Does this apply to low or high mood continuum?
Triggers to low mood: I've done something wrong, thoughts of being worthless and feeling guilty, nightmares
Low mood
140
Does this apply to low or high mood continuum?
Triggers: calling mum can make me agitated
High mood
141
Does this apply to low or high mood continuum?
Actions: Try not to think about things, rationalise with self, try to think clearly to knock off the positive, relax
High mood
142
Does this apply to low or high mood continuum?
Actions: See friends, go to work, exercise, watch a DVD, listen to music, try to think clearly
Low mood
143
What metaphor is used to describe bipolar disorder, specifically, mood continuum?
The Icarus Metaphor
of Conflicting Appraisals
144
The Icarus Metaphor
of Conflicting Appraisals is a metaphor used to describe what type of disorder?
Bipolar disorder
Specifically = Mood continuum
145
Describe the The Icarus Metaphor of Conflicting Appraisals
Anger is flying in between the sun and the water
Sun = Warm (+) but melts wax holding wings (-)
Water = Cool (+) but wets feathers (-)
146
According to the Icarus Metaphor of Conflicting Appraisals, what happens to the bandwidth after TEAMS?
Bandwidth increases
People tolerate and accept wider range of moods to pursue life goals
147
According to the NICE guidelines (UK), what treatment is recommend for people with bipolar disorder?
Evidence-based psychological intervention(s)
148
Evidence-based psychological intervention(s) is recommended for...?
People with bipolar disorder
149
What treatment is recommended for people at-risk of bipolar disorder?
Cognitive Behaviour Therapy
150
Cognitive Behaviour Therapy is recommended for ...?
People at-risk of bipolar disorder
151
Early Intervention in ___ services show health & economic benefits
Psychosis services
152
Youth service models propose to widen intake criteria to include ___ and ___
Bipolar disorder and those at risk of developing Bipolar disorder
153
Youth service models propose to widen intake criteria to include Bipolar disorder and those at risk of developing Bipolar disorder
This could yield ____ in savings in the UK
a. £52 million
b. £18 million
c. £41 million
d. £29 million
d. £29 million
154
Describe the Cognitive model of Bipolar At Risk (CBT BAR)
List 6 points
1. Trigger (event)
2. Change in internal state
3. Appraisal
(severe extreme personal meanings)
4. Faulty Self and Social Knowledge (Beliefs – Self/World/Other, procedural beliefs about affect and control, metacognitive beliefs)
5. Mood and Physiology
And/Or
Responses (cognitive and behavioural) - ascent/descent
6. Life Experiences & Environment
(Including current environment and reactions of others)
155
According to the Cognitive model of Bipolar At Risk (CBT BAR), what influences Appraisal?
List 4 points
- Change in internal state
- Faulty Self and Social Knowledge (Beliefs – Self/World/Other, procedural beliefs about affect and control, metacognitive beliefs)
- Mood and Physiology
- Responses (cognitive and behavioural) - ascent/descent
156
According to the Cognitive model of Bipolar At Risk (CBT BAR), what influences Responses (cognitive and behavioural) - ascent/descent?
List 3 points
- Appraisal
- Faulty Self and Social Knowledge (Beliefs – Self/World/Other, procedural beliefs about affect and control, metacognitive beliefs)
- Mood and Physiology
157
According to the Cognitive model of Bipolar At Risk (CBT BAR), what influences Mood and Physiology?
List 3 points
- Appraisal
- Faulty Self and Social Knowledge (Beliefs – Self/World/Other, procedural beliefs about affect and control, metacognitive beliefs)
- Responses (cognitive and behavioural) - ascent/descent
158
According to the Cognitive model of Bipolar At Risk (CBT BAR), what influences changes in internal state?
List 4 points
- Trigger (event)
- Life Experiences & Environment
(Including current environment and reactions of others)
- Mood and Physiology
- Responses (cognitive and behavioural) - ascent/descent
159
True or False?
Symptoms of bipolar disorder are on a continuum with ‘normal’ experiences
True
