Sense of hyper-positive self, goal-attainment beliefs and coping strategies in bipolar I disorder

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Abstract

Background: There is some evidence that cognitive therapy (CT) is beneficial in reducing relapses in bipolar disorder. However, not all bipolar patients benefited from it. Lam, Wright & Sham (2005) found that a group of non-responders to CT shared common characteristics: they value some of the high goal-attainment beliefs and characteristics associated with being in a state of mild hypomania - a high ‘sense of hyper-positive self’ (SHPS). In order to promote of our understanding of this group of patients, the present study investigated the relationship between SHPS, preferred internal state, dysfunctional attitudes and coping with hypothetical manic prodromal scenarios. Method : 54 bipolar I patients filled in self-report questionnaires which assess preferred mood state, coping with scenarios, dysfunctional attitudes and SHPS. Results: Ideal SHPS predicted patients’ preferred internal state of mania. Coping with hypothetical scenarios were predicted by the DAS goal-attainment scores: the higher the goal-attainment score, the higher the participant’s tendency to identify with self-descriptors linked to hypomania and to engage in stimulating behaviours that may escalate the prodromal stage to mania. Conclusions: These results suggest that clinicians should check and modify goal-attainment beliefs, particularly those who exhibit features of hyper-positive sense of self. Furthermore, these patients’ tendency to identify with hypomanic traits as self-descriptors should be dealt with by psychological techniques such as cognitive restructuring.

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